Pandora's Box: Lifting the Lid on Life's Little Nasties

For Mubby and K.K.

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The Penis – does size matter? ‘Chrysalis’ B.O. (Pong! What is that?) Body and facial hair – on gals! Premature and delayed ejaculation Help! I’ve got boobies! Breast development in males Menstruation (Eek! I leak!) The New Femininity Vaginal discharges (Help! I’m leaking again!) One hundred reasons why it’s better to be female ‘But weight – there’s more’ Skin deep Dieting disorders Fat: it’s not a four-letter word Pap smears Keeping abreast of your breasts! Assessing breast cancer risk Abortion: whose decision? Immortality and Euthanasia

PEOPLE Making passes Infatuation Love at first sight ‘Mum, Dad, this is Trog …’ Meeting the family Mothers and daughters: the love/hate relationship that never ends Love song dedications Xmas party Fallinginloveagain Doing the Dump Monogamy Dinks, Pinks, Sinks and Sins Hello young widows, wherever you are …

Golf widows Honesty – is that really what you want to hear? Getting Dumped Rejection Revisited: what to do and what not to do when you’re dumped! Trust Sexual abuse, emotional abuse, physical abuse, economic abuse and social abuse

MIND Relax! Why f**k is such a good word Being assertive Pathological liars: personality disordered or just creative? Guilty parties: soirées for the conscience oppressed Anxieties, fears, guilt feelings … and interruptions Suicide: it brings on many changes but it’s not painless Dreams Sleep problems What happens if I don’t get enough sleep?

DRUGS Marijuana: pot, grass, dope, mull, cannabis, hash, hashish, hash oil, weed, yarndi, THC Ecstasy: E, MDMA, ecky, vitamin E The most popular drug in the world Do things go better with coke? Trippin’ Heroin: H, horse, smack, skag, hammer Smokin'! Speed: amphetamine, go-ey, ‘ice’, shabu, crystal meth, base

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SEX Fellatio Cunnilingus: there’s no substitute for a cunning tongue Rimming Am I happy or gay? S’n’M, B’n’D, M’n’Ms: cruel to be kind, in the right measure Fantasy, fetish, fone sex Food/sex Sex work: the oldest profession in the world Condoms! Aphrodisiacs Anal sex: it ain’t dirty, it's just another hole Sex’n’TV Bisexuality: it’s not kinky, really Lesbian delight ‘2 old 4 sex’ ‘Virgin’ – it's not a dirty word Twenty-first Century Concubine Impotence Extraordinary sex First sex, first love: not the same thing? Porn Sex and Power Rape Sex and pregnancy Group sex and grope sex: the ultimate orgy Celibacy – the pros and cons Coming clean to your sexual partner What's a NORMAL sex life?

THANK YOU USEFUL CONTACTS ABOUT THE AUTHOR CREDITS COPYRIGHT ABOUT THE PUBLISHER

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The Penis — does size matter?

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wo of the commonest questions I get asked by young men and adolescent boys are ‘What is the average size for a penis?’ and ‘How do I make my penis bigger?’ There are numerous variations on this theme such as ‘My brother’s/friend’s/cousin’s penis is 2/3/4/5/6/7/8/9/10 inches long, flaccid. Is this normal?’ and ‘I am too embarrassed to have sex with my girlfriend because if she sees my tiny dick she will laugh at me.’ The anxiety surrounding penile dimensions is ENORMOUS. The more microscopic the appendage, the more gigantic the complex. But even guys with spot-on average measurements can be riddled with insecurities and dissatisfaction, regardless of whether there is a girlfriend or boyfriend (or both!) complaining. Girls may occasionally guffaw amongst themselves over ‘weeny weenies’ or ‘king-sized schlongs’ in beefcake photo spreads or male revues, but rarely quibble about dimensions in their real-life consorts. They are far more likely to bemoan deficiencies in the communication skills or romance department than any perceived shortfall in genital allocation.

But we are talking watermelons here. With sufficient relaxation and arousal the vagina can accommodate very large objects, animate or inanimate as the case may be. By definition, the ‘birth canal’ is capable of allowing the passage of a full-term babe. Any penis larger than that

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Just as every sensible girl knows that there is no such thing as an overly capacious vagina, she also recognises that no penis that is visible to the naked eye is ever too small to work with effectively. If the penis is not visible to the naked eye, it is quite possible that the issue is not one of ‘penis too small’, so much as ‘gut too large’. Gut size is, health risks aside (that is the risk of heart attack for him, suffocation/crush injuries to the partner), largely a question of taste. Theoretically, for those for whom the ‘bigger the better’ principle holds strong for penile size, this could be expanded to include total body size and waist circumference as well. Which brings me to the crux of my argument. It is a question of balance. Big is good but ‘too big’ is not. Small is good too, but invisible is a challenge only the blind are really up to handling. Thank goodness for the well-accepted phenomenon that ‘love is blind’. There is no need for, and no functional benefit in having, a large penis. The vagina, being only a potential space until penetrated, will wrap cosily and snugly around whatever is inserted, be it pinkie finger, tampon or cotton bud. No object is too small! The converse however is not true: certain objects may definitely prove overly large.

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deserves both awe and respect, but I wouldn’t be having sex with it. Essentially all penises are good: the big, the small, the thin, the fat, the tapering, the bulbous, the bent, the stumpy, the tricornuate (okay, I made that one up). The crunch is more to do with what they are capable of in terms of dynamics. A large, well-formed but flaccid penis does no-one any favours. And it’s not the size of the pencil but what you write that counts. On the popular issue of penile enlargement, there have been few but significant developments in the past decade. Operations to cut ligaments, thereby causing the penis to hang lower and appear longer, have been pioneered with varying success. Fat injections into the shaft, in an effort to increase diameter and stoutness, have frequently resulted in a lumpy looking organ, not unlike an overcooked frankfurt which has burst its skin. In my professional experience this has led to increased self-consciousness. At least after the operation the self-consciousness was warranted. In general, penises should be left alone. Occasionally surgery is necessary, for example when the penile urethra opens out on the shaft rather than at the tip of the glans or head of the penis, but this sort of thing is usually treated early on, long before the penis becomes an organ of selfesteem. Circumcision (removal of the foreskin) has had its periods of vogue and certain religions, Judaism for example, advocate it without exception. These days it is becoming accepted that circumcision may decrease the risk of urinary tract infection and even HIV transmission in populations where these are prevalent. With good hygiene and safe sex

Top ten reasons why it’s better to have a small-tomedium-sized penis: 1. Uses less petrol; cheaper to run. 2. Easier to park in tight places. 3. Handles better in wet conditions. 4. Safer. 5. Owner less likely to become phallocentric in thought, word and deed.

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practices, however, the removal of the foreskin should not be de rigueur. As for circumcision for purely cosmetic motivations, my advice is, get a life. Where foreskin replacement is being contemplated, ditto. Sorry. In terms of exercises to increase penile size, thankfully there are none. Why thankfully? Because that is one less thing to feel guilty about. Imagine if on top of not pumping the pecs, not whittling the waistline and not building the biceps, you had to worry about the penile enlargement exercises you promised yourself you’d do then promptly forgot? You’d be a complete nervous wreck. Isn’t it nice to have at least one thing that is completely beyond your control, that can be enjoyed utterly au naturel? Okay, if you really can’t bear au naturel, you can always sculpt your pubic hair, topiary-style. That’ll get you noticed. Somewhere.

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6. Owner less likely to end up in porn movie career (not that there’s anything wrong with that). 7. Makes the rest of your body look bigger. 8. Makes your legs look longer.

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9. Penis less susceptible to feeling cramped when something unexpected arises. 10. Since like attracts like, you may end up with a partner with a small-to-mediumsized vagina/anus/car, with all the attendant benefits thereof.

‘Chrysalis’

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r Cindy Pan, what is a “chrysalis”?’ asked a most endearing thirty-something female patient of mine. Recently emigrated from mainland China, her accent was still strong as was her deeply rooted respect for doctors, which would not allow her to call me ‘Cindy’ or ‘Bitch’ like everyone else. ‘“Chrysalis”?’ I enquired, bemused. She was in the process of a perhaps belated discovery of sex, with an apparently enthusiastic but relatively novice Aussie male, and I envisioned her somehow as a butterfly of sensuality emerging from her . . .

‘I don’t think I’ve got one,’ she pronounced matter-offactly. ‘You do!’ I think I slammed the desk with conviction. She shook her head with equal conviction.

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‘“Chrysalis”! Yes. “Chrysalis”. What is a “chrysalis”?’ she persisted, eyes boring into my face, rousing me from my reverie. Tick tock, tick tock . . . ‘Oh! You mean clitoris!’ I’d had a brain wave. ‘Yes, “chrysalis”!’ she repeated, impatience mingling with untamed curiosity. ‘Oh, the clitoris is a part of your genitals, and when you touch it or stroke it or rub it, most people think it feels very pleasurable and sexually arousing,’ I explained. I started to draw a picture of the female genitalia with special attention to the anatomical feature in question and was feeling very competent and helpful. She nodded knowingly before asking, ‘Dr Cindy Pan, do you think I’ve got one?’ This caused me to double take. ‘Yes of course you’ve got one!’ I beamed. ‘Everyone’s got one. Except guys that is. They’ve got the penis. In fact the clitoris is like a rudimentary penis. Embryologically, the clitoris develops in male foetuses into penises and in female foetuses it just stays as a clitoris. In fact if a woman takes anabolic steroids she can get clitoral enlargement . . .’ Lost in the wonder of my fascinating monologue on amazing clitoral facts, I had failed to notice the eyes of my audience of one, glazing over.

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‘I’m sure you’ve got one! Every woman’s got one! Every female! Even babies!’ ‘I don’t,’ she contradicted. ‘Yes! You do! I’m sure you do. I’ll prove it to you! I’ll find it for you right now. Do you want me to?’ I rose from my seat. Hopefully unthreateningly. ‘Really?’ she wavered. ‘Yes . . .’ ‘Do you really think I’ve got one?’ ‘Yes!’ ‘Hmmmm . . . then why can’t my boyfriend find it?’ In our sex lives more than in any other sphere of existence, some of us are very prone to blaming ourselves, deeming ourselves ‘abnormal’ or ‘defective’, when things don’t run to plan. ‘Failings’ or ‘shortcomings’ of others in terms of interpersonal skills or sexual techniques are easily interpreted as our own failure to be attractive enough, enthralling enough, frankly good enough. And frankly that ain’t good enough! The fault lies in faulty expectations as well as faulty communication and technique. If a gal can’t orgasm or a guy can’t get an erection; if a gal thinks her bum’s too big or a guy thinks his willie’s too small, whose fault is that and are these individuals all defective sexual beings? Nein, nein, mein Herr! Nein, nein! Just as being unable to find a clitoris on a perfectly normal female specimen does not mean the specimen is broken or incomplete, being unable to make your partner or yourself come (or go) at the determined moment doesn’t mean you

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or your partner have a chip missing. It just means you both need to acquire new skills. That’s right. What you don’t know you can learn. What you can’t find, is probably right there in front of you, yet to be discovered. The instructions to find, feel and use all the body parts, are available to one and all. Trust me, all the parts are included, even though the instructions might sometimes seem to be written in Japanese. What a pity we don’t come with labels. They could be ruboff tatts that you just remove once you’ve memorised all your anatomical sites. Maybe I could start a business: ‘Come in and have all your body parts identified and individually labelled! You’ll never lose your clitoris/penis/head again!’ To be able to learn anything, you need a bit of confidence in yourself. Confidence that you are capable of learning and putting into practice what you have learnt. Then you need a ‘teacher’ or learning resource you can trust. This could be a more experienced lover, a friend, a book, a video, a parent (not highly recommended, generally), or maybe even yourself. Yes believe it or not, you can discover a lot about your own sensuality simply by experimenting on your very own take-home specimen: yourself! Masturbating is probably the best way of working out how you function sexually. You don’t need a vibrator, dildo, blow-up doll, full-length mirror or life-size poster of Britney Spears/Bardot/Ricki Martin (although all of the above could be useful). You don’t need a manual, timetable or score card. All you need is a bit of privacy, a bit of imagination and maybe a bit of gel/lube. Nothing wrong with saliva but not everyone can spit on command.

For guys, masturbating usually centres on genital fondling of one kind or another. The rhythm, intensity, direction and range will vary according to the individual. Hands, pillows, socks and beloved teddies (the girlfriend’s silk and lace lingerie ‘teddy’ or the furry Ted with the chewed-off ear from childhood) are common favourite surfaces to jack off with/onto, with texture preferences being surprisingly varied. Fantasising (about people you know, would like to know or who you’ve just made up for the occasion) is a common mental accompaniment but sometimes it’s good to simply tune out everything but the physical sensations that are engulfing you. For gals, homing-in directly on the genitals can be counterproductive. Beating around the bush is way important for most females. Sometimes fantasy alone can bring a woman to a state of high arousal such that very little is needed or desired by way of foreplay. But usually, touching other non-genital body parts — torso, limbs, face — is a good starting point, followed by breasts and finally genitals. A gentle touch works best initially, particularly for beginners and learners. Let your fingers do the walking and sooner or later you will discover all the hot spots. This potted account will get you everywhere unless anxieties, fears, guilt feelings or interruptions get you first. But that’s another story.

B.O. (Pong! What is that?)

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remember once fronting up at the Children’s Hospital after spending the weekend at my Mum’s. I had been waxing on to Mum before the weekend about how much I liked leeks. How I absolutely loved leeks and shallots and garlic. Couldn’t get enough of ’em. Sure enough she had cooked up leeks with garlic, shallots with garlic and garlic with garlic and we had feasted fit to burst. On the Monday when I went back to the hospital where I was living in, I thought I could smell something funny and checked my pockets and washed my hair. Still there. Funny. When I turned up at the paediatrician’s office, the paediatrician to whom I was attached for that period, he tolerated me for a while before asking me if I had eaten garlic on the weekend. I admitted I had, wondering how he knew, before realising the awful truth. One good thing was he gave me the day off. Poor guy couldn’t stand the smell of me.

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Since then I have been wary of over-indulging my passion for leeks and their relatives. Obviously some odours we emit are caused by the foods we have eaten or the clothes we have put on (e.g., mothball smell). These extrinsic sources are easily remedied. But body odours that are produced by our own glands are harder to deal with and sometimes harder to be aware of.

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People may feel okay about complaining that you smell of mothballs or garlic, or even cigarettes or alcohol. They may however feel a bit more squeamish about telling you that you just smell full stop. Bad breath may be caused by poor dental hygiene or gum infection. A trip to the dentist is in order here. It may be caused by a respiratory or gastrointestinal infection too. The doctor can help there. But the commonest reason for having bad breath, apart from smoking, is simply not eating or drinking sufficiently or frequently enough. Virtually everyone has dog’s breath in the morning before breakfast. That’s ’cos you haven’t eaten or drunk anything for about nine hours usually. If you eat and drink infrequently during the day, your breath may well stink. Solution: quit smoking and drink water or fruit juice through the day or even chew gum occasionally so your saliva doesn’t stagnate and start ponging. Body odours are caused by glands secreting oils that have a particular fetid odour. Not all sweat smells. It depends which glands are active and also how quickly the secretions are washed away. When people are under stress they are more likely to secrete the really smelly stuff, although some people might be the most laid-back people in the world but still be able to create a stink to evacuate the Entertainment Centre. What do you do? Well try wearing a deodorant for one thing. Shower daily or even twice daily if you do a lot of physical exercise. Wear cotton, silk and natural fibres and avoid nylon and synthetics like the plague. Err towards loosefitting rather than tight styles. Try to avoid overheating. Men are usually more inclined to have really serious body odour because of their hormonal make-up. Yay. Interestingly

though, not all body odour should be frowned upon and concealed. Some of our body odours are actually chemoattractants, called pheromones, and are important in modulating perceptions of attractiveness. In studies in which women are exposed to pheromones collected from the armpits of men, it has been shown that the pheromones make the men seem more attractive to the women. It is postulated accordingly that spending money on anti-perspirants, perfumes, aftershaves and deodorants, in order to attract the opposite sex, is a waste of money and actually counterproductive. All we are doing is disguising our naturally enticing smell. Indeed, when animals are on heat they communicate this by letting off a smell (no, not a fart) and letting prospective gentleman callers sniff their nether regions. So if you don’t want anyone to know you’re horny, load on the Arpège. But if you want them to come a-running, let it all out, au naturel. Just go easy on the garlic.

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Body and facial hair — on gals!

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he first time you notice that you have a shadow of a moustache or a beard on your chinny-chin-chin is a pretty horrifying moment. If you haven’t had it yet, don’t worry: if you live long enough you will. I can still remember my Mum saying to me once that what she feared most about senility was the thought that she might no longer have the nous to pluck the stray hairs from the places only Santa is supposed to grow them and would I please do it for her when I visited her at the nursing home/asylum. I said yeah sure but was once a year really gonna be enough? (Besides, who’d see it underneath the muzzle?)

Of course you don’t have to be old or insane to start getting hair in places Dolly magazine never told you about. It is quite common for girls from the teen years up to get hair on their upper lips, chins, around their nipples, between the pubic area and the belly button and all kinds of other places where its appearance causes consternation and quandary. ‘Am I turning into a man?’ is the horrified response commonly echoing inside the gal’s head. As illogical as it seems, many people fear this (even some men). Needless to say the hairs usually look a lot thicker, blacker and longer if you stare at them for prolonged periods in a magnifying mirror under the bathroom’s fluoro lights. What seems like

Hair growth and distribution is largely genetically determined and depends on such things as ethnicity and family history. If your Mum has a moustache, face it, you probably will too. But facial or body hair does not indicate anything about your intrinsic femininity or womanliness.

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a forest to you is probably imperceptible to the human eye. But then again you’re no longer human. You’re from the Planet of the Apes. It is important to try to get some objectivity here. Asking your infuriating baby brother is not likely to yield the best results. Mum or Dad may be able to help although they may trivialise your problem and leave you unassuaged. Talking to girlfriends may help. But not if they are all blonde and hairless. Your best bet here, to be honest, is probably to see a doctor and might I say it might even be good to see a female doc since she is likely to be on the same wavelength and you may feel less embarrassed. But hey! Male docs can be very cool on this too! The doctor will take into account not only what he/she sees in the way of hair growth: distribution, thickness, darkness etc. but also the degree of distress it seems to cause you, and advise you accordingly. Beauticians can show you many ways of dealing with excess hair, from bleaching to plucking to waxing, electrolysis and shaving. The medical approach involves using medication in the form of ‘antiandrogen’ drugs such as the pill (particularly Diane 35 ED or Brenda), spironolactone (Aldactone) or cyproterone acetate (Androcur). The doc will only prescribe medication if it seems really necessary since all medications have potential risks and side effects.

Don’t compare yourself to people in the movies or in magazines. They have a team of workers concealing their ‘unsightly hairs’ and the photo probably gets touched up anyway. Even Marilyn Monroe, supposedly the sexiest cat ever, had facial hair. If it’s good enough for Marilyn, I say lay it on me too. In any case, why do they always call it ‘unsightly hair’ anyway? Who says it’s unsightly? This is one of the insidious catch phrases of the beauty myth that exists largely to create and play on our insecurities so we’ll feel bad about ourselves and buy stuff. What a dastardly deed. What I find interesting about ‘excess hair’ is how subjective the judgement of ‘excess’ is. I’ve had women with legs so hairy I gasped and almost fell over, hitch up their skirts for a Pap smear with the greatest nonchalance. The hair was so thick you’d have to call it fur. The fur pants went right up to and just past the belly button. No hipsters for them and thankfully no flares. And no comment whatsoever. Then there’ve been women bellyaching and completely distraught over a few tiny weeny pale hairs around the nipple you’d need a microscope to really discern. It’s really a personal thing and while some people evidently have never been affected by the so-called beauty myth and are revelling in their fur pants, others are completely ruled by it and attack every sprouting follicle with maniacal ferocity. Ah well, we’re all different. One thing’s for sure, if you wanna get rid of hair, it’s usually feasible with the aid of physical and medical interventions. On the other hand, if you weren’t blessed with fur pants naturally, you’ll just have to take up knitting with mohair and make yourself a pair.

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Premature and delayed ejaculation

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Doctor: The average time between insertion and ejaculation is two minutes. Troubled guy: Get outta here! No way! Doctor: Yes way! Troubled guy: No way! Doctor: Yes way! Troubled guy: No way! Doctor: Yes way! Troubled guy: No way! Doctor: I feel as if you’re not hearing me . . . Troubled guy: Two minutes! There’s no way I can last that long!

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rue to say, while there is the occasional fella who considers two minutes an eternity, most guys are supremely relieved and start to feel quite cocky when they realise that the average time to ejaculation is only about two minutes of thrusting after insertion. Fact is, a lot of guys and gals complain if they haven’t been able to get through every page of the Kama Sutra before the geyser spurts.

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In such cases, ‘premature ejaculation’ is a relative term. The man is ejaculating before the couple wish him to, but long after what is considered physiologically ‘normal’. Sometimes simply realising that he is not only ‘normal’ but rather a stud with amazing stamina, is enough to set all things aright. Other times, the couple may wish to learn new techniques to further enhance their staying power. Before embarking on this quest however, it is worthwhile defining one’s goals. If one aims simply for quantity, in a kind of Guinness Book of Records-style bid, the quality of the sexual experience may suffer. Some women have no desire at all to prolong intercourse. While the guy is selflessly struggling to maintain his sang froid and avoid coming at all costs, his bored partner might be composing grocery lists and planning the next week’s dinners, wishing profoundly that he would ‘just hurry up and get it over with’. Particularly women who do not orgasm with intercourse may find all this bouncing up and down rather a drag but difficult to excuse oneself from. Lack of communication is more likely to cause dissatisfaction than simple issues of bodily control. It is worthwhile chatting and teaching each other what you find enjoyable, pleasurable and satisfying. Perhaps using your partner’s hand to masturbate yourself is a way to show him/her what does it for you. Sometimes a guy with a tendency to come early can stimulate his partner to orgasm before intercourse, to give her a ‘head start’. He and she may feel more relaxed when intercourse begins and it may take less thrusting time before she is ready to come again. In terms of delaying the guy’s ejaculation, there are a couple of well-known techniques that may prove useful. Masters and

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Johnsons’ squeeze technique is very effective and commonly used. It involves firm squeezing of the head of the penis, usually performed by the man’s partner when the man feels the urge to ejaculate. The man should give some feedback as to the degree of pressure required and the partner needs to be confident enough to exert sufficient pressure. The erection may temporarily and partially subside, but there’s plenty more where that came from. Obviously, in order to practise this technique, the man needs to be sufficiently aware of the contours of his sexual arousal to know when ejaculation is imminent. This can be learnt through a careful study process otherwise known as ‘conscientious and serious wanking’. In other words, when you jerk-off, think about what you’re doing, what you’re feeling and take note of the sensory signposts along the way. That way when you come through those parts again, you’ll know how far you are from the point of no return. Another technique is called Semans’ technique and involves gradually increasing stimulation of the man up to but avoiding the point of orgasm, stopping the stimulation until the urge to come subsides, then starting up again. Sounds cruel? Well it depends on how you look at it. It is indeed a fairly rigorous method of doing things and a little counterintuitive but it works. You start off with the subtlest stimulation: the partner just touches the man, avoiding the nipples or genitals, which are like the accelerator pedals for his arousal. You want to take it real slow. When the guy is erect and ready to blow, you stop the stimulation until it blows over. Then you start touching him again and so on, several times over. The next stage allows touching of genitals and

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nipples. The next step is insertion of penis without pelvic movement. If he can manage this without orgasm, the next step is penile insertion with pelvic thrusting. The idea is that the guy gets used to ‘enduring’ all this stimulation without reflexively mounting to orgasm. He learns how to back off and delay ejaculation. And hopefully then everything will be hunky-dory. Either that, or everyone will be so bored with it all that unbeknownst to him, they have left the building. Sometimes after the first orgasm, the guy can last a lot longer the second time. What second time, you say? Well most young guys can mount another erection within minutes. More ‘mature’ males may take over an hour. Sometimes the refractory period is more like days, but don’t take it personally. This is another alternate solution: get the first one over with relatively quickly and take it more slowly after that. With an older male, hey, you may be able to get in a few rounds of golf between sessions. The main thing is probably to avoid getting too uptight and anxious about the whole affair. How long, strong and hard your erection is should not be the measure of your self-esteem and sexual worth. Partners: try not to take his penis personally and be responsible for your own sexual pleasure. Mutual masturbation is a perfectly valid form of sexual gratification and a good way of complementing intercourse. Quality not quantity is the key. There is more than one way to skin a cat and you should try as many as possible, not just peno-vaginal intercourse. Most importantly of all, partners should avoid berating their quick-off-the-mark males. Expressing your disappointment at the early detumescence is cruel and can be very destructive.

The penis is like a Magic Pudding that can rise and rise again, for repeated consumption and enjoyment. Don’t bash the empty tin and throw it away! If you speak to it nicely, it will re-form before your very eyes and you can lick your lips and dive in again. Delayed ejaculation is a much more difficult and complex problem. It is less common and guys may try to hide it by pretending to come when they are sick of trying to really come. There have been cases of supposed infertility that were actually the result of the male partner ‘faking orgasm’ for years, unbeknownst to his partner. Some guys can only come with masturbation in private. Some guys can come with masturbation in the presence of a partner but not with intercourse. The problem may be related to emotional and situational factors as well as deep-seated psychological and sexual issues that require specialist sex therapy. Certainly the guy should not feel ashamed of his problem and should seek specialist help. With therapy, he will be able to overcome the problem. By continuing to ‘fake it’, he fools no-one but himself and deprives himself of genuine enjoyment and honesty in his relationships. He also creates and reinforces anxieties. Through fear of being abnormal, he ensures the continuation of his problem by ignoring it. As with many worrisome issues, the first step requires facing and owning the problem and having the courage to do something about it. We cannot solve all our issues on our own. Seeking help is the bravest and smartest thing to do. Don’t stew in your own juice. Jump out of the pot and let someone sort you out!

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Help! I’ve got boobies! Breast development in males

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reast budding in gals is usually greeted by anything from suppressed to over-the-top overt elation. Occasionally if the breast-budder is beating her classmates to the chase in this department, shyness will overshadow rightful pride. But catty comments from flat-chested felines are more than likely simply manifestations of poorly controlled jealousy and ‘immaturity’ in more senses than one. Breast development in males, however, is universally received in an atmosphere of negativity. While bulging pecs are admired objects of aspiration, it seems that when it comes to chest adornment, consistency and shape are of utmost importance. Just as a breast plate of steel would be considered unalluring in a female, plump cushions of adipose and glandular tissue are unacceptable on the male upper torso. Fortunately breast development in boys and men, called gynaecomastia, is a relatively unusual occurrence. Which, unfortunately, makes it all the more distressing when it arises. In young boys around the time of puberty, small amounts of breast tissue may develop behind one or both nipples. It feels firm in consistency, not soft like fat. It usually

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regresses spontaneously over time (months, usually) but may need to be removed surgically in rare cases. There is unlikely to be any hormonal problem. The breast tissue is simply responding to the changing hormonal environment of puberty. Reassurance is the main treatment. And a nice bra. Only kidding. A boob tube in the footy colours is ideal. Hehehehe. Breast development in the adult male is usually more problematic since it could indicate a hormonal problem or liver disease or it could be a side effect of medication. Development of firm, breast-like tissue behind the nipples needs to be checked out fully by the doctor and managed accordingly. Obesity or even excessive body building can result in bosom-like contours but in such cases where the boobs are composed of pure fat or solid muscle, this is not gynaecomastia so much as excessive mass. This can become a problem when the girlfriend starts feeling inadequate or worse still, jealous of your superior bustline. Or when you find that your cleavage is attracting unwanted, lustful attention from your drinking buddies. Of course this sort of attention is not always undesirable. Some men crave distinction of this kind and have breast implants or take female hormones in order to create by prescription the curves genetics failed to provide. Of course there are side effects but where there is a will there is a way and some of the most sculptedly ‘perfect’ femmes fatales owe more to estrogen shots, anti-androgen

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pills and silicone infusions than to Mother Nature or even their own mothers. Breast implantation in men works in much the same way as in women. The saline or silicone-filled sac is inserted behind the existing nipple via the armpit or via an incision under the curve of the new breast. For a would-be-wo-man who is serious about physical transformation, getting breasts is usually only the beginning, but it is an important and defining first step: putting your best chest forward. Many women ask ‘Will I still be able to breast-feed after my implants?’ to which the answer is ‘Yes!’ Men, unfortunately, will not be able to breast-feed post-implants. But no suckling does not mean no sucking. And there will almost certainly be a power of that. Given that regardless of breast size and contour, men will never have the capacity to lactate, one wonders how long it will be before evolutionary development renders this vestigial organ — the male nipple — completely obsolete and passé. Perhaps its status as an organ of sexual pleasure will save it from the dust heap. In very hairy, bearded men, nipples also serve to distinguish the front surface from the back. For what it’s worth.

Top five reasons why it’s not so bad to be a man with breasts: 1. Legitimate reason to browse in lingerie department. 2. More than one organ to fondle when you’re bored.

4. Breasts are erogenous zones. Bigger breasts = more erotic.

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3. People will believe you when you claim to have developed your feminine side.

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5. Next time you fall flat on your face, prepare for a softer landing.

Menstruation (Eek! I leak!)

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enstruation is a pain. It basically involves leaking blood for a few days without letting anyone know that’s what you are doing. With urine and faeces, we are allowed to store it up and jettison it at regular intervals when we are good and ready. With menses, the old blood just dribbles out in fits and starts and you have to either wear a glorified plug (tampon) or nappy (pad). What kind of design is that? It makes you believe the Creator must have been a guy. A guy with a sense of humour!

The length of periods can vary from one day to two weeks and the heaviness of flow can range from spotting to streaking to flooding. Some women have to wear two maxi tampons simultaneously as well as backing up with an overnight pad. Wearing black is de rigueur.

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Mastering the blood collection and concealment is one thing. Dealing with the associated aches, pains and mood swings is another. Some people have PMT (Premenstrual Tension) that lasts most of the cycle and can consist of physical symptoms like fluid retention, pimples, bloating, constipation, lower abdominal pain, back pain, breast tenderness and increased appetite and need for sleep, as well as psychological ones such as low libido, depression, feeling irritable, cranky, insecure and irrational and being unable to think clearly. PMT can drive some women up the wall because they feel as if they are at the mercy of their hormones. Many treatments can be tried, such as dietary modification, exercise, herbs, evening primrose oil, the pill, other hormone preparations and even antidepressants. Some women only escape PMT when they are pregnant, post-menopausal or post-hysterectomy. Knowing that your symptoms are caused by PMT can be useful, however, as at least you have an explanation of sorts, and on occasion, an excuse. It can be helpful to externalise the problem and say that it is the hormones that are bringing out the bitch in you rather than it simply being that you are just an unspeakable bitch. For partners of sufferers of severe PMT, it is good to watch the calendar and be aware of where she is in the cycle so as to be able to offer support when necessary and perhaps give a wide berth when the Medusa raises her ugly head. Living with someone with bad PMT can be hard especially if the PMT sufferer has little insight into her moods and has a tendency to take it out on those around her indiscriminately.

It is possible to not menstruate at all if you like, by taking the pill continuously, and many people do this. The usual

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On the other hand, it can be tempting to take advantage of the PMT person, telling them they are being unreasonable and ‘it must be that time of the month’ when really it is you yourself that is being a shit and she is just being assertive and stopping you from trampling all over her. There is nothing more condescending than someone who presumes to know why we are behaving as we are and patronises us accordingly. Hate that. Grrrr. Sometimes women think they are suffering from PMT because once a month they feel miserable and start to resent the fact that their boyfriend of twelve months still hasn’t introduced them to any of his friends, hasn’t said ‘I love you’ and oh yes, hasn’t divorced his wife. They tell me how they fight at these times and how the boyfriend explains it away as ‘just PMT’. I tell them that I don’t think PMT is the problem. It sounds more like the premenstrual period brings them their only moments of clarity. Maybe what they need is the assertiveness to actually complain more often and when told it is ‘just PMT’, to be able to shout ‘Don’t patronise me, f**kwit!’ Maybe. In any case, periods are not such a big deal for everyone and not everyone even notices any PMT. People on the pill can control their periods and the pill usually makes the bleeding lighter and less prolonged. It is nice to be able to set a clock by your period stopping and starting. Although there are probably more reliable ways of telling the time.

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pill packet has twenty-eight pills per card and of those, seven are sugar pills or blanks. With monophasic pills, that is pills where all twenty-one active pills are identical (e.g., Loette, Nordette, Microgynon 20, 30 and 50, Diane 35 ED, Brevinor), one can simply skip the sugar pills and take active pills continuously thereby missing the bleed altogether. With triphasic (e.g.,Triphasil,Triquilar,Trifeme,Triminulet) pills or biphasic (e.g., Biphasil) pills there are three or two different kinds of active pills respectively, so skipping the menses is a bit more complicated. It basically requires staying on the same strength active pill in the final phase continuously, which means wasting a lot of pills. Speak to your doctor for advice but if you really want to go menses-free you’d be better off going on a monophasic pill. Fortunately there are heaps of different ones so there is likely to be one that suits you. People often think that skipping the periods sounds too good to be true and there must be a catch. It must be harmful or give you cancer or something. Not really, actually. In fact for people who have heavy troublesome periods it can be the greatest thing ever. Not everyone can do it: some people who try to skip periods on the pill will get break-through bleeding. But most people do fine. For people who tend towards iron deficiency or anaemia, it can help by decreasing blood loss too. Anytime you get sentimental and ‘miss’ your periods you can always get them back simply by stopping the pill for seven days. Voilà. The bloody thing’ll be back. Great. Before the invention of tampons and pads with wings, sphagnum and aerodynamic properties, women had to use rags and sponges and all kinds of other revolting things.

The New Femininity

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K so what’s femininity? Does feminine mean pink and frilly, perfume and lace? Do you have to cross your legs at the ankles and tuck them neatly to one side? Who cares! As long as feminine doesn’t have to mean subservient and servile, weak and ornamental, I’m happy to wear perfumed, pink, frilly lace undies beneath my King Gee dungarees. As for the deportment, I’d rather cross my eyes and tuck my ankles behind my ears . . . but that’s another story.

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They weren’t disposable and don’t imagine Dad or the big brother was busy rinsing them out or making fresh ones. Nup. That would have been women’s work for sure. Yum. So even though we guffaw and poke fun at the ads that seem to suggest our menstrual fluids are blue and watery and seem to imply that wearing their product will suddenly give us the ability and desire to water-ski, windsurf or simply frolic euphorically in white shorts, we should at least be grateful that these products have been designed (and so carefully designed!) and we no longer have to tie rags around ourselves like a sumo wrestler. We’ve come a long way baby, now we can say: ‘Periods? Yeah I used to have them once.’

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Are we in the process of seeing a ‘New Femininity’ emerging? Jeepers, I sure hope so. Over the years we’ve seen some pretty warped ideas of what it takes to be a real woman, some of them threatening to female life itself: from corsets — yeah, great idea, guys — to high-heeled shoes (it broke my heart to see Baby Spice in a wheelchair after falling off her platforms), to those ceramic talons stuck onto perfectly healthy nails . . . which somehow end up at my surgery surrounded by horrendous fungal infections and painful, purulent, flaking morasses of boggy skin. Gee that’s so glamorous. What is it with this idea that women should look ridiculous, improbable and downright bizarre? What kind of point are we trying to prove here? ‘Oh I’m such a silly little twit that I haven’t got anything better to do with my time than stick plastic caterpillars over my own perfectly normal eyelashes.’ ‘Oh I’ve just had a brain wave: nail polish that I can peel off!’ ‘Oh yes — don’t you love it — it’s called a “shrug”. I couldn’t possibly just get a long-sleeved top.’ Yeah right. And as for sex, well we’ve got two kinds of femininity when it comes to sex: the whore and the virgin. Let’s start with the innocent virgin — she’s just so much fun. Shy, reticent, oh so young (but legal!) — she’s a flower needing to be plucked, a bud about to bloom, only she doesn’t know it! Large doe-like eyes, baby-faced and coltish . . . basically what we’re describing is pure paedophilia. It’s a power thing. This ‘fragile therefore feminine’ wisp (or is that ‘wimp’?) of a thing exists purely for the pleasure of the dominant male, who’ll ‘teach her a thing or two’. The ‘Singapore girl’ handmaiden is an extension of this ‘how may I serve you’ fantasy, just like ‘I Dream of Jeannie’

As for the body, I’d like to see the return of the waist. Not the nipped in, hourglass, ‘hey I’ve had some ribs

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(yeah well dream on, buddy). Can we please send these women to assertiveness training and ask them to stop cocking their heads to one side and clasping their hands in submission? Enough already. As for the vamp/whore phenomenon who is sex-crazed and just can’t help being turned on by anything male or phallic . . . the bosomy, hair-flipping, man-eating tigress who is also a part-time lesbian sexhibitionist when she can’t get enough man around her . . . gimme a break. If I had a say in what should be the ‘New Femininity’ (yeah, dream on, Cindy), I’d start by redrawing the image of the sexually desirable female form. Let’s start with the hair. Hey I’ve got a crazy idea — what about au naturel . . . it’ll never catch on but let’s fantasise a little. Maybe we could go for ‘Hair Out’ as in ‘not tied back’ and ‘Hair In’ as in ‘tied back’. Kinky, huh? As for the face, I think ‘defensive make-up’ is the go: what about very bright, glossy and indelible lipstick for when we don’t want to be kissed — it sends the message:‘Watch out, unless you want a facial tattoo in “Fatal Fuschia”.’ And makeup that does rub off :‘Hey, look but don’t touch!’ That way when we aren’t wearing any make-up, they know we’re ready for action. When they’ve seen us in all our bare-faced glory and they still want to suck face, then we know who we’re talking to. The new vision of a really sexy, feminine face will be the touchable, clean-skin, ‘looks like she’s not wearing any make-up, ’cos (gasp) she’s really not wearing any make-up!’ look. Hooray!

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removed’ waist, but the ‘couldn’t bear to see it go to waste’ waist of the well-fed woman! Did I bypass the breasts? Omigod. Well yeah. Can we just get over them? So there we have it, two breasts. Large, small, perky, pendulous . . . if we like you we’ll let you touch them and that’ll be some fun, but until then can we just forget about them? Move on. OK so maybe Vogue isn’t interested in my concepts for the new millennium; after all without all the ads, they’d have to write a lot of actual articles . . . and then who’d buy it? But isn’t there somebody out there who wants to embrace the new femininity unfettered and free of artifice? All right. I can take a hint. So what about the ‘New Feminine Sexuality’? Well for starters let’s toss out the tyranny of the orgasm. If you want to orgasm buy a vibrator. If you couldn’t care less, please feel free to care even less. Let’s say ‘Ta Ta!’ to being passive, retiring and sexually naïve, and ‘Hello sailor!’ to taking initiative and being unashamedly active and assertive, especially when it comes to negotiating the use of condoms, discussing STDs and contraception, and refusing painful or distasteful sexual practices. Now that takes feminine finesse. Let’s learn how to ask for sex and get it (can someone teach me?) and let’s know how to say ‘No’ and make it stick. Get rid of the idea that child-like equals sexy. The New Femininity should be strong, womanly, knowing and selfdetermining. The New Woman should know how to take control and when to relinquish it. To be feminine should not mean to be frail, feeble, flower-like, fawning, acquiescent, deferential, decorative and disposable. The New Femininity

should incorporate strength, grace, power, panache, bravery, guts, conscience, independence and integrity. Now that’s sexy.

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Top ten signs that she’s a new woman (and clues to when she’s gone too far):

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1. Doesn’t waste time obsessively removing ‘unsightly’ body hair (underarm hair is plaited). 2. Refuses to slavishly follow illogical fashion fads (still wearing old school uniform). 3. Takes initiative in matters sexual (and is the subject of rape allegations). 4. Insists on men wearing condoms (even when they’re not having sex). 5. Feels comfortable discussing STDs (graphically, at company board meetings). 6. Refuses distasteful sexual practices (including kissing and holding hands). 7. Knows how to say ‘No’ (but never gets asked any more anyway). 8. Has ditched her high-heeled stilettos (in favour of Ugg boots).

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9. Rejects elaborate hairdos (dirty tangled mop on her head has become home to small native fauna). 10. Doesn’t need a man (needs a restraint).

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Vaginal discharges (Help! I’m leaking again!)

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erhaps as a principle of physics, we should understand that any fluid-containing body which has holes on its surface may be expected to drip, leak or ooze from time to time. As females, we have three significant orifices from which unexpected emissions may lead to consternation. Milky drops from lactating nipples perinatally are easily explained and, given the other dramatic changes taking place in this context, are likely to pale into insignificance. A lick or a wipe and they’re forgotten amidst the greater impact of haemorrhoids, varicose veins, stretchmarks . . . oh and the baby. Vaginal discharges however can start as early as infancy and continue to bug us well past menopause. Bane or blessing? Normal or paranormal? Well, it depends.

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It is certainly not only normal but necessary to have some degree of moisture or lubrication in the vagina, in just the same way as the mouth needs saliva. An oral cavity deprived of saliva would not only be profoundly uncomfortable but would in the long term lead to complete dissolution of the teeth, a very unsavoury prospect. Similarly, a dry vagina inevitably leads to squirmingly, chafingly irritating discomfort, such as would be familiar to some post-menopausal women who have chosen to forgo the option of hormone replacement therapy. Few women would discount this requirement for vaginal wetness but when that wetness ventures beyond the labia to soil the crotches of their petal-like panties, they get very up in arms. Discharges from runny to viscous, clear to white to cream, yellow or green are looked at askance and bemoaned. Some women look on vaginal discharges with the same disdain others reserve for skid marks and faecal or urinary incontinence. Of course there is no such thing as ‘vaginal incontinence’. Vaginal lubrication is undoubtedly a good thing and, depending on where you are in your menstrual cycle and whether or not you are feeling sexually aroused, you may have a little or a lot of it and it may be sticky and cloudy (after ovulation) or viscous, elastic and stretchy like raw egg white (maximally stretchy 24 hours either side of ovulation). Does it smell? Well like every part of your body from your scalp to your toes, the vagina has its own unique perfume. It may alter through the menstrual cycle and it will certainly vary from one individual to another. The odour is usually

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only detectable at close range although some women with sensitive noses (or occasionally, overly active imaginations) claim to be able to smell themselves fully clothed even directly after showering. Such women are usually convinced that everyone else can smell it too and feel dirty and ashamed. Unfortunately, people who fear or are embarrassed by perceived unusual discharges or smells are often inclined to wash or even douche excessively with soaps, detergents and antiseptics. These ministrations, performed on a previously normal vagina, will actually cause a depletion of the good, normal flora or bacteria, Lactobacillus, and promote overgrowth of those less desirable vaginal constituents: Candida (thrush), Gardnerella (Bacterial Vaginosis) and their cohorts. Candida overgrowth is characterised by vaginal and vulval itch, irritation, soreness and thick, white, cottage-cheese-like discharge, which is odourless. Bacterial Vaginosis (BV) is noted for its strong, unpleasant, ‘fishy’ odour and thin, watery discharge that can range from colourless to yellow to green. Both these conditions are harmless enough in themselves and given time will usually resolve spontaneously. If they are causing botheration, treatments are available which include vaginal applications and oral preparations. Candida is commonly treated with antifungal creams or pessaries (solid tablets of cream you insert into the vagina), which are available over the counter at the chemist. Oral antifungals require a visit to the doctor for a script and are restricted for use in intractable or severe cases.

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Antibiotics are used to treat BV in courses that can range in length from one day to one week, depending on the doctor’s assessment of the severity of the condition. Antibiotic creams are now also available on prescription for intravaginal use. Occasionally women find themselves falling prey repeatedly to one or other of these conditions and despite swearing off every substance or activity they suspect of causing or exacerbating it (anything from starchy food to nylon undies, sex to sport, washing detergent to body wash) the condition persists in bugging them. ‘I’m baa-aack’ the discharge seems to gloat, staring back muckily from the cotton crotch piece. Out of their wits, such women scrub with increasing vigour with lotions and potions from chemist, kitchen and cauldron, with ever-decreasing hope. It is a simple fact of life that some people will go through phases when thrush and BV will be more recurrent and, despite correct management, will seem to outwit the most vigilant. In such cases it is more important than ever to wash only with sorbolene cream and not soap and to treat as required with the appropriate oral or vaginal preparations from the chemist. Yogurt, vinegar and other foodstuffs are messy, poorly efficacious and potentially hazardous in the wrong hands and should be reserved for dressing salads and other culinary wonders. There is no outstanding scientific proof that yogurt, containing live Lactobacillus or not, eaten or inserted vaginally, has beneficial effects on vaginal thrush. Antifungals do help eradicate fungal conditions, just as antibiotics assist in cutting

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down unwanted bacteria. Yogurt is a great source of calcium, protein and carbohydrates, and comes in a range of delicious flavours. It belongs in your mouth, not your undies. So far we have covered a range of benign conditions that are not sexually transmitted infections (STIs), that nonetheless cause concern. More worthy of concern are the actual STIs causing vaginal discharge, which include trichomonas, gonorrhoea and, less commonly, chlamydia. While chlamydia is possibly the most serious and even most common of these in Australian women, it rarely results in a vaginal discharge. It would actually be a hell of a lot more sporting if it did because it would allow more easily for its detection. Unfortunately, chlamydia is often symptom-free in women. In men it may cause urethral discomfort particularly on urination but it can be asymptomatic too. Left untreated, chlamydia in women can lead to PID (pelvic inflammatory disease), which causes chronic pelvic pain and in some cases, infertility. It is an STI and can be prevented by using condoms. A simple urine test can be sent by your doctor to the lab to detect the presence of chlamydia and treatment is as easy as a single dose of antibiotics. Gonorrhoea in women can be symptom-free or may sometimes cause a purulent (pus-like) cervical discharge which may be noticed by the woman herself or by the doctor when examining her cervix using a speculum (plastic contraption used to lever open the vaginal walls to allow for better viewing of the cervix). It is also an STI that is preventable by using condoms and can be

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detected by the doctor taking a swab from the cervix. It is treated by antibiotics very efficaciously but left untreated can progress to PID. Trichomonas usually causes a greenish, fishy-smelling discharge but may also be asymptomatic sometimes. It can be prevented by using condoms and is detected by the doctor taking a swab from the posterior fornix (top back corner) of the vagina. It is treated by the same antibiotics used for gardnerella (BV) but, unlike BV, it is sexually transmitted. All these STIs can recur after treatment, but only if reinfection occurs, such as if you have unprotected sex with someone new or if you have sex with the original infectious partner who has not been treated yet or who has been reinfected by someone else. Fortunately all these infections and their nasty consequences are preventable by practising safer sex. That includes using condoms or dental dams and gloves and getting both yourself and your new partner checked out by a doctor for STIs. For a gal this would include a urine chlamydia test, a cervical and vaginal swab, a Pap smear (if it hasn’t been performed recently) and blood tests for HIV, Hepatitis B, syphilis and Hepatitis C (depending on perceived risk factors). For a guy, the same blood tests and urine chlamydia test should be accompanied by a urethral swab. That’s right, a tiny swab is introduced briefly into the eye of the penis. Yeah it hurts but a second of pain is worth it for the invaluable gain: reassurance, peace of mind and safety! Depending on your sexual practices, a rectal swab may or may not be in order. Don’t be embarrassed.

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If you have any suspicious or annoying discharges, get your doc to check it out. If it is something that has been there all your life, it may well turn out to be normal and something to just get used to, but if it is new and different it definitely warrants investigation — particularly if you are sexually active and have not been overly diligent in using condoms. If it turns out you have an STI then it is vital that you inform your partner so he/she can get treated too. It may be necessary for you and your partner to trace back through your sexual history and inform other partners so that they can also be treated. Discuss these issues with the doctor, who can advise you as to how far back you need to trace, depending on your actual history and which STI you have. Is it possible to get an STI through fellatio (sucking a penis) alone? Well yes. Gonorrhoea in particular is quite commonly spread in this manner. For the other STIs, oral sex is not considered ‘high risk’, but it’s not considered ‘no risk’ either. Fellating through a condom, giving cunnilingus (licking or sucking the vulva, clitoris and vagina) using a dental dam, using gloves to manually excite a partner — these are what safe sex advocates suggest for ultimate sexual safety. Well, while in theory these safety measures are all well and good, the frequency with which they are practised is, unsurprisingly, low. When I have suggested such precautions to patients they have responded with snorts and disbelieving glares and I have kept my side up with difficulty with such feeble rejoinders as ‘You’ll get used to it!’ and ‘I know it sounds strange, but really, this is how it’s done nowadays . . .’

One hundred reasons why it’s better to be female 1. We’re sexier, smarter, have better personalities and are more humble. 2. Our breasts and nipples actually serve a purpose. 3. We never have to be cannon fodder. 4. Our farts don’t smell.

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Given that condoms only came back into fashion because of their ability to prevent HIV and given that anything less than anal or vaginal sex is largely perceived as low risk for HIV, convincing people to use precautions for oral sex is an uphill battle. Gonorrhoea is easily treatable and does not instil the awesome fear of HIV, so many prefer to take their chances with it. One way of getting around it without having to cover every square inch of flesh in latex (although those who do will tell you of its benefits!), is to get both yourself and your partner tested and maintain a monogamous sexual relationship. The safest sex is sex between two partners neither of whom have any sexually transmitted diseases. How to ensure that what you think is monogamy really is? Well that’s a different chapter.

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5. 6. 7. 8. 9.

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10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24.

If anything they smell sweet. Our farts are silent. If anything they’re musical. We are allowed to wear make-up to improve on nature. Getting a stylish, flattering new hairstyle does not incite speculation about our sexuality. We smell better. We don’t sweat, we glisten. We don’t have to shave every day. We are never accused of inflicting stubble burn. We know how to make you feel guilty regardless of actual guilt. We are better at making subtle criticisms. We are better at making overt criticisms. We have a higher pain threshold. We can have babies. We can breastfeed and make you feel either useless or queasy. It costs us less to get drunk. We look good in both men’s and women’s clothes. We can borrow your clothes and you don’t mind because it looks sexy. We mainly borrow your clothes to do really dirty work (that we don’t want to ruin our own clothes with). We are not expected to do really grimy work.

25. Men are supposed to offer to carry heavy objects for us (handbags excluded). 26. We don’t get ridiculed for carrying handbags. 27. Penis envy does not exist in women. Handbag envy does. Men envy us our handbags.

47. A fleshy woman is curvaceous and voluptuous, a plump guy is just a slob. 48. We don’t have to make excuses for reading women’s mags.

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28. We don’t feel compelled to brag about sexual conquests. 29. We don’t get impotence. 30. We can fake orgasm. Harder to fake erection and ejaculation. 31. Small women are dainty, small men are just short. 32. We don’t have to know what’s under the bonnet. 33. We’re not expected to be able to change tyres. Actually it’s not that we can’t, it’s just we don’t like getting our hands dirty. 34. We don’t have to watch football. 35. We don’t have to play football. 36. We suffer fewer sporting injuries. 37. We know the toilet is not a reading room. 38. We understand the art of gossiping. 39. We know why we go to the toilet in pairs. 40. Female models get paid more. 41. Men are supposed to protect us. If they get into a fight they’re just violent and impulsive. 42. On the Titanic, it was ‘women and children first’ onto lifeboats. 43. The ‘helpless act’ is an essential survival skill not an embarrassment. 44. We look good in G-strings. 45. If we need to wear a bra it’s a good thing. 46. If we still don’t wear one, you still think it’s a good thing.

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49. 50. 51. 52. 53.

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54. 55. 56. 57. 58. 59. 60. 61. 62. 63.

64. 65. 66.

We live longer. When parents fight, kids usually take Mum’s side. We don’t have to get prostate checks. Our genitals don’t disappear in cold water. Wearing a lot of gold jewellery does not invite speculation about our ethnicity. We care about our body shape. We are aware of our body shape. We have more choices in swimsuits. We know that the natal cleft (bum crack) is meant to be concealed. Cleavage in a woman is considered alluring. Men with cleavage are the ‘butt’ of jokes. As secretaries and PAs the buck never stops with us. DMCs in private are easier to arrange — we go to the toilet more often. Give a tampon to a woman in need and she’s your friend for life. (As long as it’s an unused one.) We star in most fairy tales — Cinderella, Sleeping Beauty, Snow White — the Prince is an interchangeable incidental. No need to clean up after orgasm. Multiple orgasms and no latency period. If we don’t want to go again it’s not because we can’t. (It’s probably ’cos you can’t.)

67. We don’t have to urinate in a trough with a whole lineup of other guys. 68. Women’s public toilets smell better and are usually a lot bigger. 69. Urinating never gets competitive.

85. We don’t have to arrange our genitals surreptitiously. 86. If we do touch ourselves accidentally or intentionally, it’s considered sexy not disgusting.

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70. Penis envy is a male delusion — a lot of men envy other men’s penises. 71. Saying ‘no’ to sex doesn’t mean we are depressed. 72. We’re more likely to be able to do the splits. 73. Having sex during our period is great. We get to see how you like having blood all over your genitals. 74. We can be tetchy and unreasonable at least once a month for several days for good biological reason. What’s your excuse? 75. In a custody battle we usually come out on top. 76. We usually decide what’s for dinner. 77. We’re better actors and can lie convincingly. 78. If we do lie, we are at least aware of it and have a conscience. And it is probably for a good reason. 79. In us,‘vulnerable and fallible’ is appealing. In a guy, it’s pathetic and a major detractor. 80. PMT justifies anything and can last all month if you’re not careful. 81. You’re supposed to open doors for us but we can scold you if you do just as we can scold you if you don’t! 82. Women have a shared consciousness. Men are only rarely fully conscious. 83. When we cry, people don’t think we’re weak, they think we’re put upon. By men. 84. You’re supposed to pay for us but we can criticise you if you do and criticise you if you don’t. Going Dutch is still stingy.

87. We have legitimate reasons for looking at lingerie catalogues. 88. Our phone conversations go beyond:‘G’day, yup, yeah, okay then, bye.’ 89. We can make a day of looking for a blouse. And still not find the right blouse. 90. We might on the other hand find several fabulous pairs of shoes. 91. And still call it a stupendous success. 92. Successes like these can inspire another shopping expedition with or without gal pal, with or without aim, with or without our own income. 93. We have your income. 94. We can wear pink, orange and lilac. 95. Simultaneously. 96. We can watch soppy romantic movies without an alibi. 97. We don’t have to behave like macho idiots to bond with others of our sex. 98. We are more polite and aware of etiquette (no, not ‘air ticket’). 99. We are always distinguishable from other species. 100. We are more highly evolved, we are more self-aware and we love it.

Dave: Anti-wrinkle cream there may be but anti-fat-bastard cream there ain’t. Dave: The less I eat, the fatter I get. Lumper: Well stuff y’self and get thin then. From the movie The Full Monty.

‘Even thin people look fat there [New York], and fat people are always out with handsome men (not like in California, where everyone thinks fat is something you can catch, and therefore is to be avoided).’ Roseanne Arnold 1953– : ‘Roseanne’ (1990).

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n the TV show ‘Roseanne’, Roseanne Arnold plays a suburban housewife with three kids, a loving husband and a very smart mouth. She is the star of the show, the heroine and the emotional centre for all the characters including her spinster sister who, incidentally, is slim. Roseanne is a strong and positive example of a woman who is all woman, living out loud, at large. Being fat in no way inhibits her from being assertive (to the point of feisty), proud, sexually confident and lovable. The issues dealt with are to do

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‘But weight — there’s more!’

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with family, relationships, love and humanity. Fat doesn’t enter into it. Eating is depicted as a fun, enjoyable and partly social activity. Food is consumed heartily, happily and casually without a drop of self-consciousness, guilt or hesitation. Roseanne is a striking contradiction to the myth that only thin people are happy and all fat people really wish to be thin. Although the current ethos dictates that slimness is to be valued and fatness is less desirable, we all know fat people who are glowingly happy just as we know thin people who are not, and vice versa. Fortunately there is a lot more to each of us than simply our bodies, the shape and size of which is only partially under our control. So what determines body shape and size anyway? Well, one thing’s for sure, there’s a hell of a lot more to it than simply what we eat. Knowing what someone eats is not an accurate indicator of his/her weight, contours or body composition. Everybody knows someone who eats like a horse remaining reed thin and someone else who picks at food like a sparrow but never loses his/her rotund physique. That is because, while undoubtedly dietary intake plays a role, our body shape and fat distribution are largely determined genetically. Genetic inheritance and gender are major influences that cannot be ignored or overridden. Robert Altman was quoted as saying ‘If you have a child who is seven feet tall, you don’t cut off his head or his legs. You buy him a bigger bed and hope he plays basketball.’ This concept of accepting one’s natural form and accommodating it and taking advantage of it by appropriate life choices is a good one to grasp but remains elusive to many.

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Attempting to drastically change body shape and size is an uphill battle against Nature. Our weight fluctuates around a genetically predetermined set-point, depending on our food intake and activity. This set-point varies for each individual and with reasonably ‘normal eating’ will almost always be within the healthy weight range. But what is so called ‘normal eating’? Does normal eating mean only eating fresh fruits and organic vegetables? Only eating when you’re hungry? Only eating what you can fit in two hands? Only eating as much as the person sitting next to you? Only eating what Oprah or New Idea says? None of that! Normal eating is eating in response to numerous cues only one of which is actual hunger. The presence, sight or smell of appetising food may trigger appetite. We may eat for the simple pleasure of eating: because it’s there. There are many social and habitual influences. Meals may be family occasions, excuses for a date, a component of a meeting, a prelude to a kiss. This is all normal. It is neither greed nor excess. It is normal. Cafés, pâtisseries and snack food companies would all go out of business if people only ate when they were hungry. The average person will eat not only when he/she is hungry but also when peckish, curious or a bit bored. The snacking or grazing does not necessarily lead to over-eating since by frequent munching, we ‘spoil’ the appetite and meal-time intake is somewhat lessened. When food is not restricted and when a person is allowed to eat ad libitum, thoughts of food and eating diminish and the mind is left to concentrate on more important and (gasp!) more interesting things. Our natural appetite and metabolism will ensure that our

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weight fluctuates continuously but always around a reasonable set-point. Contrary to the belief of some, food regulation is not the solution to life success. Not only that, conscious food regulation is generally unnecessary and counterproductive. Starvation and food restriction induces a preoccupation with thoughts of food. Even people without dieting disorders, if placed under strict food restriction (say in concentration camp conditions), can develop obsessive behaviours and thoughts about food. Restrictive eating triggers the urge to binge. Food-related dreams and fantasies are common in people whose food access is restricted, for whatever reason. Metabolism is altered during starvation, so that fewer calories are needed for basic body functions like breathing and circulation. This increased efficiency with energy utilisation continues when re-feeding begins such that weight gain is rapid and usually exceeds that which was originally lost. If the idea was to lose weight, the opposite will be achieved. Serial crash-dieters tend to gradually increase their weight despite strenuous and punishing attempts to decrease it. They also waste valuable time, energy and brain space. After eating in a highly controlled manner for a long time, reverting to ‘eating normally’ is much easier said than done. Lifting the self-imposed restrictions is difficult without going from one extreme to the other and in fact ‘losing control’ is the greatest fear for the chronic dieter or weight obsessed. ‘Once I start I won’t be able to stop!’, ‘I’ll be the size of a house!’, ‘I won’t fit any of my clothes’,

Formal exercise per se may be unnecessary for good health if a person’s lifestyle includes a lot of incidental activity or moderately physical work, be that vacuuming

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‘Everyone will laugh at me and I’ll be a social exile!’ These are common catastrophising thoughts of the wouldbe ‘normal eater’. These exaggerations need to be challenged and viewed in perspective against the alternative: chronic dietary restriction and yo-yoing of weight. Indeed, after eating reasonably regularly and normally (even if this requires some conscious effort initially), thoughts of food and eating decrease and weight balances out to eventually rest at the natural set-point for that person at that age. Of course this may be more (or less) than desired. But it ought to be accepted. Changing the size or shape of specific body parts, say thighs or hips for example, is another relatively futile goal. Exercise can tone muscle and increase muscle bulk but this will only persist for so long as the exercise is maintained and changes will be fairly minimal unless the amount and intensity of exercise is fairly dramatic. In the long term, the contours genetically predetermined will prevail. While exercise does accelerate weight loss by increasing energy output, it also tends to pique appetite. The amount of energy expended through exercise is not much compared to the amount of energy contained in the average snack and is minimal in comparison to the amount of energy required just to keep the body alive with low activity. It takes a lot of energy to alter weight even a small amount and weight may even increase with exercise due to the development of muscle which weighs more than fat.

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the floors, mowing the lawns, carrying the groceries, lifting small children or pets, washing the car, climbing the stairs, walking the corridors, cruising the aisles of the grocery store or trying on clothes! Even sex and masturbating can constitute significant physical activity. It depends how you do it. Some people who do little to no conscious exercise may still be highly physically active simply through constant fidgeting. These people may not realise it but they never keep still, squirming and readjusting in their seat, tapping their pen, jiggling their legs and changing posture. This kind of incidental activity uses up surprising amounts of energy and is fairly constant, with no effort whatsoever. It is probably a largely genetically predetermined tendency and efforts by non-fidgeters to become fidgeters and vice versa, are futile. Just hope you are not sitting next to a fidgeter during an exam (unless you are one yourself, in which case you probably won’t even notice). Being suitably physically active and eating ‘normally’ allows most people to effortlessly regulate their weight. These days, however, learning to eat normally can be an enormous challenge. Even conceptualising an idea of ‘normal eating’ that is remotely close to the real thing is near impossible for some. The food myths are entrenched from an early age and rigid ideals of body shape are imposed early and reinforced constantly. Thank God for Roseanne. In experiments in which young children are given free access to a complete range of foods, from meat and vegies to lollies, ice-cream and chocolate, researchers have found that in the initial period the children tend to gorge

Dave: We was strippers, only I couldn’t could I? Wife: Why not? Dave: Well look at me. I mean who wants to see this dance? Wife: I do Dave, I do. From the movie The Full Monty.

Top thirteen tips for eating normally: 1. Eat all foods in moderation. 2. Lose the idea that carbohydrates, sugars and fats are bad for you. 3. Eat a wide variety of foods. 4. Stop eating when you’re full. 5. Eat when you’re hungry. 6. Occasionally eat even when you’re not hungry.

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themselves on the foods that are usually forbidden: the cakes, biscuits and sweets. After a few days however, the children give up on these sticky treats and revert to what is essentially a balanced, nutritious, ‘normal’ and exemplary diet with only occasional and moderate intake of the high fat, high sugar foods. Adults can do the same. Hooray!

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7. Eat because you feel like it. 8. Don’t eat if you don’t feel like it. 9. Eat foods you like. 10. Don’t eat foods you don’t like. 11. Be open to trying new foods.

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12. Enjoy your food. 13. Enjoy your body: take advantage of it.

Skin deep

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s beauty more than skin deep? Appreciation of beauty is highly subjective. Different cultures have long created ideals of beauty with criteria based on such diverse features as tininess of feet and height of forehead. Traditionally, Chinese value the ‘watermelon seed’ face: that’s a face shaped like a watermelon seed, not a watermelon. Small mouths are prized, perhaps with the hoped for corollary being that a woman with a small mouth would be less likely to be a blabbermouth or harrying nag. (I myself am proof positive that volume and volubility are unaffected by modest mouth size.) Over the ages, with increasing globalisation of society, ideals of beauty have tended to merge into a very limited

The delusion that one’s life will be magically transformed by a tummy-tuck, bum-lift or tilted Meg Ryan snout

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range of beauty stereotypes such that it is noted that many icons of beauty such as models, actresses and television presenters have started to look remarkably alike. With the growing popularity and accessibility of plastic surgery, this trend towards clone-like resemblance between ‘beauties’ of the world is only likely to strengthen. Candidates for such surgery universally bring clippings of their favourite actresses and supermodels to the surgeon with requests for ‘Julia’s nose’ or ‘Linda’s eyes’ or indeed the more ambitious/delusional wish: ‘I wanna look like Barbie!’ Plastic surgeons have varying degrees of scruples when it comes to performing ‘unnecessary’ surgery on people with unrealistic expectations. Some surgeons do their utmost to discourage potential plastics patients, reassuring them that their existing nose/chin(s)/cheeks/eyes/boobs/bum/tum(s) are just fine and, moreover, match the rest of their face/ body perfectly. Others offer to makeover the rest of the face/body to match the one minor modification originally requested in a ‘Would you like breasts with that?’ fashion. The unrecognisable recipients of these creative ministrations stumble out with all their fat and gristle rearranged to the point where they hardly know themselves. Sometimes this is the basis of the problem. People who hardly know themselves let alone appreciating or accepting themselves are very vulnerable to external pressures to conform to a very narrow perception of physical beauty.

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encourages many starters who, post-surgery, find their lives largely unchanged apart from a sizeable bank debt (for the surgery and the new wardrobe of brassières and hot pants to show off the new apparatus). Many then focus on some other perceived physical fault and line up dutifully for another chop/lipotransfer in the hope that this modification will be the one that tips the scales of life in their favour. Dissatisfaction with surgical outcomes is frequent and to minimise disappointment surgeons take care in choosing patients (neurotics, histrionics and psychotics are not ideal candidates) and warn them scrupulously of after-effects, as well as giving computer-generated previews of what the final result should look like. Having Meg Ryan’s nose will not give you Meg Ryan’s life nor even make you look like Meg Ryan, particularly if your ethnic origins are Asian/Indian/ Middle Eastern. Complications, such as major infections, wound breakdown and reactions to anaesthetic, including death, rarely deter the beauty wannabe who, distracted by sunlit images of Pamela ‘Hollywood or Bust’ Anderson bouncing blissfully by, invariably presume ‘that won’t happen to me.’ Such complications are well-accepted risks of any surgery and taking such risks is clearly warranted when the surgery itself yields a major health benefit. The risk:benefit ratio is more difficult to calculate in cosmetic surgery cases since although risk can be assessed objectively, benefits are intangible and largely psychological. No amount of surgery can necessarily supplement devastating deficits of self-esteem. Second-rate social skills

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and work capabilities and deteriorating marriages are not problems amenable to surgery. Women and men have described feeling pressure to go under the knife in order to keep up a youthful or glamorous image for work. I have no doubt that the feeling they experience is real but to what degree this represents entrenched prejudice on the part of employers or misplaced insecurity on the part of employees, or both, is hard to tell. There is a tendency to undervalue or even take advantage of the vulnerability, naïveté and freshness that are at the heart of youthfulness and which are in many ways its most appealing aspects. On the other hand the physical attributes of youth are overvalued, idolised and idealised. This is to the detriment of not just the elderly who are compared negatively but also the young people themselves who are worshipped for characteristics that are beyond their control and essentially transient. To measure someone by their glowing skin, lustrous hair or lissom figure is extremely depersonalising. It is also highly threatening, when the acne and puppy fat of the teen years take their toll. Beloved pets are described first and foremost by their temperament, not by their shiny coat or healthy teeth. Elderly pets often gain a position of respect and deference in the household while elderly humans sometimes find themselves falling rather than rising in the household hierarchy. Venerable old Fido has it all over Granny, who is increasingly regarded as something of a nuisance. While very frail pets are tearfully put to sleep,

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elderly humans are sometimes subjected to indignities and inhumanities that make the pet’s fate seem like an enviable and merciful kindness. Even those anointed with the glossy features of youth can come to regard them as a mixed blessing, bringing with them, as they may, unwanted attentions motivated by shallow preoccupations. At the same time, if one’s identity is highly invested in these highly touted physical features, any minuscule change or loss may be perceived as devastatingly threatening. As Effie (Mary Coustas) once said: ‘Beauty is a curse. And I’ve got it.’ She was right. Youth, middle age and golden age: the inexorable progression is as intimidating as it is inevitable but the loss of firmness of flesh and acuity of vision should not be bemoaned. We each have the use of the body we were given for one lifetime and naturally, after four score years of use, we may find it battered and worn. The marks of time, those wear and tear scuffs and scrapes, are the badges of a life well-lived. They are the sometimes random, sometimes meticulous notes scribbled in a well-thumbed diary. Why should we worship the pristine white page over the dog-eared, curling manuscript with its hurried annotations, revealing doodles, intriguing prose and soaring poetry? We are, each of us, living souls trapped in a body not necessarily of our choosing. While the human spirit may be capable of increasing empowerment, growth and contortionist chameleon-like transformation right up until the last breath, the physical shell largely deteriorates, sags and finally snaps, regardless of remonstrations and efforts at rejuvenation.

Dieting disorders

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lim good. Fat bad. Skinny excellent. This about sums up prevalent attitudes today about body size. Once upon a time, calling someone skinny was considered a cruel insult. These days it may well express admiration, awe and envy. Despite the fact that scrawniness and emaciation are not in themselves sexy or appealing to regard, much less to touch, a lot of people, young girls especially, worship thinness, seeing in it the embodiment of strength, beauty and power. Relentless pursuit of thinness, however, commonly leads to dieting disorders which drain strength from the body, rob its beauty and leave the sufferer in a position of powerlessness as she fights uselessly against her own natural urge to eat, one of the most basic survival instincts of all. Anorexia nervosa and bulimia nervosa are two dieting disorders with high prevalence in Australia. Both conditions

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Investing in the sorry carcass is worthwhile in so far as it is needed to shelter and maintain the internal life spark. But it is this life spark that should be treasured, nurtured and admired. To do otherwise would be as foolish and vain as embellishing the envelope with little care as to the contents of the letter, or painstakingly, gorgeously giftwrapping a steaming turd.

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are marked by an obsessive preoccupation with body weight and shape, eating and food. Bulimia affects about one in six females, starting usually in the late teens. Anorexia affects about one in fifty teenage girls with a decreased prevalence in older females. Males are also affected with increasing frequency, but still far less than girls. Typically, with anorexia the main feature is voluntary starvation resulting in drastic weight loss. This is driven by the person’s morbid terror of becoming fat. Sufferers will go to extraordinary lengths to achieve weight loss, ignoring hunger pangs, exercising compulsively and using deceit and trickery to hide their weight loss activities from loved ones. Their existence becomes ridden with ironies: while on one hand they are fiercely proud of their weight loss, they usually hide their bodies in baggy, multi-layered clothing. This is partly to conceal the emaciation which draws negative attention from family and friends and also to keep warm: starving bodies are cold almost all the time. In fact the fine lanugo hair (a downy, thin coat of hair), which grows over the face, trunk and limbs in many cases of entrenched anorexia, is thought to be the body’s attempt to keep itself warm, bereft of the natural insulation of the fat layer. The anorexia sufferer may spend exorbitant amounts of time thinking about, buying, handling and preparing food but refuses to eat it. The obsession with cooking, grocery shopping, recipe books and nutritional information is fuelled by their constant hunger but they deny that they feel hungry and claim to have neither need nor desire to eat. The anorexia sufferer is frequently a perfectionist with an outstanding record of school achievements. They are often

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perceived by parents as ‘perfect’. As the dieting disorder absorbs their consciousness and energies however, not only their health but their studies, careers and relationships may deteriorate, in many cases irretrievably. It is always sad to see highly talented and motivated young people go down the gurgler, dropping out or significantly under-performing because all their talents and motivation are being directed towards the futile and self-annihilating goal of excessive weight loss. In some cases, overwhelming hunger may cause the anorexia sufferer to binge eat. This induces enormous guilt and remorse and sufferers punish themselves accordingly with prolonged fasting, vomiting or laxative abuse. Disgust and self-loathing may precipitate social withdrawal, depression and even suicidal thoughts. When the predominant behaviour consists of recurrent and uncontrolled bingeing and purging, with or without significant weight loss, the diagnosis is bulimia nervosa. Some people may go from anorexia to bulimia, with 30–80 per cent of bulimics having a prior history of anorexia. Whereas anorexia sufferers are grossly underweight, bulimics’ weight may fluctuate. Bulimics are often of average weight or may be slightly over or underweight. Coupled with the extreme secrecy of their behaviour, this apparent normality frequently allows their disorder to go undetected for months or even years. Bingeing typically involves consumption of alarming quantities of ‘forbidden foods’: chocolate, ice-cream, biscuits, pizza and other high fat, high sugar, calorie-dense foods that are regarded as fattening by the sufferer.

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During the binge the person feels out of control and may feel a sense of elation. This is rapidly superseded by extreme regret and physical discomfort from the abdominal distension and fullness, both of which prompt the desire to induce vomiting. In between binges the bulimic eats in a highly controlled and restricted fashion, sometimes fasting entirely or consuming at each meal less than half as many calories as the normal population. The resultant hunger triggers further bingeing. The binges may vary in duration but usually go on for an hour or so. They may occur daily or multiple times per day. On top of the time taken to buy, prepare, hoard (and finally regurgitate) the provisions, this represents an inordinate amount of time. On top of everything else it can also become extremely expensive. Physical symptoms of bulimia include loss of periods, swelling of salivary glands (giving a chipmunk face), dental decay (from stomach acid regurgitation), swelling of hands and feet, disturbed bowel habit, electrolyte imbalances (potentially causing heart problems, brain seizures, muscle cramps, liver and kidney damage) as well as nausea, fatigue, headaches, insomnia, hair loss, easy bruising, chronic sore throat and hoarse voice. Anorexics may suffer all the above as well as inability to concentrate or think lucidly, hypothermia (low body temperature), hypotension (low blood pressure), loss of sex drive and arousal, dry skin, abdominal pain with eating, dizziness, ringing in the ears, stunted growth, constipation, osteoporosis and potentially fatal abnormal heart rhythms.

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People suffering from either of these dieting disorders require thorough medical and psychiatric assessment and treatment involves re-feeding and weight gain for the seriously underweight, as well as extensive counselling to restore normal eating patterns and address distorted body image. In many cases hospitalisation is required. Usually the family needs to be involved in the sick person’s recovery. While it is profoundly important for the individual and her/his family to understand the condition and treatment, often until the anorexia sufferer has regained sufficient weight for the brain to function properly, any attempts to reason or work with her/him cognitively may be useless. The primary aim of initial treatment of the severely underweight person is to help her/him to regain sufficient weight to be able to think straight and cope with the challenge of therapy. Apart from addressing nutritional and physical requirements, a large part of the treatment involves challenging and modifying some of the person’s strongly held but erroneous and unhealthy ideas about weight, nutrition, body shape and identity. Learning what ‘normal eating’ is and how to do it sounds simple but can be painfully difficult for people with a doggedly fixed dieting mentality. Enlisting the cooperation of the patient can be extremely hard going. Anorexics in particular may strongly deny there is anything wrong with them and despite strong evidence to the contrary deny being underweight. They resist weight gain, resorting to all kinds of ingenious ruses to hide uneaten food or trick the scales (drinking a lot of water, putting weights in their clothes) and exercising secretly,

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even in bed. Far from wishing to put on weight, they would actually like to lose a few more kilos. Just as severity of the dieting disorder will vary markedly between individuals, so will outcome. Some anorexics recover in less than six months (70 per cent) but 15–25 per cent subsequently relapse and some eventually die from heart problems, infections, suicide or starvation. About 15–25 per cent remain chronic anorexics, never recovering, eventually dying of something else but having essentially wasted their lives plotting their next meal, or at least how to avoid it, and bouncing in and out of hospital. Some people recover to the point where they can function outside hospital maintaining near normal weight, but they maintain an abnormal preoccupation with food and dieting and continue their restrictive, obsessive and neurotic eating behaviours. So what causes these unfortunate, damaging and highly prevalent conditions? This will vary from one individual to another but broadly speaking, there are psychological factors, genetic factors, issues to do with the family and societal and media influences. Psychologically, dieting disordered people suffer profoundly low self-esteem. Feeling the need to validate themselves through achievement and externally evaluated excellence drives a cruel perfectionism whereby they are chronically dissatisfied with their looks, their performance or their relationships. Sense of identity may be underdeveloped and there is a great fear of being ‘not up to scratch’ or ‘just not good enough’. There is a desire for independence mingled with fear of growing up. Self-starvation is often

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their only means of asserting themselves and displaying control. Drastic weight loss becomes a way to avoid looking like an adult with the breasts and womanly curves that suggest sexual maturity. Some (but by no means all) people with eating disorders may have family dynamics that contribute to their condition. The parents may be overly intrusive and controlling. They may be excessively protective or demanding, perhaps placing overwhelming expectations on the child in an attempt to live their lives through their child’s achievements. Some parents treat their adolescent children like infants, forcing them into dependent and passive roles. Other parents may be highly critical, detached and unsupportive but nonetheless extremely controlling. The resulting family dynamics may lead to a child who is unable to assert her/himself and lives to please others, especially authority figures. The child feels the only way to express independence, protest or distress is by starving but lacks the assertiveness to actually say that that is what she/he is doing. The silent message is simply:‘You can control me and make me do what you want but I decide what goes in my mouth. At least I have dominion over this body.’ Currently society and the media tend to project an aesthetic ideal of the female form which is relatively curve-less and strictly fat-free. Unlike the busty, voluptuous come-hither sex symbols of yesteryear like Marilyn Monroe and Mae West, today’s icons of beauty are the reed thin, sometimes skeletal runway models who stalk imperiously, their gaunt faces wreathed in . . . haughty glares. Many people recognise that this thin shape is flattering not so much to the women themselves as to the expensive clothes

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that they are there to sell. Walking coat hangers and social x-rays: where would fashion be without them? Men are becoming affected increasingly. Whereas once a rotund tum was a sign of affluence and good living, thrust forward with pride, now it signifies someone who has ‘let themselves go’. The male ideal of lean muscularity is idealised by the media and some men go to extremes with dieting and bulimia to achieve fat loss while others become ‘gym junkies’ or ‘steroid junkies’ to build their pecs, abs and quads. Men in careers demanding particular body types (models, dancers and actors) are at risk as are sportsmen such as jockeys, runners, wrestlers and gymnasts. Gay men are also at risk since the gay scene often places great emphasis on physical appearance particularly the ‘hard body’,‘no fat’ look. Advertisers and image-makers are keen to create aspirational figures whose appearance is near impossible for the majority of society to imitate. By instilling the myth that ‘only if you look like this will you be truly happy’, they ride on people’s insecurity and gullibility to sell products that may be overpriced, next to useless or even harmful. There is ample scientific evidence that people who are within the healthy weight range (that is, with some healthy fat deposits in reserve!) live longer, are healthier and function better both physically and mentally. Being in the healthy weight range1 results in better longevity and quality of life than being slightly or moderately overweight but this overweight2 group still performs significantly better than the underweight3 group, which fares worst of all.

Each person’s genetic make-up determines her/his body shape and metabolic tendencies. Eating sensibly most of the time and remaining reasonably active will allow this physical potential to be optimised. The basic body shape and size can only be significantly altered by fairly drastic measures and if taken to extremes this is dangerous. If this desire to significantly alter the natural body shape is fuelled by the belief that it will lead to happiness, popularity and success, the vulnerable and desperate individual who sets her/his sights in this direction is headed for gross disappointment. The sooner we as a society and as individuals can explode this myth that ‘thin equals happy’, the better. Being thin doesn’t make you happy. And being overly thin doesn’t make you healthy. In fact it can kill you.

1

Healthy weight range: Body Mass Index (BMI) between 20 and 25 with BMI calculated as W/H2 kg/m2 (weight over height squared)

2

Overweight: BMI> 25

3

Underweight: BMI<20

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Fat: it’s not a four-letter word

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t’s not saying anything new to recognise that modern Western society gives fat people a hard time. The health risks associated with overweight — heart disease and diabetes for example — are one thing but the social prejudice and disdain are in many ways far more damaging. ‘Diet and exercise’ is the straightforward catchcry of the logical and sensible. ‘Just eat less’ sounds simple and effective but can be perceived as a cruel slap in the face to those who have struggled with this seemingly easy canon over decades of yo-yo dieting. While weight control comes easily to some, it can be a lifelong baneful burden to others for whom every failed attempt at slimming reconfirms their own sense of inadequacy and fated doom and inevitably leads to further weight gains. The dream of a cure, an end to the suffering and that much yearned for ability to eat every succulently tempting chocolate-coated bliss bomb conceivable without fatty repercussions: these are at the top of every plump to porky person’s wish list. So where are we up to in the search to fulfil those desires? Well liposuction is big business. Stomach stapling has had its day on the table. Even jaw-wiring has its advocates. But most people, however desperate, shy away from surgery and its risks. If only there were a ‘magic fat

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pill’, to melt away the rolls, the way a Lindt ball melts on your tongue . . . I get patients all the time asking sometimes lackadaisically, sometimes crazedly, for a pill to help them lose weight. Ironically, those making this request are often not remotely overweight. Sometimes they are frankly eating disordered and combine their stringent eating with copious strenuous exercise and the odd binge and vomit. There are ‘anorectics’ or ‘appetite suppressants’ available on prescription and often, once having had a taste of their speed-like, appetite-annihilating effects, people become psychologically if not physically addicted. Refusal of prescription on the valid basis that these drugs are restricted for short-term use, and even then only in the objectively overweight (‘feeling fat’ is not enough!), usually results in angry tantrums and desperate, urgent pleas. Often the person perceives a need to lose unrealistic amounts of weight in record time, e.g., ten kilos, by next week, for a wedding/audition/school reunion/hot date. Appeals to rationality may fall on deaf ears but sometimes a discussion of the root of the problem — be it faulty expectations or faulty lifestyle — may provide new opportunities for psychological as opposed to physical growth. With the arrival of a new fat-loss drug, orlistat (trade name Xenical), the phantom of you-beaut, effort-free slimming returns to haunt us. Miracle or mirage? Well probably a bit of both. Unlike the appetite suppressants, such as Duromine and Tenuate Dospan which simply suppress the urge to eat (which naturally comes back with a vengeance and usually some extra pounds of lard to boot, on stopping

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the drug), Xenical works in the gastrointestinal tract to inhibit 30 per cent of fat absorption. If you don’t eat any fat, you don’t need the drug. But if you didn’t eat any fat, you wouldn’t get fat in the first place. Side effects? Well since it only acts in the gut, there are no systemic (affecting the whole body) effects at all. But the gastrointestinal sequelae can be uncomfortable to embarrassing, largely depending on just how much fat is actually ingested. Eat little to no fat and you get little to no side effects. Eat lots of the stuff and prepare for nuclear fission. Dramatic flatulence, with or without liquid spurts, urgent diarrhoea or faecal incontinence and oily spotting (think of an old car that leaves oily discharges in the driveway) are the main detractors. But users live and learn. The oily, gassy emissions serve as a significant disincentive to overindulgence of the creamy kind. So who is this new drug for? Well for the reasonably wellheeled for one thing. At about $133 per month, cost alone may provide incentive to re-educate the palate to render the drug superfluous. It is restricted for use in those with BMI (Body Mass Index, a measure of body proportion calculated by weight in kilograms divided by height in metres, squared) greater than 30, or in those with other risk factors, a BMI greater than 27. So far, despite the intriguing and eye-catching ad campaigns, I have not been overrun with requests to try the drug, from the overweight or even the slender-but-fat-phobic crowd. Has our society been so successfully drilled in the ‘diet and exercise’ mantra that they perceive all such ‘lose weight, ask me how’ teasers as just so much snake oil? Are

Top ten mirages in the dieting desert: ‘When I lose weight I’ll be able to . . .’ 1. Wear anything I like (actually no, you’ll still be much the same shape, just smaller). 2. Eat anything I like (only if you want to experience déjà vu). 3. Date anyone I like (weight loss does not equal personality transfusion). 4. Hit Hollywood and give Julia Roberts a run for her money (yeah and Pretty Woman was a documentary). 5. Wear all my old clothes (be careful what you wish for: fashion time warps can be difficult to escape, besides what excuse

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the ads just too subtle and public awareness of just what is being hinted at, too low? Perhaps, discombobulatingly, the tables have turned and it will be left to the doctors to suggest, advocate and prescribe according to their perception of appropriateness and need, rather than being harassed and coerced by patients demanding the ‘magic cure’ they just know the doctors hold back from them out of pure peevishness. Miracle or mirage? Whatever’s the case, I call it a gain.

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have you then for the essential indulgence of retail therapy?) 6. Run like Cathy Freeman, swim like Ian Thorpe and dance like John Malkovich in Being John Malkovich (maybe in your next life).

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7. Stop wasting time worrying about my weight (weight maintenance can be just as challenging as weight loss). 8. Exercise wearing a leotard without embarrassment (think again — leotards spell fashion demise, whatever the size). 9. Improve my sex life. (Weight? Why wait?) 10. Stop making excuses for putting everything off until I lose weight (until you regain it; thank God for comfort zones).

Pap smears

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lot of women squirm at the mention of Pap smears. Particularly for women who have never had a Pap smear, the idea of it may seem intimidating, embarrassing and downright undignified. Most of us are used to the concept of seeing the doctor when we

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are unwell but the Pap smear is something we have to turn up for even when we feel perfectly fine, thank you very much. That’s because the Pap smear is used as a screening test. It’s designed to prevent the development of cervical cancer by identifying the pre-cancerous cells at an early stage, that is before they turn into cancer. More than 360 Australian women die from cervical cancer each year. The cervix is the neck of the womb or uterus, at the top of the vagina. Changes can occur in the cells of the cervix without causing any symptoms or pain. If undetected or left unchecked, these changes can progress to become cancer. Once actual cancer has developed, symptoms such as unexplained vaginal bleeding between periods and after sex may occur. However by the time these symptoms appear, the cancer has already taken hold and the chances of a complete cure are much reduced. The point of the Pap smear is to find early warning signs and treat them long before they have a chance to turn into cancer. Most cervical cancers take up to ten years to develop and regular Pap smears every two years can prevent more than 90 per cent of them from ever developing at all. So what causes cancer anyway? The fact is that no-one really knows exactly what causes it but research has shown that there is a link between sexual activity, particularly the number of sexual partners a woman has had in her lifetime, and the incidence of cervical cancer. Smoking and the presence of Human Papilloma Virus (the virus responsible for warts) are also known to be risk factors. The other big

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risk factor is age. That’s why it’s really vital for older women to have Pap smears even if they haven’t had sex for a while. The older you are, the greater the risk. The next important question is: just who needs a Pap smear? All women between the ages of 18 and 70 who have ever had sex (including lesbian sex) should have a Pap smear at least every two years and for those who start sexual activity at a younger age, screening should start within two years of first sexual intercourse. The test itself is simple and painless and takes only minutes to perform. If you have never had one you are bound to feel apprehensive so find a doctor with whom you feel at ease, perhaps a female, and take a girlfriend who’s been there, done that, for moral support. You will lie on your back with your legs bent and knees apart and the doctor will gently insert a thin plastic or metal instrument called a speculum into your vagina. This is designed to hold the vaginal walls apart so your doctor can see the cervix clearly. The doctor takes a sample of cells from the cervix using a tiny brush and smears them onto a glass slide. This feels slightly uncomfortable to some women while others feel nothing at all. No anaesthetic is required. The doctor may do an internal pelvic examination and breast check on you too, before sending the slide off to the laboratory for inspection under a microscope. There are usually about 300 000 cells on a Pap smear slide and these are carefully examined for pre-cancerous changes. Like all screening tests, the Pap smear is not perfect and occasionally abnormal cells may be missed. That is why it is so important to do the test regularly,

Depending on the type of abnormality present, your doctor may advise you to repeat the Pap test in six months,

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every two years at least, so that if by chance something is overlooked, it can be picked up the next time around. Sometimes other problems will occur such as too much mucus or blood on the slide obscuring the cells. Occasionally there may be insufficient cells on the slide for it to be satisfactorily interpreted. In these circumstances your doctor will let you know and ask you to repeat the test in 6–12 weeks, the amount of time it takes the cervical cells to regenerate. Your doctor may tell you that your smear has shown inflammatory changes. This simply means that the cells are slightly irritated. The irritation may be caused by an infection which may or may not be accompanied by symptoms. If the doctor detects an infection, this can be treated accordingly. Sometimes there is no apparent cause for the inflammation and you simply repeat the Pap smear in the usual way in two years time. Neither the ‘unsatisfactory’ nor the ‘inflammatory’ smear gives cause for alarm. They are not serious and are not an indication of pre-cancerous changes. Results such as ‘atypia’, ‘wart virus (HPV) changes’,‘CIN 1’ (also called ‘mild dysplasia’ or ‘low grade abnormality’),‘CIN 2’ or ‘CIN 3’ (both ‘high grade abnormalities’ known as ‘moderate dysplasia’ and ‘severe dysplasia’ respectively) do indicate that the cells of the cervix are growing in an unhealthy way, although none of these abnormalities is actually cancer. The more severe the abnormality, the less likely it is to go away and the more likely it is to get worse and eventually turn into cancer.

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or to have a colposcopy. A colposcopy is usually done at a colposcopy clinic or in a gynaecologist’s rooms. You will be asked to lie on your back as you did for the Pap smear and a speculum will be inserted. A colposcope, which is like a microscope or binoculars on a stand, is used by the doctor to examine your cervix. The colposcope itself never enters your vagina. The cervix may be swabbed with certain solutions, one similar to vinegar, the other iodine-based, which serve to highlight areas of interest on the cervix. A biopsy, where a very small piece of tissue is removed for subsequent microscopic examination, may be taken after which the speculum is removed and the whole thing is over. The process is not painful but some women find it uncomfortable to have the speculum in for the ten minutes or so that it takes. Some women experience a dragging or cramping sensation for a couple of hours after the biopsy, which is best managed by taking paracetamol. Avoid heavy physical exercise for 24 hours after a biopsy and it’s a good idea to leave three days before having sex again. Also avoid swimming, bathing and spas for three days. These precautions will decrease any risk of bleeding or infection. Once the doctor has confirmed the diagnosis on colposcopy and biopsy, you will need to discuss your options for treatment and ongoing follow-up. Anything from frequent Pap smears with colposcopic review to laser (destroying abnormal cells with heat from a laser beam), cryosurgery (destroying cells by freezing), diathermy (destroying the cells using heat), wire loop excision (scooping the cells out using a wire loop) or cone biopsy (removing a cone-shaped section

of the cervix containing the abnormal cells) may be recommended. All forms of treatment are effective but your doctor will advise on the best one for you depending on the type and extent of the problem in your case. These treatments do not affect your ability to fall pregnant or have children but it is best to have any abnormality checked and treated before pregnancy. If you are already pregnant when the abnormality is detected, Pap smears and colposcopy may be done in the first and midtrimesters and treatment, if required, will be delayed until at least eight weeks after delivery. At each step along the way your doctor can advise you on what follow-up is required and you should feel free to ask if anything is unclear. It is really important to have regular Pap smears regardless of whether you’re menopausal, whether it’s ages since you last had sex or whether you have symptoms or not. Of course if you do have symptoms, such as bleeding, discharge or pain, your doctor will need to investigate these anyway, even if you’ve recently had a normal Pap smear. By the way, Pap smears are not used for the detection of STDs. If you are worried about those you should discuss doing tests specifically for them with your doctor, usually in the same visit. One of the commonest reasons women give for not wanting to have a Pap smear is ‘If I’ve got cancer I don’t want to know’. The whole point of the Pap smear is to find changes before they turn into cancer. So if you don’t want to one day find out you’ve got cervical cancer, have regular Pap smears and follow them up according to your doctor’s advice, and hopefully, you never will.

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Keeping abreast of your breasts!

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s women, our breasts are very important to us, not just as another piece of our anatomy, but as a vital part of the way we see ourselves as feminine, sexual and maternal. When asked about their major health concerns, most women will cite breast cancer high on the list. True, breast cancer is the commonest form of cancer in women in Australia, affecting about one in fifteen women in their lifetime. But equally true is the fact that of the 400 000 or so women who visit their doctor each year with a breast change, more than 95 per cent will not have cancer. Obviously if you do notice a change in your breasts of any kind, it is vital that you see a doctor straight away so that it can be properly assessed and, if necessary, investigated. That way if it does turn out to be cancer it can be treated at the earliest possible stage, maximising the chances of a good recovery. If it turns out not to be cancer, the sooner you find out, the less unnecessary worry, discomfort and anxiety you suffer. So what kind of breast changes are we talking about anyway? Lumps, lumpiness, changes in the shape of the breast, dimpling or changes in the skin overlying the breasts, or changes in the lie of the nipple such as pulling or inversion, are some fairly common findings that cause concern. Sometimes one or both breasts may feel painful or just odd. Other times it may be only one area of the breast that feels

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uncomfortable. Another rather perturbing thing that is not uncommon is discharge from one or both nipples. Needless to say, when women notice any of these changes in their breasts, they are inclined to jump to the conclusion that they must have breast cancer. In fact breast cancer can indeed present itself in any of these ways and when you seek medical attention, the doctor’s first priority is to eliminate the possibility of cancer being the diagnosis. Of course in the vast majority of cases you will be reassured that you don’t have cancer and the cause of the changes you have observed may be anything from hormonal changes to cysts, fibroadenomas, fibrocystic disease, injury or infection. Glands in the body produce hormones, which make the breast feel different at various times during the menstrual cycle. Breasts may feel swollen, painful or tender particularly before your periods and these sorts of cyclical changes are not a sign of cancer. The symptoms may vary from month to month but if they are persistently troublesome your doctor can suggest treatments such as evening primrose oil or vitamins B1 and B6. A good cotton bra and a diet low in salt and caffeine can be helpful. When women reach menopause, or if they have their ovaries removed, they no longer have such hormonal breast changes. ‘Benign Fibrocystic changes’ or ‘fibrocystic disease’ are terms used to describe lumpy, tender breasts. This is the cause of most cysts and non-cancerous lumps and occurs in women whose breasts are particularly sensitive to monthly hormonal changes. Over months and years, the breast tissue

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gradually gets thicker, lumpier and more tender with cyst development. Fortunately this usually resolves after menopause. Infections of the breast, called ‘mastitis’, usually occur during lactation (breast-feeding), but can occur at other times. The main symptoms are pain, redness, heat, swelling and fever. The doctor will give you antibiotics and if an abscess (boil) develops, this may need to be drained. Nipple problems are common, ranging from bleeding, roughness or ulceration of the skin, to discharge, inversion or sometimes an extra nipple or two. Any skin changes need to be checked by your doctor as soon as possible as they could be a sign of cancer although it is more likely that rubbing or allergic dermatitis are to blame. Discharges are usually benign but still need to be followed up by the doctor. Cancer may be present if the discharge comes out spontaneously, without squeezing (‘expressing’), if the discharge contains blood or if you have never had discharge before, particularly if you are over sixty years of age. If none of the above characteristics are present, no tests are required in the initial period and you will simply be reviewed to ensure that the discharge ceases once you stop trying to express it. Nipple inversion is not a cause for concern unless it occurs as a new change. If your nipples have always been inverted, don’t worry. You will still be able to breast-feed and inverted nipples are just a variant of normal. Extra nipples usually occur under the breast, in line with the normal nipple or near the armpit. They cause no problems except during lactation when they become

Assessing breast cancer risk

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reast cancer occurs when cells of the breast grow and multiply in an uncontrolled fashion. This is thought to happen as a result of a change or mutation in the cells’ genetic material. Exactly what causes this is currently the subject of extensive research. We are, however, aware of a number of risk factors for breast cancer. Some of these factors such as age, sex and family

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tender in the initial feeding period. Extra nipples can be easily removed surgically if they bother you. Our breasts are so central to our concept of female identity. Whether we see them as erogenous zones or simply mammary glands for the purpose of suckling our young, they constitute a major sign of womanhood. Whatever their shape or size we should be proud and careful of them. Your doctor can show you how to do breast examination and you can do this each month after your periods. It only takes five minutes and will allow you to detect any changes as early as possible. If you find something, however minor, go to your doctor. It probably won’t be cancer, but the sooner you go, the sooner you’ll know.

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history are unalterable. We cannot modify them but by being aware of them, we can follow advice for increased surveillance thereby allowing for earlier detection. Certain other risk factors regarding lifestyle choices are modifiable and through recognising and changing potentially harmful habits, we may be able to minimise our risk. Unfortunately breast cancer is a fairly common disease in our community, affecting about 1 in 15 women in Australia in their lifetime. It can affect men too but much less commonly. About 1 per cent of all breast cancer occurs in men, starting usually as a lump in the breast tissue, which is generally easy to find since men’s breasts are so small. Men may be inclined to ignore such things, thinking breast cancer is an exclusively female property. While a man’s risk is 100 times less than a woman’s, he still needs to bear it in mind and if he detects a lump he needs to get it checked out straight away. Unequivocally, increasing age is a risk factor for breast cancer. A 70-year-old woman has a tenfold greater risk compared to a 40 year old. Most breast cancer occurs in women aged 40–80, but it can occur, albeit only occasionally, even in women under 30. Women over the age of 50 are strongly advised to undergo regular breast mammography every two years. The reason for this is that women over 50 are at greater risk as well as the fact that women in this age group have breast tissue which is less glandular and more fatty than younger women thereby allowing easier detection of cancerous change on x-ray. Young, highly glandular breast tissue is very dense which makes it difficult to reliably detect breast cancer on a mammogram in the under 50s.

Having had endometrial cancer (cancer of the uterus) or a previous breast cancer gives a woman an increased risk of

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Family history is another important risk factor, particularly if the breast cancer has occurred in a close relative at a young age (i.e., less than 50 years old) or if more than one relative on the same side of the family has been affected. A family history of ovarian cancer or sarcoma (bone or soft tissue cancer), particularly if diagnosed at a young age or in more than one relative, is also a significant risk factor for breast cancer. Recently several genes associated with high breast cancer risk have been discovered. BRCA1 and BRCA2 are the most notable. Potentially high-risk women can be referred to specialist genetic services to be assessed if they wish to clarify their genetic risk. If they are appropriate for genetic testing they will be counselled and advised as to the meaning and implications of the test and the results. It’s important to remember that while family history is a risk factor, about 80 per cent of women with breast cancer have no family history of it. The age of menarche (first period) and menopause (last period) are largely beyond our control, but unfortunately, may be risk factors for breast cancer. Starting menstruation before the age of 12 and finishing after the age of 55 may each increase the risk by one and a half and two times respectively. Never having had a child or having the first child late in life are also risk factors. The woman who has her first child before the age of 23 has one-third the risk of breast cancer compared with a woman who has her first baby at age 30. Breast-feeding for at least 3 months also has a protective effect.

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developing a further breast cancer. Again these issues are beyond our control. Lifestyle issues such as diet, alcohol intake and exercise are within our control, thankfully, but their role in breast cancer prevention is still a contentious one. Some studies have suggested that women who drink two standard alcoholic beverages daily increase their risk of breast cancer by as much as 70 per cent. Other studies have found links between high-energy intakes and increased cancer risk. High-fibre intake, particularly of soluble fibre such as that found in berries and oatmeal, has been found by some researchers to be of benefit. Specific foodstuffs such as soya bean and rye, which are high in phytoestrogens (substances in seeds, grains, fruits and vegetables that have chemical similarities to human estrogens), have been thought to play a role in breast and bowel cancer risk reduction. Japanese women eating a traditional high soy diet have one-fifth the breast cancer rate of women on a western diet. This rate increases dramatically if they emigrate to the USA and adopt a western diet. A diet low in animal fats has been thought to be beneficial in reducing risk too, as has regular exercise, at least 4 hours a week. The exercise need not be strenuous, in fact brisk walking is considered ideal. Unfortunately none of these lifestyle factor modifications has been conclusively proven to be of benefit in actually reducing breast cancer. Research continues and certainly there are undeniable benefits to general health (in particular cardiovascular wellbeing), from regular exercise and high-fibre, low-fat diet, but there is currently insufficient

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evidence linking dietary habits with breast cancer to warrant a public health nutrition strategy on this basis alone. Large-scale studies are ongoing and reports will be available from the National Breast Cancer Centre in the not too distant future. Similarly, links between the oral contraceptive pill (OCP) and hormone replacement therapy (HRT) and risk of breast cancer are still inconclusive, with some studies showing an increased risk, others a decreased risk! Some studies have shown HRT to be associated with an increased rate of breast cancer diagnosis but a lower death rate from breast cancer. Many believe that this is because HRT users undergo more regular breast-screening, leading to a greater chance of early diagnosis and early treatment, thereby resulting in decreased mortality. The jury is still out in regard to the OCP and HRT in relation to breast cancer, but the vast majority of studies show no correlation. And, given the various benefits of each therapy — including decreased risk of osteoporosis and cardiovascular disease for women on HRT, and decreased risk of pregnancy for women on the OCP — in most cases the potential benefits outweigh the possible but unproven risks. A sensible approach is to be aware of all the risk factors, including the controversial ones, to keep an open mind and follow the unfolding story as it emerges. Those with a strong family history of cancer should consult their doctor regarding suitability for genetic testing. All other women are recommended to perform monthly self breast examination from the age of 35, have annual breast

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examination with a doctor from age 40, and in addition, to have mammography every two years from the age of 50. The most crucial thing of all is to report any changes that seem suspicious to your doctor straight away. Any delay could impact on your chances of a good recovery. Beyond that, adopt a healthy lifestyle incorporating exercise and a low-fat, high-fibre diet, avoiding excessive alcohol intake. This in itself won’t necessarily prevent breast cancer but it will contribute to your overall health, vitality and wellbeing — and after all, isn’t that what it’s all about?

Abortion: whose decision?

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ne of the most heart-rending duties I perform as a doctor is counselling pregnant women who are contemplating abortion. The decision to terminate a pregnancy is never taken lightly by these women and inevitably they carry a burden of guilt. It is easy to judge these women and wonder how they became pregnant ‘by accident’. What is wrong with using contraception, one is tempted to ask. The fact is that often they thought they were. Figures from surveys of women undergoing terminations, regarding mode of contraception at the time of conception,

Statistics collected by FPA Health show that the commonest reasons cited by women undergoing

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reveal that 49 per cent of women were using some form of contraception at the time they conceived. The commonest forms of albeit failed contraception were condoms (22 per cent) and the pill (14.4 per cent). True enough, you have to wonder whether it was the contraceptive device or the user’s method that was faulty. True enough too is the fact that 51 per cent of times, no contraceptive at all was used. Often when I ask women what they think happened, alcohol or other inducers of faulty thinking are to blame. As with most accidents, just how it happened is often a bit of a blur. But one has to ask oneself, is everything in life meant to be planned? It has been said, I think wisely, that life is what happens to you while you are busy making other plans. Now obviously starting a new life is not ideally something that should occur by force of mere accident but the fact is that people often do not behave as cautiously or indeed as wisely as perhaps they should. Unplanned pregnancies are just one unfortunate result. Now given it takes two to make a baby and there are 90 000 abortions performed yearly in Australia alone, that’s about 180 000 careless people out there. If one of them was you, don’t be alarmed since you’re bound to be in good company: one in four women will have a termination in her lifetime. In fact one in every four pregnancies ends in termination. Now that we have established that terminations of pregnancy are extremely common, what is more interesting to explore is the variety of motivations behind the decision to terminate.

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terminations are financial — ‘can’t afford a baby now’ (60 per cent) — and to do with life direction, career and self determination such as ‘having a baby would change my life in ways I don’t want’ (38 per cent), ‘don’t want to be a single mother’ (29 per cent), ‘I feel I should establish my career before having a child’ (27 per cent) and ‘I am too young to have a baby’ (25 per cent). In older age groups (30–44 years), health considerations (e.g., high blood pressure) and ‘already have as many children as I want’ (20 per cent) were more significant factors. (Three-quarters of respondents listed more than one factor as contributing to their decision to seek a termination.) In cases where the woman makes the decision to terminate on the basis of determining what she believes is best for her life, termination becomes a life-affirming, selfdetermining issue whereby a woman takes her freedom and independence in her hands and decides for herself and her baby what is best. While it is unfortunate that a mistake has been made, it is a relief to the woman that the course of events is able to be diverted. She makes the decision knowing full well that it is irreversible but under the circumstances she feels this is best for her life overall. Any regrets she will live with just as she lives with any other life decisions she makes independently and with free will. In a number of cases, the decision to terminate is not motivated by the woman’s own desires for her life path. Rather, the decision is forced or at least strongly influenced by other parties. ‘My husband or partner doesn’t want me to have a baby’ was cited as the reason for terminating by 19 per cent of women. ‘Don’t want my parents to know I

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got pregnant’ was the reason given by 15 per cent and ‘my parents don’t want me to have a baby’ was the reason behind another 6 per cent. Such rationales are certainly less satisfying for patients and doctors. Doing something because your hand is being forced is always more traumatic and these ‘abortions by coercion’ are predictably the ones that lead to long-term regrets and recriminations. Although certainly these cases of women unwillingly undergoing abortions in order to keep partners or family happy are in the minority, they are undoubtedly still very significant and the lasting impact of their sorrow and pain has been documented by Melinda Tankard Reist in her book Giving Sorrow Words, in which she has collected the testimonies of a number of women who were extremely traumatised by their abortion experiences. I must say that in general practice I encounter a lot of women requesting termination of pregnancy and the majority of women do have few qualms about their decision although they feel regretful about the need to make it. The ones who stand out in my memory however are those very tortured few who are being pressured by partners, usually boyfriends rather than husbands, to choose between the baby and the relationship. The boyfriend has no intention of becoming a father at that time and is intent that she should not become a mother yet either. The woman is left with the difficult choice of letting go of the dearly beloved offspring of her dearly beloved boyfriend or becoming a single mum. It is a tearful and deeply upsetting scene. In most cases in my experience, the girl in such situations does terminate, against her instinctive wishes. These are the

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terminations that are mourned long after the anaesthetic wears off. These are the terminations that are coerced. And these, I think, are the terminations that probably should not happen. For the male in such situations, the termination is a quick fix and simple way of erasing a mistake. For the female however, there is no erasing the memory of undergoing a procedure to remove something you loved and wished to keep. Some men believe that, given that the baby is going to be half their responsibility and they can be legally bound to pay paternity, they should have equal say in the decision of whether to keep the baby or not. They feel that therefore they should be allowed to enforce termination so that the woman cannot force them to take care subsequently of a being they had no wish to raise in the first place. But it is not they who have to actually submit to the termination and live with the medical and psychological sequelae. Men who are absolutely adamant that they don’t wish to father a child should take absolute precautions with contraception and this is their prerogative. But once pregnancy has occurred it is no longer the province of the male to decide what the woman should do with her body. If a woman decides to terminate against a man’s wishes, similarly, it is beyond his control. He cannot force a woman to bear his child against her wishes. Just as it is the woman’s advantage or disadvantage to always have to be the one to undergo both the trials and thrills of pregnancy, labour and delivery, so it is her advantage or disadvantage to be the one who decides

Immortality and Euthanasia

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onestly, sometimes I feel like life’s pretty flat and not worth living. And I don’t even have a terminal illness that I know of. Maybe life itself is a terminal illness, given that we are born to die and nothing escapes death except that which never lives. Having children or creating timeless works, these have been ways of achieving a form of immortality. Cloning is now possible and if medical ethicists allow it we will soon be able to replicate our precious selves ad infinitum, the closest we have come so far to true immortality. Immortality. Who wants it? I must say I like the idea. My nemeses will cringe at the thought but I love the prospect of endless possibility. Possibility for success, happiness,

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whether to go ahead with the pregnancy if the desirability of a baby is in question. Termination of pregnancy is no picnic for a woman even when it is her decision and she is sure she doesn’t want the baby. Having a termination against one’s better judgement on the basis of emotional blackmail and coercion is a tragedy and sadly one from which some women never recover.

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amusement, learning, growth, deeper understanding, ability to do good deeds, create art (after a fashion), cultivate relationships, meet lovely people, fall in and out of love, build bridges . . . all these things are tantalising and exciting in prospect. Of course their corollaries and inevitable byproducts are less pleasant to contemplate: failure, loss, hurt, loneliness, disappointment, ill-resolved conflict, disease, disability, angst and regret. Such a succession, such a cavalcade of sorrow crushes the spirit. Fortunately the mixer of life’s cocktails usually combines the bitter with the sweet so that the unpalatable becomes strangely exotic and intoxicating and in spite of everything, we clamour for more. But not always. When the bad outweighs the good 100 to 1, to the point that you can no longer remember the last time you heard good tidings; when you can no longer recall how it felt to be pain-free; when regret and sorrow are eclipsed only by further prospects of regret and sorrow . . . at moments like these you need more than just Minties. Occasionally the call is for euthanasia. I have never personally felt the need for assisted suicide. Or suicide for that matter. But I can understand and respect the plight of individuals who do. When illness, disability and discomfort are profound and without hope of relief and when control, dignity and potential for self-actualisation are perceived to be irretrievably lost, death seems a kindly alternative. Suicide, unlike the ‘MASH’ theme song would have it, is not painless, neither for the subject nor his friends and family. Assisted suicide, in which all these players can

Euthanasia is in essence simply one end of the spectrum of palliative care, that is, care designed not to prolong life, since prolongation in such cases would be not only futile but tantamount to torture. The primary aim of palliative

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have a complicit role, can however minimise the pain and provide an exit that returns the subject to a position of dignity and control. Euthanasia is illegal. No right-minded doctor or palliative care worker actively participates in illegal practices. However there are ways and means of achieving the same ends, without perceived or perceptible criminality. Pain relief or even soporifics can be administered, with the patient’s knowledge, in doses that are known to hasten death. This can be negotiated and planned and, ironically, the prospect of this happy and timely finale can give the pain-addled subject something to look forward to, indeed something to live for. What gives incentive to life is hope and possibility. But possibility is merely the product of probability and in the terminally ill it does not take an SP bookie to calculate the probabilities. The question of whether euthanasia should be made legal is, to me, completely separate from the issue of whether euthanasia is or is not a good idea. By definition, euthanasia means ‘good death’ and therefore is something devoutly to be wished, in principle. In practice however, legalising the affair introduces potential for abuse by profiteers who have more interest in acquisition of worldly goods or unloading of burdensome dependants than in giving control, power and peace to the dying person.

care is to make the dying person comfortable and prepare them for a good death. Death is inevitable. If you’re gonna do it, do it right. If it’s sudden, accidental and unexpected, hope it’s quick. If it’s planned or expected, palliative care givers can help you make it as peaceful, painless and good as possible.

PEOPLE

Pandora’s BOX

Making passes

PEOPLE

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ntil recently I didn’t even know what making a pass was. It wasn’t until I read a book in which a specific interaction was described, that I finally got it.

Der. It was Louis Nowra’s memoir, The Twelfth of Never. One day as I was going to the beach to fish she grabbed my long hair and stroked it, saying ‘Long hair on you is cute’. In that brief moment I was aware I had two options. I could pretend I didn’t realise it was a pass or recognise it for what it was.

I read and re-read those lines. That was a pass? I had thought a pass was, like a football term, a physical action where a man, usually, would make a body grab with the aim in mind being to pash. The success of the pass would be determined by the extent of the pash. I had always wondered about these passes. I asked myself miserably why no-one made any at me. In retrospect what I was looking out for would possibly be more accurately described as attempted sexual assault. Nonetheless, I felt rather left out.

Dense? Cold? Frigid? I shuddered as I contemplated the conclusions my past pass-makers must have drawn. Just not

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Reading Louis Nowra’s words made it clear. In a blinding flash I realised: ‘Damn. All this time people have been making passes at me. And I didn’t realise.’ ‘Damn.’ I instantly rewound the tape in my head, pausing to go over and over various ill-defined moments that had remained in my memory, because of their provocative and arousing nature. Initiatives had been taken. Sidelong glances and semi-direct compliments had been paid. Nuances and innuendoes had been slid in my direction. I had successfully ignored them all. Damn! I immediately set myself two tasks. Firstly, to recognise any future passes, not only those sent my way but even any observed flying past as a casual bystander. Secondly, to start instigating as many such passes as possible. Preferably with reasonably specific and worthy foci. I had always wanted to make passes. But since no-one made any at me, I didn’t think it ladylike or even within my capabilities to up the ante and take the offensive. The idea of grabbing an alluring someone and attempting to insert tongue in cheek . . . foot in mouth was more likely. ‘Men don’t make passes at girls who wear glasses.’ I had concluded that this aphorism must extend to include contact lens wearers and in fact all the vision impaired: astigmatics, myopics, presbyopics and cataract-growers alike, regardless of severity. It was a mystery. How did these potential pass-makers even know I wore lenses?

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interested? Taken? Lesbian? The possibilities were endless and beguiling. I went from one extreme to the other. As is my wont. After believing I was a pass-free zone, enlightened, I began to perceive multiple passes zipping and zooming and squealing towards me from all directions. I was caught in a veritable crossfire! I could hardly walk down the street for a paper without gaining the flattering yet nonetheless discomfiting impression that everyone was falling in love with me! Not a single lid-lowered glance or raised eyebrow failed to catch my attention. The most innocuous conversation with bank tellers, male or female, about potential upcoming weather conditions, became in my mind, the most shameless and audacious come-ons. And of course I responded in kind. In short, the dry old tinderbox was aflame. Just call me ‘Cinder-box’. Needless to say, picking up on merely imagined initiatives can be a supremely unrewarding experience and I got my comeuppance soon enough. From being labelled ‘inaccessible’, ‘numb’, even ‘android-like’, I must now have become ‘presumptuous’,‘lascivious’, even ‘sleazy’! I pity those who were subjected to my relentless efforts to inject into the most innocent of conversations, lewd and prurient connotations. It was not really the reputation I had wanted for myself, much less that desired by my parents, who would have been distraught, had they been aware. Thank God I restricted my semi-lecherous activity to non-family-related social events. Buddhist monks were also spared. In my wisdom.

A guide to flirting from a certifiable failure in the art: Interpret as a list of caveats. (Precede each instruction by ‘Do Not . . .’ ‘Never . . .’ or ‘Under no circumstance . . .’) 1. Wear extremely low-cut revealing attire and interpret any raised brows as an approving encouragement to reveal more. 2. Spray on a lot of perfume. Imagine you are entering malaria-infested regions and it is only a weak mozzie repellent. But it’s all you’ve got. 3. Laugh loudly, frequently, for no obvious logical reason. Like attracts like. 4. Touch others uninvited, preferably below the waist. 5. The lip-lock is the Holy Grail of your quest. In the immortal words of Michael Jackson: ‘Don’t stop till you get enough.’

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Now, incompletely rehabilitated, I am cautious in interpreting and issuing any potentially charged messages. Wishful thinking is not the same as uncontestable proof. A smile and a wink is not a veiled invitation to co-habit with a view to marriage. Sadly. The bottom line is, if he hasn’t called, he’s not interested. But you can always call him, just to check.

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Infatuation

Seven predisposing factors PEOPLE

1. 2. 3. 4. 5. 6. 7.

Too much time on your hands. A sense of delight in the unattainable. Narcissism. A penchant for novels/films with happy endings. A penchant for novels/films with tragic endings. Chemical imbalance — chocolate, alcohol, E, LSD . . . Overactive fantasy life.

Seven danger signs 1. Every time the phone rings you calculate the chances of its being him . . . even if you know he doesn’t have (or want) your number. 2. You are exhausted from the taxing restraint of refraining from stalking him. 3. Your friends groan in a chorus as soon as you mention his name. 4. You resist using his name . . . because it’s too sacred . . . besides when you say ‘him’ everyone knows who you mean. 5. You recall verbatim every sentence he has uttered in your earshot . . . and have constructed 3–5 interpretations for each one.

OK, who’s never been infatuated? Stand up you rational robot. I’m gonna shoot crimson candied peanuts at your control panel until you scream ‘Danger Will Robinson! Danger!’Anything to rouse you from your torpid stupor! For who would be spared that most stirring, alternately enervating and energising of human conditions? What else can pique the senses, galvanise the mind and simultaneously sabotage basic bodily functions: sleep, appetite and coherent speech alike? Begin the ‘béguin’ I say. Let that tortuous, torturous dancing dervish whirl begin! So what’s infatuation all about anyway? It begins with a look, a glance . . . a voice that melts . . . a distinctive, disturbing aroma that envelops. There’s a fleeting facial expression as indecipherable as it is indelible. An invitation that amounts to a promise, however unintended, may be conjured from the most ambiguous of half-smiles. One moment’s fabulous flirtation fuels aeons of night and day dreams. Who would be so foolish let alone masochistic as to misinterpret genuineness for tenderness? So fatuous as to canonise on the basis of a bewitchingly turned upper lip? So giddy as to derive palpitating thrills from the incidental utterance of a name? Who would plummet from carefree, air-free altitudes of ecstasy to oppressive, suffocating

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6. You are convinced the mystery of your precarious future could be unravelled if only you knew just what he meant when he said ‘so I guess I’ll see you later . . .’ 7. While every axon in your central nervous system yearns for that next sighting, you also dread it, since with every encounter, the lack of reciprocity is confirmed.

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dungeons of despair on the basis of a single phone call . . . awaited in vain? Well anyone who’s human really. Some bodies just demand to be played with; some people unaffectedly ooze charisma; movie star good looks are not only safely confined to the silver screen. As long as such tantalising entities roam the earth, errant hearts will throb in their direction. And who can help it? Who would? Of all the ridiculous extravagances of which we mortals stand accused, infatuation must be the most divine and heady . . . and affordable! Or is there a cost? A price exacted in heartbeats and heartaches? In a parachute ride or even a free-fall from a skyscraper, the gravity game poses no problem at all until that delicate but inevitable encounter with terra firma demands to be negotiated. With infatuation, the fantasy is harmless and enjoyable, even exhilarating, right up until the inescapable clash with reality. What started as nothing more than a filthy desire to play with someone’s naked body may ripen into awe, admiration and profound respect or remain firmly rooted in lust. A friendship may develop or, nurtured by Eros, love. These are the serendipitous ‘gentle touchdowns’. Then there are the ‘rocky landings’: you discover the Achilles heel which turns out to be an Achilles hindquarter. The god you once worshipped is progressively demoted from demigod to demon. The disillusionment and crushing disappointment can be shattering. The urge to retreat into erstwhile dreams competes with the cynical conviction that ‘all men/women are bastards’ and you’ll never soften again.

All this is perfectly healthy and simply a sign of robust emotional fortitude and a resilient and elastic capacity to encompass extremes of passion. All of which will serve you well when next you stumble across an Adonis in Levis who leaves you panting. Finally there are the ‘emergency crash landings’. The ones from which no-one escapes unscathed. These occur when from breathless optimism burgeons anoxia-driven, delusory bravado. You fling yourself lemming-like at the object of devotion, that luscious phantom, and find yourself bleeding from newly discovered orifices at the base of that cruel cliff called ‘Rejection’. But that’s another story. Just remember: from each slow death, springs life renewed with unexpected vigour. From each excruciating deception will emerge a fresh and more exquisitely articulated dream.

Pandora’s BOX

Love at first sight

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absolutely believe in love at first sight although I acknowledge that love at second, third or even last sighting may be just as lasting and rewarding. The loveat-first-sight phenomenon occurs when two people see in each other the embodiment of their sexual fantasy or imagined ideal partner, whether or not they had ever consciously formulated or envisioned such an entity. The resultant mutual attraction is usually so strong they find themselves irresistibly drawn together. They may break swiftly with existing partners and from then on be inseparable. Often decades later they will still be as deeply in love, seeing in each other not only the person who stands there today but as with a prism effect, myriad reflections of the same person as they were at first sighting and at multiple other significant points that made a strong impression. These images are deeply imprinted not only because of their intrinsic beauty but because they correspond to preexisting ‘fantasy images’ hidden in the subconscious. They make a deep impression partly because they rouse a barely perceptible déjà vu feeling. For some people the fantasy lover has certain specific characteristics. Perhaps they look or behave like a hybrid of existing movie stars or known people. For others the fantasy lover is a being that cannot be described. They define the concept in the same way the American

A man might choose a ‘trophy woman’ with conventional, model-type beauty but his need for her may be related mainly to status building. Like a man who serves caviar for

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Supreme Court Justice defined ‘hard core’ pornography: they can’t describe it but they ‘know it when they see it’. When people, feelings or events are recognisable from dreams or the subconscious, their real life impact is multiplied. When the idea that ‘dreams can come true’ is reinforced, the childhood sense of endless possibility is rekindled. The ultimate gratifying and uplifting experience must be when real life and fantasy are imperceptibly merged. Early life experiences and influences mould and modify the fantasy lover concept. One’s first erotic experiences (from having one’s penis thoroughly and vigorously washed by a diligent and meticulous mother to being smacked barebottomed with wet rubber gloves by a strict nanny in a plastic apron) may have a lifelong impact on sexual fantasy activities. The media and our peers have a great influence on our consciously perceived sex symbols. Knowing that someone or something is highly sought or lusted after can make them seem more attractive in a ‘I’ll have what she’s having’ way, even if one’s natural preferences run in quite the opposite direction. The objects of our subconscious desires may be unrecognised or repressed. Having a penchant for women with say, large wobbly buttocks, claw-like hands, hairy armpits or thick eyebrows, may be so at odds with what one is culturally attuned to desire that one denies those leanings, making a beeline for petite, hairless waifs, wondering later why the animal lust and attraction is missing.

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show although his real preferences run to SPC baked beans and spaghetti, this person will either feel chronically unsatisfied or else be driven to have his other appetites sated on the side. Sexual fantasy objects are diverse and may seem inexplicable: scars, amputations, burns, tattoos, piercings, extremes of stature (giants and ‘little people’), facial hair (on men and women) — all these can arouse powerfully erotic feelings in some individuals. Commoner features of the sexual fantasy creature are well-formed breasts, shapely legs, rounded buttocks and long swirling hair. Muscular torsos, broad shoulders, tall stature and ‘tight buns’ are commonly considered attractive in the male physique. Porn mags and movies show exaggerated images of these stereotypes. The sexual fantasy figure may differ wildly from the person-I-see-myself-marrying figure. Well described is the ‘Madonna–whore’ complex where the wifely figure is perceived as nurturing and good but not truly erotic whereas the sex-hungry nymphet or virago is seen as slightly evil and treacherous but charged with eroticism. Indeed, if the wife varies from her designated role and starts to be sexually assertive or aggressive, initiating sex, pushing for experimentation and showing preference for wild, abandoned or unconventional activities, the husband, who may fantasise about exactly these qualities in other women, may react negatively or even punitively. For many people, fantasies remain in the realm of the imagination and there is no attempt to merge them with reality. The emphasis is on controlling one’s surroundings

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and establishing and maintaining routine. They may feel guilty about fantasising about other people while having sex with their partner but may find it difficult to get aroused and perform sexually without doing so. There is nothing wrong with fantasising about other people or even other species. A fantasy can encompass whatever your imagination conjures. We own these thoughts just as we own our own minds and should not have to feel guilty about them. Partners may feel threatened by the idea that they are not the ‘one and only’ but this kind of narcissism, while common, is not really healthy. We cannot own or dictate anyone else’s thoughts, feelings or fantasies and to attempt to do so is futile and rather selfish. On the other hand, feeling the need to ‘tune out’ one’s partner and concentrate on fantasy exclusively is not ideal either. Fantasy can enrich sexual relationships. Sometimes sharing fantasies can deepen intimacy. Sometimes it can destroy it. Either way however, if the sexual relationship is dependent on fantasies that exclude the partner, development of intimacy can be impeded, with the partner feeling left out or even exploited. If we own the right to have our fantasies and engage in fantasising during sex, we can expect our partner may do the same. We may wish to share some of these thoughts and keep others to ourselves. Most important is to appreciate the person who is no fantasy but living flesh and blood in our arms. To be able to share physical intimacy together is both real and fantastic and fantasy should be used to supplement not tune out that experience.

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The phenomenon of love at first sight means that one may find oneself living the fantasy. How lucky are those who get to do this. If you fall in love at first sight, mutually, you have the very best chance of lifelong bliss. Although living up to a fantasy may seem a near impossible challenge, maybe it is not so impossible for you!

PEOPLE

‘Mum, Dad, this is Trog . . .’ Meeting the family

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eeting the man of your dreams is just the first step towards achieving blissful harmony in your social life. The next major stumbling block comes when he has to meet the friends. This, however, is just a warm-up for ‘The Big One’: meeting the family. Whether you come from the Brady Bunch or the Addams Family, your clan is bound to have some oddities that, although endearing to some, may seem downright bizarre and frankly off-putting to the uninitiated. Right from the start you need to decide on your approach:‘warts and all’ or ‘window-dressing’. Most of us, if we really like the guy, will opt for the latter. You have to take a long, hard, honest look at your rellies. It can be a clarifying moment but there’s no need to linger

Carefully remove anything organic: two-month-old cheese sandwiches, coffee cups in which your parents are apparently attempting to cultivate their own penicillin,

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over it. Just try to be as objective as possible and visualise these people as an outside viewer might. Would you want to be related to them? Don’t be alarmed or disheartened. The only people who aren’t in the same boat . . . are orphans. Your father’s inch-long protruding nasal hairs are only a snip away from oblivion: ‘Dad, you look tired. How about a quick nap?’ Mama’s penchant for plunging necklines and no bra can easily be concealed by a flatteringly styled apron: ‘Here Mum, let me tie that on . . . nice and tight . . .’ or even a large bib, the excuse: ‘Spaghetti Bolognese can be sooo messy. You don’t want to spatter that glam frock, Mum!’ Obviously tidy up the main living areas, dining and kitchen areas, removing incriminating substances such as your brother’s festering collection of toenail clippings and Mama’s strewn about array of feminine hygiene products. Put them away where they belong, that is, anywhere other than the coffee table where they usually reside. Even if you are not normally the domestic type, this is the time to discover where Mama keeps the vacuum cleaner and how all those tubey things fit together. Have a quick whip round. The dual benefit here is in marshalling together all those fluffy dust balls and cockroach carcasses as well as gaining a legitimate excuse to move furniture around and check for potentially embarrassing reading materials (sticky porno mags or worse still, a sticky Britney Spears: Teen Idol mag). NB, don’t forget the magazine rack beside the toilet.

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mouse traps complete with mouse. You may find that the mysterious odours which have always intrigued you and made you feel at home, have all but disappeared. Any remaining aromas are likely to be emanating either from the cooking, the dog or the family members themselves. Without being obvious about it, sniff them out. It is usually a question of simply minimising offensive odours that are extrinsic (e.g., Daddy’s overly liberal application of ‘Old Spice’ or Mama’s excessive delight in her Avon delights) or masking obnoxious odours that are intrinsic (B.O.). If the later, try ‘Old Spice’ for Dad, and anything from Avon is sure to delight Mum. Titrate the dose against the nose. So now that the Munster household is well and truly transformed, you are ready to tackle the more challenging issue of making Mr Right look right. Once again, you have the choice of letting him appear au naturel, warts, tatts and piercings a-shimmer, or ‘modifying’ his look, to conform to your parents’ rather narrow aesthetic tastes (think Dr Kildare meets Richie Cunningham). Unless you want the meeting to turn into a confrontation in which your father is inspired to unearth his rifle and order ‘That punk, off my premises!’, you may wish to consider some subtle but artful changes. It is not dishonesty. He is still the same person. But just as Julia Roberts had to get a new outfit to powwow with the toffee-nosed in Pretty Woman, so the boyf’ may need some retail therapy in order to become palatable for your family’s consumption. T-shirts bearing evidence of his allegiance to heavy metal as a musical form, while colourful, comfortable and a sure-

This is where you act as social lubricant cum etiquette police. Try to find points of commonality. Perhaps your father and his potential son-in-law share an enthusiasm for golf, football, fine wine or simply getting sloshed? Perhaps your mother and boyf’ can discuss the latest developments

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fire conversation starter, should be relegated to informal occasions when they should preferably be worn inside out. Repeated washing with generous quantities of bleach may also increase their acceptability. Anything with ‘ventilation holes’ (i.e., rips) that were not part of the original design may also be considered unsuitable. As far as materials go, lycra, mesh, lurex and anything with sequins, beading, metal studs or spikes are unlikely to please on this occasion. Where footwear is concerned, insist that he does wear some. Ideally, the toes should be covered, particularly if he has a habit of wearing toenail polish. It is best, for the first meeting at least, that he refrains from painting his fingernails or if this is not possible, that he chooses a natural colour such as ‘clear’ or ‘buff’. Ask him to desist from eating whole cloves of garlic for lunch and when emitting gas from either end, to remember that discretion is key. Alas, all this attention to the externals will be worthless if the loved one cannot keep a civil tongue in his head or insists on eating with his fingers and wiping his greasy hands on the velveteen upholstery in an expression of disrespect for bourgeois values and property in general. Similarly, if the folks are intent on turning up the screw in their scrutiny, even Prince William, with all his fine breeding peeping through a flap of blond fringe, will be unable to pass muster.

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in their favourite soap and conjecture as to just why Joey and Dawson can’t get it together on the Creek? It is up to you to research such conversation fodder in advance and if necessary make a list, which could be posted surreptitiously under a vase or better still, written in indelible ink on your sweaty palms. Maybe your boyf’ has a number of show-off points which only require a brief introduction to have your parents stunned into submission. You could casually mention his scholarship year at Harvard or his work with Médecins du Monde. The ability to burp on command and fart to the tune of ‘Yankee Doodle’ should not be showcased here unless it qualifies as a point of commonality with your father, or, ahem, your mother. Some boyf’s are humble, with much to be humble about. Even this can be a quality about which to boast:‘Trog’s not in the habit of bragging . . .’ you can mumble, humble. The fact that he has never had anything to brag about can be subtly overlooked. Most boyfriend–family rendezvous take place at the headquarters: Mum and Dad’s place. Some believe this gives the home side an unnatural and unnecessary advantage. A casual style café or restaurant could provide a welcomingly ‘Neutral Territory’. While McDonald’s and Pizza Hut are charmingly described as ‘family restaurants’ in the ads, this is not what I have in mind in this instance. Choose a place where all parties will feel comfortable. Your own pad, shared with the boyf’ or not, is unlikely to be an advantageous meeting spot, filled as it probably is with evidence of your ‘housekeeping skills’ or pitiful lack thereof

as well as his pet snake (Snake-Eyes), rat farm (to sustain Snake-Eyes) and home brewery (to sustain self). Wherever the meeting of minds and souls takes place, just remember that if this relationship is going to be a lasting one (i.e., more than say two weeks!) there will be plenty of future opportunities to develop the rich tapestry of which this is only the initial thread. So relax and let things unfurl as they may. Broken crockery can always be mended and red wine stains bleached out. The most important point of commonality finally, is you. What draws the parties together and what will keep them striving to achieve a harmonious rapport is their shared interest in you. Allowing boyf’ and family to witness your loving regard for each will foster equally loving feelings between them. Or at least that’s the theory. Good luck — you’ll need it!

Pandora’s BOX

Mothers and daughters: the love/hate relationship that never ends

PEOPLE

Top 40 reasons why we love our Mums 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

It’s easy to rile them up just by swearing a bit. They know how to get stains out. They’re good at ironing. They rescue us when we lock ourselves out. They’re soft and cuddly. They sing good lullabies. They’re on our side. They can cook. They cleaned up after we vomited. They re-fed us after we vomited. They changed our nappies, all 4000 of them. They taught us how to wipe our bums. They praised us just for making it to the loo. They commiserated with us when we didn’t make it. They were charming to our school friends. They make sure the family never runs out of toilet paper. 17. They are interested in all our bodily secretions. 18. They save our bodily secretions in their handbags, to show the doctor.

27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39.

40. They love us unconditionally.

Top 40 reasons why we hate our Mums

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They cry when we get our first haircut. They never forget our birthday. They never forget our birthweight. They always think the best of us. They brag about us to their friends. They are always full of advice. They are sentimental. They can’t understand why people would want to see a movie like Pulp Fiction. So violent! They make good chauffeurs. We don’t have to thank them or pay them, they are just happy to serve. They don’t need sleep. We can call them at all hours for a whinge. Not much embarrasses them. They don’t blame us for their stretchmarks. Even if they almost died giving birth, they say it was the best thing they ever did. The older they get, the more eccentric they become. They’re not afraid to be brutally honest. The threats to kill us or disown us are never carried out. They rejoice genuinely over our victories. They get more disappointed than us over our failures. Their dreams for us always involve them beaming in the background.

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19. 20. 21. 22. 23. 24. 25. 26.

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1. 2. 3. 4. 5.

PEOPLE

6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22.

They always think they know best. They love to say ‘I told you so’. They’re so anal about keeping rooms tidy. They nag. They tell the same stories 20 000 times and still expect fresh laughter. Apparently we’ll look like them when we grow up. They comment on our table manners — always negatively. They listen in on phone conversations. They make snap judgements on our friends. They sulk. They won’t let us do stuff that ‘EVERYONE ELSE is doing’. They say ‘Well you’re not EVERYONE ELSE’. ‘Because I say so’ would not hold up in court as a valid reason for anything, but Mums get away with it. They were responsible for all the daggy outfits we wore as kids. They made us eat soggy cornflakes. They psychoanalyse us and say ‘I know you better than you know yourself!’ They use our pet names in front of our friends. They give us bowl haircuts. They manipulate us. They say ‘Oh I don’t mind’ but make it obvious that they do. They think all our problems are related to not eating enough vegetables. They always think we’re ‘burning the candle at both

23. 24. 25. 26. 27.

28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40.

ends’ just because we stay up till midnight occasionally. They always act the martyr. They criticise our dress sense. They themselves have appalling dress sense. They think they have the right to know everything about us. They talk about our most private affairs at the top of their voices in public places and then say ‘But I’m not talking loudly’. They don’t like our partner until after we break up with him, then they start to see all his good points. They bemoan how slovenly we are and blame themselves out loud. They tag all their arguments with ‘But don’t listen to me, I’m just your stupid mother’. They always think we drive too fast. They drive like snails and say ‘Better late than dead on time’. They love talking about ‘When I’m gone . . . ’ and how sorry we’ll be. They’re full of superstitions. They believe every urban myth going about contaminated water, food, air, you name it. We always seek their approval. They act dumb when it’s convenient. When they’re disappointed in us we feel like irretrievably big losers. They think they’re responsible for our survival up until now. They’re usually right.

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Love song dedications

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’ve got a request, and it comes straight from the heart: could we start this chapter with a quiz? Oh goody! Now, what do the following songs have in common: 1. Bryan Adams’‘Everything I do, I do it for you’ 2. Celine Dion’s ‘My heart will go on’ (theme from the movie Titanic) 3. Trish Yearwood’s ‘How do I live without you?’ 4. Boyz 2 Men’s ‘I’ll make love to you’ 5. K.C. and Jo Jo’s ‘All my life’ A. B. C. D. E. F.

Sky-high romance rating Inestimable emetic value Sincerity rating through the roof Zero sense of irony or comic insight Most popular requested songs on ‘Love Song Dedications with Richard Mercer, the Love God’ All of the above.

And the answer is, yes you guessed it: ‘F’ for . . . well you know what ‘F’ stands for! I was lucky enough to interview the Love God himself recently. What an enlightening experience that was. Love song dedications have always held a certain fascination for me you see. I have always wondered two things: first of all, why do people ring up the radio station to say ‘I love ya,

Shazza’ instead of just ringing Shazza direct and secondly, is that ‘Love God’ guy for real? What gives the Love God’s show its indefinable edge? Is it a sense of irony and comic insight . . . or some other unique quality?

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CP: Yeah, I really like listening to your show, especially when I’m driving home? [upward inflection] Some of the conversations you have with your callers are really funny. RM: Well, if you think they’re funny, I think that says more about you. People these days are so cynical and judgemental, I find. CP: [feeling chastened, guilty but unrepentant] No I just mean, sometimes it’s funny ’cos the questions you ask are, look, no offence, but, so obvious and the answers are pretty clichéd . . . RM: Look, I really think that just says more about you. CP: Oh.

PEOPLE

This of course instigated a lot of soul-searching on my part. I am ever one to be self-critical. When it comes to faults of character I am eminently suggestible. I will heartily agree on one hand with accusations that I am excessively naïve and gullible but when it is suggested that I am, as Mercer intimates, also a hard-hearted, jaded, ‘cynical and judgemental’ bitch who scoffs at the tenderloving expressions of others, I am quick to take that moniker on with equal contrition. It’s a hard life. But if there’s a bad personality trait skulking around without a

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soul in which to lodge, thorn-like, hey, it’s always welcome here at Panno’s! In discussing the show with Mercer, I notice with increasing bemusement, that the phrase ‘cynical and judgemental’ keeps popping up. It would appear to be his bête noire.

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CP: Look Richard, you keep bringing up this thing about being ‘cynical and judgemental’. Are you saying that everyone who thinks your show is funny, is cynical and judgemental? I mean maybe I’m cynical and judgemental but I can’t believe that all my friends are cynical and judgemental too, ’cos . . . they’re not! In any case I’m not saying we think it’s all funny, some of the calls are really touching . . . RM: Look hang on, I’d hate to see myself being quoted as saying that everyone’s cynical and judgemental . . . CP: Oh okay . . . RM: But there is a trend in radio talkback these days for shock-jock tactics which require putting the caller down. This is now the norm in talk format and I find it negative, destructive and cynical. CP: Yeah sure . . . but isn’t there a middle ground? There must be something between that and oozy, schmaltzy, saccharine sentimentality. I mean isn’t it possible to have humour and irony with neither cynicism nor syrup? You don’t have to go from one extreme to another . . . do you? RM: [jovially] Well maybe. But I prefer to do a show based on love rather than cynicism.

Okay, so now we’ve established one thing: yup, he’s for real. I spend the rest of the interview pestering the enduringly patient Love God, he of the reformed-rapier-wit, on ‘But why do they do it?’ to the point where he is good-naturedly responding ‘Oh, no, that again!’ But he won’t give up on me. He really is very kind and tolerant. Believe me. I’m a real pain and he put up with me. Amazing. CP: But why do they do it? I’ve got no problem with people saying ‘I love you’ but why do they have to do it

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Apparently Mercer wasn’t always the velvet-tongued smoothie of endless empathy that we know today. He was once hauled up in front of his high school peers and trounced by the Headmaster for having a ‘tongue like a double-edged sword’. ‘I used to be acid-tongued, sharp and critical,’ Mercer admits in that honey-cured voice. ‘I went to boarding school from the age of twelve, at King’s in New Zealand. That was the time of fagging and it was important to be tough. My defence was that I was a talker. I was a vocaliser. A monologuist.’ So what changed him? ‘Fifteen years ago, I had a breakthrough,’ he reveals, mysteriously. ‘I started reading a lot of self-help books and books about spirituality. I mainly read non-fiction because I read to expand my mind.’ (I internally writhe at this, mentally countering that fiction can expand the mind too, even more perhaps.) Mercer continues that he likes to ‘find out others’ viewpoints on what life is about. I like finding out what others think. I’ve been moderated from thinking I had all the answers. Now I realise how little I know. I was judgemental myself fifteen years ago. I’m not as much now.’

over the radio? Why do they have to share it with the general public? Isn’t that a kind of emotional exhibitionism? RM: It means a lot to some people to mass communicate their love. They know that it will mean more to their partner. Sometimes their partner has asked them to do it. Seriously weird if you ask me. But as Mercer says, ‘we’re all different’. The people who call are ‘people in love who aren’t inhibited about sharing that love’. I ask him, ‘If you weren’t, like, doing the show, y’know, um, like, would you ring up y’self?’ This’ll be telling, I think to myself. Sure enough, the Love God comes through. ‘If I thought I could trust the person taking my call not to be cynical and judgemental, I would.’ ‘But whyyyyy?’ I cry plaintively. ‘Because I believe in getting a more positive message out there. A message about what life is all about. I think it’s about love, romantic love. I believe in love and sharing those things.’ Oh God. I think he’s for real. So whether you’re feeling lonely, desperate, lovestruck, romantic or simply prostrate with lust, don’t be afraid to call Richard Mercer, Love God. Whatever your woes or joys, he will nurture, protect and encourage your vulnerable budding emotions. For better or for worse, his soothing baritone promises never to mock, tease or ridicule. He leaves that to the rest of us! Heheheehehehe.

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‘W

hat Christmas Means to Me.’ Who doesn’t remember writing compositions in primary school on this topic and lying through their teeth about Christian goodness and baby Jesus and how it was better to give than receive (Come again?) when we all knew Christmas really meant presents. Oh sure there were plum puddings, reindeer, jingling bells and the one-horse open sleigh, hey! Certainly. But most importantly, there were presents. When you grow up and have to take a bit more responsibility for these events, presents take on a new meaning: credit card debt. This dulls the sheen a tad but then there’s always that end-of-year ‘rage till you puke and let it all hang out’ to put the glint back in your eye: the Office Christmas Party. Some workplaces encourage you to bring partners (at your own risk). Hubbies and boyfriends can finally see in the flesh all the Karens, Jacks, Marks and Marges you’ve been bitching about all year long. Isn’t it infuriating when these office wart-hogs put on their best behaviour especially to impress your partner so that all your so-called ally can rustle up is a measly ‘Yeah, his hair did seem a bit greasy . . . but he seemed like a nice bloke other than that . . .’ His suspicions about your unnecessarily close relations with tennis champ Joel from Marketing can be confirmed (when he sees him in his fetching tennis shorts) or cast

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Xmas party

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away (when he discovers Joel’s horrific B.O. problem and the irritating way he snorts just before he utters each inane comment). Your partner doesn’t get much chance to snoop if he is on the grill himself, forced to chat to your immediate superior or worse still, his chihuahua-enthusiast wife. Seeing how hard your partner strives to be charming and prepossessing is a good way to judge how much he really loves you or whether he is just an insincere, backstabbing faker who is never on your side, ever. But perhaps scarier still are the piss-ups where partners are either not encouraged or actively prohibited from attending. You don’t want to be the only wimp who can’t go anywhere without the ‘other half’. You want to take the opportunity to mingle with the lads and lassies and build that all important camaraderie. Be it the photos that are going to adorn the pin-boards for the next few months, the anecdotes that’ll be passed on down the ranks, or the in-jokes that no-one else will be able to decipher, your attitude is unashamedly ‘I don’t know what it is, but I wanna be in it!’ The need to bond is a desperate one and never more urgent than at yuletide. It is in this spirit that one enters the fray, willing to lay it all on the line: dignity, self-respect, commonsense, position and reputation. It’s the one and only time in the working year when you are willing to grasp the hand of every and any colleague from top-dog to tea lady, and transmit genuine warmth, openness and cheer. Hey, it’s Christmas. If you’re going to ooze sincerity, make sure there’s lashings of it. Suddenly old prejudices are relinquished. Bygones

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are bygones. Your fellow man and woman are . . . well actually, kind of attractive. How is it that the legend of good St Nick has been so indelibly drummed into us (by the little drummer boy? Pah Rum Pah Pum Pum!) that simply by donning red garb and a beard or even just a fur-trimmed Santy cap, the meanest, surliest, laziest photocopy Nazi can seem well . . . kind of sexy in a rotund and Rubenesque fashion? It is these insidious and uncontrollable factors that lead to the much fabled and ill-advised flirty fumbles beneath the mistletoe and even more regrettable, the fire escape/ storeroom/ladies’ toilet, clothes off, make-up incriminatingly smudged, rough and tumble sex-rumble. Blame the eggnog. Blame the empty stomach. The preholiday jitters. The impress-the-execs anxiety. Blame the carols that addled your senses or the tinsel that dazzled you leaving you momentarily blinded. Blame it on the boogie, for all I care. Just decide: do you send in your resignation by international post or do you brave it and face the music? If the misadventure was a relatively covert operation — only you, he and maybe his sniggering, pimply sidekicks know about it — the damage is contained. Take a leaf out of the Clinton book and deny, deny, deny. If there are witnesses — e.g., you did it on the front lawn and someone was trying out his new digital camera (‘See, I do this, I can edit right here and then download onto my computer . . . drone, drone, drone . . . Say! Isn’t that va-va-voomVelma with Vlad from Accounts? Whoa!’) — then this approach has limitations. This is when you use the biological

arguments. Morbid PMT, temporary insanity, ‘he was wearing Brut’ . . . whatever, so long as you can establish that it was ‘beyond my control’. And get a medical certificate. Remember John Malkovich’s famous mantra in Dangerous Liaisons? Repeat ‘It’s beyond my control, it’s beyond my control,’ and maintain a straight face. If nothing else they’ll be intrigued. OK, now, let’s say what you did was not only reckless but broke new boundaries in idiocy and mortifying shamefulness. Twirling one’s black lace undies above one’s head is one thing. Hanging suspended upside-down from the chandeliers at the same time is altogether another. Stealing someone else’s panties and wearing them as a Zorro-style mask could also fall into this league. Madness alone is insufficient defence here. This is the time to bring in the obfuscator, the ulterior motive and the creative lie. Try: ‘You mean you didn’t get what I was doing there? Yeah, look that’s OK. A lot of people don’t understand performance art. I’m really ahead of my time. Van Gogh was the same.’ The selfless, loyalist ploy is another worth an attempt: ‘You know what I was doing don’t you? I was trying to draw attention away from Sandra and that hideously embarrassing dress she had on. I mean her boobs were just hanging out! I felt sorry for her. I know she’d do the same for me.’ If you don’t think your skills at impromptu invention are up to it, you can always rely on the faulty memories and compromised mental states of others. ‘You thought I did what? No way! Gee you must have been really out of it. I wasn’t even there when that was happening. My babysitter charges double after midnight. God. You guys.’

Pandora’s BOX

F

alling in love again and again and again is something you only get to do after having fallen out of love again and again and again. Nonetheless it is something I highly recommend. Like taking a bath in warm honey, it makes your insides feel like the caramel oozing out of a just-bitten chocolate Rollo. But what’s it all about and is it just hormonal? In order to feel lovey-dovey in the first place there are a few predetermining factors. You ought to be feeling pretty good about yourself for one. A sense of equanimity is a potent predisposer to attracting turmoil. You feel so good you treat yourself to a few trips out of the shell, just to have a look around. Lo and behold, there are attractive and engaging humans out there in throngs. You scuttle home panting with a glint in the eye and sure enough it all falls apart soon after. What can you do to save yourself major injury? Well for one thing, don’t take it all too seriously. Just behave normally and get on with whatever you were doing before. Be it ironing your socks or inventing the hands-free toothbrush, whatever you were busy with previously is bound to be more useful to mankind than engaging in what I call ‘telephone warfare’. Telephone warfare is like nuclear warfare in that very few shots need to be fired. It is the calculating and prognosticating that takes up most of your energy. This is what wears both you and the enemy down.

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Fallinginloveagain

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Exchanging telephone numbers is like a call to action. It means the games are on and short of changing your number, there’s no calling it off from here. A phone call made and a phone call not made: both action and inaction send potent messages. Unless it’s just because one or both are busy. The important point to remember here is that ‘no phone call’ is better than ‘bad phone call’. The bad phone call goes something like this: ‘Hi, it’s Steve here.’ ‘Hi Steve, how are you?’ ‘Good. You?’ ‘Oh, pretty good thanks. You?’ ‘Yeah, good.’ ‘Oh, good.’ Phone calls like this do nothing to advance positive impressions on either side. Each one rings off: wondering ‘What did she mean when she said “good”? Did she mean “really good” or more “okay good”?’ It can be a perplexing one. The issue of who rings first and when and for how long is a hoary old chestnut. Despite exhaustive research and extensive government funding, we seem to be no closer to finding answers to the questions that have plagued us ever since Alexander Graham Bell invented the dastardly contraption. Are phone calls just for arranging dates or can the phone call be a kind of date in itself? How early in the piece do you set limits for appropriate times for calling and being called? What are the punishments for subsequent transgressions?

Naturally my friends completely ignore these exclamations now. Some people say: ‘That’s not love, that’s just infatuation.’ I say:‘That’s not relevant, that’s just semantics.’

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The introduction in the past decade of the ‘Easycall’ function has created new delicacies in etiquette. Is it better to ignore the beep or risk losing one or both callers? If you take the other call, how long should the other caller be expected to wait before hanging up in a huff? If you are somehow ‘separated’, whose responsibility is it to call back? These seemingly subtle niceties can take on alarming significance in the establishment phase when egos are fragile and it’s all hanging by a thread . . . of saliva. The phone, the phone, the phone. One minute it is jangling furiously, wakening you mid-slumber to offer you a great deal in Life Insurance. (Once interrupted, those Harrison Ford dreams are devilish hard to get back into.) The next, it is smugly silent as you pace expectantly, metabolising at an ever increasing rate. ‘Why doesn’t he call?’ One of life’s most enervating enigmas. The answer of course is ‘42’. Falling in love is a very enjoyable state to be in and oddly nostalgic at times. Each time one falls in love one can’t help but be reminded of all the other times it has happened and wonder if one is simply being duped again. Just as I walk out of every good movie saying, ‘Wow. That was the best movie I’ve ever seen,’ I also gush, ‘Wow. This guy is the nicest guy I’ve ever met’ after every date that doesn’t end in tears.

Falling in love — the major risk factors: 1. Meeting new people. (Easy to avoid. Grimaces and scowls work well here.) 2. Feeling fancy-free and happy. (Just remember — it’s not worth it.) 3. Giving new people the time of day and maintaining an open mind. (See above.) 4. Feeling generous and uncharacteristically un-paranoid. (‘This too shall pass.’) 5. Not a lot on at work or worse still, on holidays. (Create busyness or at least impression thereof.) 6. Summer. (Go overseas.) 7. Recent messy break-up +/– desire for revenge. (Once bitten, twice bitten.) 8. Usual friends overseas or studying for exams. (Reflect on why you have so few friends.) 9. Something chemical — the active ingredient in chocolate, starlight and Prozac. (It’s the things we don’t understand that we should fear the most.) 10. Vulnerability and humanity. (Hard to put your finger on but you know it when you’ve got it. Strive to stamp it out.) 11. Anyone with any sense should strictly avoid all of the above risk factors for falling in love. Remember, prevention is better than cure.

There are two major categories of approach to the Dump. There’s the Band-Aid approach: the idea here is you get it over with in one fast motion, so it’s ‘ouchless’. Then there’s the one most of us cowards usually go for: the long, slow kiss-off.

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‘G

iving Someone the Flick’ is something only the Joan Collins/Alexis Carringtons of the world truly relish. For the rest of us, those with tender beating hearts, it’s a painful art we need to cultivate in order to perform with panache. Most of us have, at some point, been at the receiving end of a Dump. As excruciating as it all is, at least society and sympathy is usually on the reject’s side and the role is very passive, requiring very little shouldering of responsibility. With the Dumper, however, rests an onerous moral burden. Having all the power behoves you to use it for Good, not Evil. The issue of how to do the Dump depends largely on Why You Need to Dump. The reasons may be manifold. Perhaps you have simply fallen out of love, or more guiltinducingly, have fallen in love with someone else. Perhaps the whole thing is a misunderstanding and you never meant to get into an intimate squeeze with this Dumpee in the first place. These are the hardest ones to get out of in a way because not only are you saying that it’s over, you are also intimating, that for you at least, it never really started. This is a situation in which vagueness will get you everywhere.

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Doing the Dump

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Depending on the nature of the existing relationship, the long slow kiss-off may involve means as subtle as simply lengthening the time between dates until you find you are only seeing each other once a year. Or perhaps agreeing to communicate only via email, on the nights of a full moon. The disadvantage here is that it may take a long time to dwindle it down to such low frequency and in the meantime you may have to counter some awkward questions. You might continue the same frequency of rendezvous but simply limit the time spent. Instead of the date beginning with dinner and ending with breakfast, perhaps make an Egg McMuffin on the run constitute the whole date. The two of you simply ‘drive thru’, munch and skedaddle. Before the Dumpee knows what has happened, he’ll discover that not only are you now ordering different breakfasts but you are now ‘driving thru’ in separate cars. If that’s not a strong hint, I don’t know what is. Believe it or not, regardless of what you actively or consciously do, the Dumpee can usually read the writing on the wall before you even realise what you’ve scrawled. The waning love light in our eyes will give it away long before the first ‘I love you’ is deflected and when the flame is finally extinguished, the hiss and sputter, while possibly inaudible to us, sounds like firecracker night to the poor Dumpee who has to endure it. All you can do is try to be empathic and ‘do unto others as you would have them do unto you’, as Jesus, that well known heartbreaker, once said. There are of course exceptions to the rule. You may, for example, feel you are on a moral high ground and wish to

Portia in The Merchant of Venice (or was that Portia de Rossi in ‘Ally McBeal’?) said memorably: ‘The quality of mercy is not strained. It droppeth as the gentle rain from heaven upon the place beneath.’ I think she meant, ‘When it comes to being merciful, don’t stress and strain over it,

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teach the Dumpee a lesson. Perhaps the trigger for the breakup was the fact that you caught him en flagrant with your best friend/sister/mother/brother-who-was-not-previously-gay. In such cases, kid gloves are off and the idea is to be as inventive as possible. Have fun with it and make creativity your key word. Perhaps you wish to publicise his bad behaviour, using the available technology and his financial resources. Skywriting and banners trailed from blimps have a je ne sais quoi that seems to delight children and adults alike. Then there’s always the wonder and ease of email, especially inter- and intra-office. Many would say that Lorena Bobbitt went way too far, and I thoroughly agree, but there are other things that can be harmlessly lopped off. Start with his shirt sleeves. Then try shaving off just one of his eyebrows and while you’re at it, take a tip from Delilah and snip off his beloved ponytail. As far as the latter is concerned, you will probably be doing him a favour. Just make it the last. Ideally you want a situation where you feel avenged and he, chastened. Maybe he won’t be so quick to maltreat his next conquest. But before you indulge in this kind of Judge Judy justice dispensing, make sure you truly are justified. Nothing worse than carrying the burden of guilt as well as the sorrow of loss.

particularly in wet weather conditions when the roads are slippery and you might have an accident and end up in Heaven or, if you’ve been mean to your Ex, Hell.’

Top ten tips for dumping someone: 1. When you’re all alone, sharing an intimate moment, call him the wrong name. 2. When you’re with his friends or workmates, call him ‘Bozo’, ‘Idiot’ or ‘Einstein’ (the latter with an ironic sneer, of course). 3. When he suggests you sleep over, say bluntly, ‘What, here? What for?’ 4. When he suggests you could canoodle, simply counter: ‘Yuck!’ 5. If he says he’s offended, say ‘You’re offended! More like offensive! ’ 6. If he says he thinks it’s time to say good night, say ‘How about “Good riddance!”’ 7. If he’s still talking to you, for Pete’s sake, have a heart! 8. Kiss him on the ear and whisper ‘Let’s be friends’. 9. If that doesn’t clinch it, try ‘I need some space’ or ‘Let’s see other people’. 10. If he still hasn’t got the message, you need to go really easy. Either that or get an interpreter.

Anonymous woman quoted as epigraph to Fear of Flying by Erica Jong, 1975.

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he Oxford Dictionary definition of monogamy is ‘1. the practice or state of being married to one person at a time. 2. Zoology, the habit of having only one mate at a time.’ Fortunately these definitions leave open a power of loopholes. Being married to one person does not preclude mating with several others. Even having only one mate at any one time doesn’t rule out sex with multiple different partners so long as each is mated one at a time. Serial monogamy is a nineties term for having a series of sexual partners, one at a time, but it does not define how long one stays with each partner — one month, one decade or one lifetime. Cereal monogamy is highly prevalent amongst Iron Men. When HIV/AIDS hit the headlines in the early eighties, the word ‘monogamy’ was bandied about with abandon as being the only way to avoid the scourge. The idea was to have just one sexual partner to avoid high STD rates.

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‘Bigamy is having one husband too many. Monogamy is the same.’

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Monogamy

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These days with OneTel competing with Telstra and a number of other also-rangs, high STD rates are not so awesomely feared. Having your steady living overseas may nonetheless grossly inflate both your phone bills and your chances of straying sexually. Monogamy may be difficult to achieve, with level of difficulty being determined by a number of personal traits as well as circumstances: 1. Vast geographical separation (especially when combined with fear of flying). 2. Ample opportunity for sex elsewhere (e.g., one of you is lead singer in a famous band or regularly passes self off as such). 3. Low opportunity for sex with ‘steady partner’ (e.g., partner in gaol, in iron lung, in heaven). 4. Low chance of being found out (partner either extremely gullible or too preoccupied with own affair to care). 5. Frequent conflict (e.g., won’t share remote control, pay packet, bed). 6. Poor communication (you don’t speak the same language, literally, or you do but just can’t stand the sound of each other’s voice). 7. One (or both) partner(s) no longer sexually attractive to the other (e.g., transiently, when female is pregnant or when male has perpetual pseudo-pregnancy known as beer gut). 8. Mid-life crisis provokes need to prove sexual pulling power (e.g., you have recently lost job/hair).

This last risk factor is an important one, since it is such a trap. Often the issue of monogamy, sexual or otherwise, is not discussed but assumed. While one may be thinking monogamy equals bliss, the other may believe monogamy equals monotony. Some people separate sexual monogamy from emotional monogamy. It might be okay to have sex outside the core relationship so long as you do not fall in love. Sexual monogamy also has myriad variations. Exclusivity might apply only to actual intercourse. It might extend to cover kissing or any body contact, including hands. Even flirting with intent could be off limits. Each person has a different understanding, depending on his/her social, cultural, moral and religious background. First relationships play a hefty role in determining expectations in subsequent relationships. In that initial, formative experience, each one is to some extent learning from and modelling the behaviour of the other. The expectations and standards set in this early period remain and each new partner is, consciously or unconsciously, judged against the original prototype. Supporters of monogamy live by the philosophy that ‘When you’re on a good thing, stick to it’. Polygamists

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9. Recovery of potency after prolonged period of impotence (e.g., Hugh Hefner after he discovered Viagra). 10. Poorly understood or absence of mutual understanding of monogamy in the first place (e.g., pledged monogamy but had fingers crossed behind back — legally valid in some states).

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however may be motivated by the concept of ‘When you find something better, change’, or simply ‘the more the merrier’. All these rationales have merit. Biologically, one could argue that it makes sense for the female to seek a loyal mate to care exclusively for her and their brood. For at least the child-rearing years there is an advantage in monogamy for the female. For men, with the idea of genetic preservation and dissemination being key, the ideal would be to inseminate as many fertile females as possible. The male still demands monogamy from his females, however, since how else can he ensure that all those offspring actually share his DNA? But human beings are more than vehicles for procreation; biological urges need not hold primacy. These days, women do not necessarily want to have children and even if they do, may choose to bring them up independently. Some men do not have a problem nurturing another man’s child and loving it as his own. Biological rationales are insufficient incentives for many to pursue what is the sometimes arduous road of monogamy. So what makes it worthwhile if it is? Well certainly the issue of security regarding STDs and paternity is not inconsiderable. Then there is the fact that maintaining loyalty to one person may allow for the development of greater intimacy and trust. Concentrating one’s energies into one emotional and sexual relationship means that there is potential for a richer accumulation of experience and growth within that relationship. Then there are always those lucky couples who are so in love

with each other that no-one else exists anyway, rendering monogamy an inescapable imperative. For the rest of us, monogamy may seem like inertia. Not moving on even though you are not genuinely content with the relationship is probably masochistic and fruitless. Relationships need work sure, but they should not feel like all work, no pay, no play. Monogamy is certainly not the only way. Many couples negotiate sex outside the primary relationship or occasionally (e.g., Jack Thompson and his successful long-term ménage à trois with two sisters) manage to maintain more than one primary relationship. Monogamy should not be taken for granted as an ideal revered by all. It needs to be discussed and negotiated not only at the start of a new relationship but throughout the relationship as developments arise. Monogamy comes easily to some. It may seem impossible for others. There is no right or wrong in choosing monogamy over polygamy, but it’s best to let your partner know what you’ve chosen.

Pandora’s BOX

Dinks, Pinks, Sinks and Sins

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Dinks: double income, no kids Finks: kids Pinks: gays and lesbians Sinks: single income, no kids Sins:

single income, no sex

Dicks: double income, cum kids Sicks: single income, cum kids

Dinks

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he Dink lifestyle is often characterised as hedonistic and carefree with high disposable income. Unburdened by the responsibility and time-drain of child-bearing and child-rearing, Dinks can concentrate on their careers and enjoy lashings of ‘me’ and ‘us’ time. Couples with kids (Dicks and Sicks), wavering between self-righteousness and pure envy, sometimes label Dinks as selfish and indulgent, although this is really quite unfair. Some people choose not to breed for all sorts of good reasons. For others, the Dink condition is a default position, taken unwillingly as a result of infertility or other medical or circumstantial issues.

Dicks and Sicks, as Bridget Jones pointed out so . . . pointedly, are the biggest culprits for inducing a sense of guilt/inadequacy/utter barrenness in their Pink, Dink, Sink and Sins fellows.

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For others still, Dinkdom is a temporary condition. People need varying amounts of time to grow together as a couple and establish intimacy as well as differentiation before they have the maturity and mental (as well as physical) resources to raise families. Some Dinks revel in their freedom and take the opportunity to travel, advance their careers, pursue artistic endeavours and socialise. Parental and societal expectations that the Dinks will eventually settle and produce Finks can be perceived as a pressure, inducing guilt and sense of inadequacy, or alternatively as an opportunity to defy the oldies and give a stout finger to convention. Just because Dinks are Fink-free does not necessarily mean they are free of responsibility and care only for themselves. One’s offspring may not be the only beings that need nurturing and tending. Elderly parents, grandparents, in-laws, sisters, cousins and aunts, as well as nephews, nieces, neighbours and friends may all constitute part of one’s charge. Or not. In fact Dicks and Sicks may also be regarded as self-centred in the way they usually prioritise the needs of their immediate family (themselves and their children) and use grandparents, uncles and aunts as so much unpaid help. There is frequently a presumption that their children come first not only for the Dicks and Sicks themselves but also for anyone else who has the privilege of coming in contact with them.

Pandora’s BOX

Pinks

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The term ‘pink dollar’ was ‘coined’ to describe the impressive spending power of gays and lesbians. With their high proportion of Dinks and Sinks, Pinks are commonly stereotyped as being highly aesthetically aware, sensuously indulgent, flamboyantly fashionable and conscious of creature comforts. This discerning and demanding group are often typified as having a generous propensity to spend. Shop ’til you drop is in fact the slogan for an important and successful HIV/AIDS fundraising event. Perhaps indeed, the awareness of our mortality and the urge to ‘live while I’m alive’ has been heightened, particularly in this community, by the scourge of HIV/AIDS. One way or another, Pink power is seen as a vitally important consumer force and the Pink lifestyle, aka La Vie En Rose, is nowadays a choice that can be made proudly, defiantly and rewardingly. Sure there is inevitably still a degree of guilt at least at some point in the Pink person’s journey, but with respect for La Vie En Rose and all its charms well on the way to becoming universally established, who knows how far behind can be the advent of ‘Pink envy’?

Sinks While Sicks can lord it over Dicks, claiming superior Finkrearing capabilities, mocking the Dicks’ tendency to delegate Fink-fondling and Fink-feeding to nannies, grannies and bug-infested Fink-care centres, Sinks have a little more

Sins Scraping the bottom of the social barrel, we now examine the dreggy Sins. True, Sins can be disdainfully contemptuous of the unfortunate Nins (no income, no sex: think monks, nuns and most Finks), but finally, is that anything to brag about?

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trouble finding the higher moral ground from which to stare haughtily down on their Dink counterparts. The non-income generating partner in the Sink couple is bound to have to answer the stated or implied question of ‘So you don’t work, you don’t have kids . . . what the hell do you do then?’ Obviously it is a presumptuous and prejudiced viewpoint to assume that unless one has paid employment or Finkrearing duties one is a hollow, soulless, purposeless parasite. Perhaps the job-less Sink individual is pursuing an artistic career that has yet to pay cash dividends or indeed any dividends at all. Perhaps she/he has a strong philanthropic urge and spreads her/himself thinly across a multitude of charity functions. Perhaps the job-less one is just a touch lazy but at least has the sense to attach her/himself to someone with a big enough pay packet to support them both. Whatever’s the case, while Sinks probably have little justification for feeling either superior or inferior to the Dinks, unquestionably Sinks can sneer with snobbish glee at the Minks (meagre income, no kids) and the inexpressibly lowly Ninks (no income, no kids) aka NN (no nuthin’).

While an unprepossessing prospect at first glance, the single-income-no-sex individual does however have some remarkable advantages in life. They can attend innumerable weddings, christenings, engagement parties and toddler birthday parties, stag, of course, and spend intriguing hours shopping for appropriate presents. Having no practical knowledge of what marriage or baby care entail, they can amuse one and all with the glaring inappropriateness of their gift choices: e.g., ‘Itty Bitty Book Light’ for the newlyweds, fishing rod for the baby shower (perhaps the baby will enjoy fishing . . . or sashimi?) The Sins can revel in being set up for blind dates by well meaning rello’s and smugly sadistic Dicks, Sicks, Sinks, Dinks and Pinks. The female Sins may develop a côterie of male Pinks called ‘Girlfriend, Girlfriend & Girlfriend Inc’. The male Sins may develop a beer gut and a certain indescribable leering aspect. Sins veer occasionally (at least annually) into the territory of the SINS-T-S-O (Single income, no sex to speak of) which provides fodder for ‘GF, GF & GF Inc.’ conversation for the next twelve months at least, conversation peppered with ‘Bastard!’ and ‘Well, I’m glad I’m out of that! I’m well out of that!’, punctuated with mucusy sobs. Apart from obsessive re-readings of Bridget Jones’ Diary, Sins can also empower themselves by repeating the fortifying mantra: ‘Well at least I’m not a NINS!’ and by throwing themselves into their work, their needlework, squabbling with siblings and blaming their Mums. Jesus died on the cross to pay for our Sins. Much good it’s

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here’s nothing more tragic than losing a husband, especially early in the marriage. But it would seem that this is the fate of increasing numbers of young women today. More devastating still is the fact that these fair females are relinquishing their loved ones not to cancer, heart disease or work-related accidents, but to chronic conditions far more egregious in nature: golf mania, footy fetishism and the ‘Dreaded Computer Bug’. Around water coolers and café bars everywhere, women are bemoaning the fact that ‘If he’s not out wandering the greens playing bloody golf, he’s on the couch watching f**king cricket while I’m vacuuming the Corn Chip crumbs from under his feet . . .’ ‘Spends all day hollering his lungs out at the footy then comes home snores all night like a pig . . .’ ‘Goes fishing whole weekend comes home smelling like a sewer dumps the gear dripping all over my white carpet, should never have gotten that carpet spend my life trying to keep it from going entirely black he’s the one wanted black carpet seems like he’s determined to get his way one way or another . . .’ ‘Mine, comes home from touch footy absolutely starving. Makes a huge bloody mess in the kitchen that I have to clean

Pandora’s BOX

Hello young widows, wherever you are . . .

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done us.

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up . . . Then he wants to be thanked for doing the cooking!’ ‘Sounds pretty tame to me,’ thinks the most pathetic maiden of all, the Computer Widow (CW), cowering in the corner of the tea room. ‘I should be so lucky!’ she wistfully daydreams, before being thrust once again into her living nightmare. ‘Dinner’s ready darlingkins!’ our dauntless CW hollers into the mist. ‘Hmph,’ grunts her computer-bugged (CB) spouse. He’s in the middle of a game you see, playing ‘Doom’ over the net with a nine year old from Lakemba whose Dad eventually logs on with a message: ‘Jamie has to say g’bye now David. He has to do his homework.’ ‘Spoil sport fart of a Dad,’ the CB murmurs to himself as he bids Jamie a fond farewell. ‘We’ll play again soon, Jamie,’ he adds longingly. CB, despondent and hanging out for another game, drags himself to the kitchen for sustenance. ‘Doom’ can like, really take it out of you, you know. CW’s mood has curdled just as the lovingly prepared feast has cooled and hardened a little during the wait but the semi-estranged couple enjoy a little quality time over the cheesy macaroni. That is to say, while CW serves out the cheesy macaroni. As soon as CB’s plate is filled, he swiftly repairs to his keyboard and screen. Gotta check if there are any players out there up for a game. Any conversations with the CB must take place standing behind him facing the beloved screen, in between email gathering or enemy fire. Woe betide if you cause him to lose concentration and get destroyed! ‘Why do you have to spend [word ‘spend’ more tactful

CW retreats to the kitchen to stir her congealed cheesy macaroni. She sharpens her resolve to keep the computer terminal out of the bedroom. Her antennae had been tingling when she saw the small swing table move to his side of the bed. Then there had been the new power board

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than word ‘waste’] so much time playing computer games?’ CW whines when emotion fails her and she resorts to . . . reason. ‘One day when the aliens attack, it’ll be people like me who’ll be the only ones equipped to defend Earth. Then you’ll be glad I did all this training!’ he replies testily without a glimmer of irony. The ‘I’m only doing all this for you’ argument is a perennial favourite and, frankly, a real winner, usually. ‘But you don’t have a fighter plane . . .’ ‘Not yet. But they haven’t attacked yet either . . .’ ‘How do you know that the controls’ll be designed like your computer games anyway?’ Rolling his eyes at the ignorance of the Unenlightened, ‘You’ve SEEN Independence Day, haven’t you? Will Smith just jumps in the enemy spaceship and works it out! It’s obvious. You develop a Basic Instinct, a . . . a . . . a Sixth Sense . . .’ He shakes his head. If you haven’t got it, you just haven’t got it. Nothing that a whole lot of hours with a computer terminal couldn’t fix . . . most probably. ‘Independence Day was a movie,’ CW counters impotently. But the audience with her husband is over. He is now absorbed in the computer-generated art he has created with a sound card and is chortling to himself at the beauty of it. Ah. You can keep your Guggenheim!

and trailing leads. ‘Then I can log on as soon as I wake up!’ had been his logic. ‘And last thing before I go to sleep.’ She had dug her heels in so far. How long could she maintain her steely resolve? At least he’s at home. I have access to him at any time if I really need him. But he’s never really listening to me. The only way I can communicate effectively is if I send him an email. Then at least he’ll respond. By email, that is. CW listens jealously as her Widows’ Club moans moans moans about golf-playing footy-headed fly-fishing beerswilling cricket-fanatic Grand-Prix maniac TAB-betting porno-salivating husbands. ‘At least you’ve got him when he comes home! My husband — the only way I can get quality time with him is if I meet him in an internet chat room! And then I have to address him as “Vulcan”!’ she cries out passionately, unable to restrain herself further. Her widowed comrades’ eyes flicker from one to the other mischievously. ‘Hmmmmm,’ they think. ‘Sounds kinky!’

Some women may choose to join their partner for a game. Others may take the opportunity to pursue their own white rabbits: stretch class or yoga with the local guru,

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ne of the challenges of creating a harmonious partnership is working out not only how to spend time together but how to spend time apart. Early in a relationship, the amount of time spent together may gradually or precipitously escalate. You realise you kinda like each other and then that you can hardly bear to spend a moment apart. Fortunately, this period of interdependence passes. Negotiating how much time to spend together and how to spend it is really important. There’s good quality time — spent ‘communicating’ and doing pleasurable things — and then there’s bad quality time — spent arguing — but it’s all quality time. Compromising over how to spend time apart often brings couples undone. When Bob trundles gaily off to golf, Marlene may well be gnashing her teeth with resentment as she slams the front door after him. Certainly many a female has been known to cluster in corridor and coffee shop with her fellow female to bemoan the ‘golf widow’ state. Other women on the other hand clap their hands and kick up their heels with delight at the mere sound of his clubs being tossed in the boot. They know that while the cat’s on the green, the mouse’s life’s serene!

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Golf widows

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a spin at the potter’s wheel (increasingly popular since the movie Ghost), or the favourite: a natter with the girls. Unfortunately a common topic of conversation at these covens is ‘Why does my husband have to spend so much time playing golf?’ Capable, strong and highly independent viragos grizzle like babes when the subject of their husbands’ golfing penchant arises. They resent it. They don’t understand it. They hate it. Now why do some women so begrudge their partners’ golfing time? Well there could be lots of reasons but it’s probably all to do with the nature of golf itself really. See golf is purposeless from the hunter-gatherer point of view. It reaps no tangible rewards. On the other hand it brings the player satisfaction and fulfilment to the point of being quite addictive. Anyone can play and everyone can improve. It can become compulsive. It can be a social or a solitary pursuit but one way or the other, it represents A-grade quality ‘Me’ time. There is no question in the woman’s mind that he is going out there purely to ‘enjoy himself’. Not even a pretence of doing it ‘for the family’ let alone specifically for her. While on the green, which might be miles away, he is relatively hard to contact. Mobiles may be ‘switched off or out of service area’, besides, short of emergency, calls are highly unwelcome. Women’s pastimes on the other hand are usually of a different nature. There is almost always some genuine or pseudo-purposeful aspect to it. There is almost always a justification or excuse or at least a sense of compulsion to create one. Exercise classes may be fun and relaxing to a degree but there is also a health-and-figure-maintenance

Resentment of the partner’s golfing does not necessarily imply a narrow-minded killjoy nature. It is more likely an

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objective to be fulfilled. Shopping expeditions may have the underlying primary objective of increasing the glamourfootwear range, probably unnecessarily, but while out there she may also feel obliged to pick up some milk, bread, his dry-cleaning, pop into the post office for some stamps and while she’s there realise she has to send Aunty Bess, his favourite aunt, a seventieth birthday card on his behalf. She’s gotten used to signing his name for him! Outings with spawn in tow are again supposed to be fun and are undoubtedly pleasurable in a warm and woolly way, but nonetheless do not represent total relaxation from the cares of the world. She is definitely on duty, bearing responsibility for the gang. Probably, if he had to take the kids to golf with him every time, the pursuit of the small white ball might soon lose a lot of its allure. Over the past few decades roles have been modified marginally and some husbands have taken on more of the household and parenting responsibilities but the default position still leaves the female holding the nappy and the dishcloth. If He has chosen to go play golf, there is often a tacit understanding that she will not only stay home, mind the kids and do the week’s ironing but also have dinner ready when he gets home all hungry from the chase. The inedible-ball-chase that is. While she can probably stomach this, from habit if nothing else, expecting her to take a sincere interest in his incremental handicap improvements may be just enough to make her barf!

expression of righteous fury and indignation at the taking of a liberty by the spouse that the female feels unable to take for herself. Perhaps she cannot bear the thought of swanning out the door when there are so many home duties left undone and therefore grinds her teeth flat seeing him tramp off to golf oblivious to the front lawn being thigh-high despite her repeated reminders to him to mow it. ‘He can spend time playing golf but he’s got no time for his chores,’ she’ll moan to the girls, or else, ‘He’s like a race horse at the gate — can’t wait to get up and at ’em for golf but anything else: he’s too knackered.’‘How would he like it if I made time to go scuba diving but kept “forgetting” to iron his work shirts?’ That’s where the crux lies. Don’t get mad, get even. Better still, discuss the issue and compromise. Work out what you want to do that you have a passion for, that may be as futile and goal-free but fascinating, addictive and compulsive as his golf. For a few hours at least once a week, grant yourself total escape, to do whatever you like without any pressure, conscious or subconscious, to justify or rationalise your choice. Try to coordinate this with your partner and either get a babysitter for that time or make him the babysitter for that time. What’s good for the gander is good for the goose. The goose just has to learn to reach out and take it and the gander has to learn that it is better to give than to receive. At least sometimes.

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o I’m writing an instructive, reflective piece about sex and relationships. Never fear, the irony of this isn’t lost on me. Surely topics like these should only be tackled by those in certifiably functional relationships. Oh well. Anyway, trying to pick the brains of my fully-functioning friends on the topic of honesty, they respond with such solicitousness I think they suspect I’m secretly in a quandary as to whether to embark on some personal web of deceit. Well I’m not. In a quandary that is. I’m perfectly aware that my own love-life has been embroiled in deception since the day dot — from the first time someone with big brown puppy eyes said ‘I love you’ followed by a pregnant pause and I mumbled ‘mmmphft . . . erm . . . me too’ (subtext: ‘Gee I wish I felt the same way, maybe in time I could’ or more literally ‘Well I love me too’) to the last time I . . . OK here goes . . . faked an . . . well look everyone’s seen When Harry met . . . OK, OK so it’s out there. But really, telling lies about sex is a sex-chromosome-defined reflex isn’t it? The President didn’t exactly set the precedent here. Ask any man if he’s been having an affair and even if he’s mid-thrust he will reflexly deny it. The validity of such a response has got to be considered in the same sort of light as the response to questions like ‘Do you love me?’

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Honesty—is that really what you want to hear?

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(post-coitally) or ‘What do you fantasise about?’ (mid-coitally) or ‘Do you love me?’ (pre-coitally). Obviously in general, honesty is the best policy, but we have to be aware of the consequences. For example, if a swarthy someone comes to me and lisps ‘I am a hithman. I am on a mithion to eliminathe your brother. Where ith he?’, rigid honesty might be viewed as a distinct failure of sisterly duty. Similarly, there are other instances when people’s feelings might justifiably be protected. A dear friend’s boyfriend, on the point of final departure, revealed to her that not only did he no longer find her sexually attractive, the feeling fell just short of repulsion. It must be said that she provoked this exposition. (‘Are you saying it repulses you to lie next to me?’) Perhaps, you see, he could have lied. The fact is we all lie on a regular basis (and not just in our beds — boom boom!) Indeed psychological tests of people’s honesty and integrity are validity-tested according to their response to the statement ‘I never, ever, ever tell lies’. Anyone who responds ‘strongly agree’ has just told another one. But when is it permissible to lie? Well, to quote my father’s time-honoured refrain, ‘Well . . . it depends.’ It depends on the liar’s intentions and the likely consequences. Are they lying to protect someone’s feelings? Is the lie-recipient (lie-ee?) absolutely unprepared or incapable of bearing the truth? Or are they lying to shield themselves from the lie-ee’s wrath/rejection/ revenge? What is the likely consequence of the truth remaining veiled? Is this consequence harmful to anyone,

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and if so to whom? Will this be the beginning of an increasingly tangled web? It may be that one party is simply not in a position to handle the truth at this stage. A dear friend of mine, who is gay, is not entirely ‘out’ to his parents . . . yet. He says he is not even out to his workmates although having seen him in full flapping action I find it hard to believe that they may not have twigged. Indeed once, before his workmates arrived at a party at his place, he sternly warned us (we, a côterie of straight females and str’acting — that is ‘straightacting’ for those of you who never read the personals — males) to ensure we acted very straight because he was still in the closet at work. I countered: ‘Well, I think I’ll be OK since I am straight; and as for the guys, well I think you better hope they act as camp as possible ’cos that’s the only way you’re gonna look comparatively macho.’ Maybe his workmates would muse ‘Mmm, we thought he was camp . . . but look at his friends — now that’s camp!’ So you should only deceive if you can reassure yourself that you are not doing it for merely (merely?) selfish reasons and that the consequences are worthy of you. And when do we want to be lied to? Well there are a number of situations when hopefully we can rely on our true friends to lie graciously and seamlessly, such as when we ring, sounding desperate, at odd hours and ask frantically ‘Ooh, did I wake you up?’, or when after a horror haircut/injudicious perm we wail ‘How long do you think before it grows out?’ Equally questions such as ‘Do I look really fat?’ and ‘Is this pimple very noticeable?’ can safely be answered creatively. Some questions such as ‘So isn’t my new boyfriend, Thuggy,

just dreamy?’ merely invite reflective listening. I find ‘Well you certainly seem to like him. What is it you like about him?’ works for me. Be prepared for the rave about Thuggy’s virtues which are often something of a ‘vibe thing’. You may remain unconverted but showing interest is what counts and your failure to field a personal opinion will slip by unnoticed. So, when don’t we want to be lied to? Well basically at all other times. Candour is truly what we crave. Don’t treat us like weakling babies who can’t stomach reality. Don’t protect us from crushing truths when what won’t kill us will make us stronger. And certainly don’t lie to us just so you, you snivelling bastard, can continue to get away with it. Important truths will eventually out and our latent wrath will be all the more mighty for being stored up (think Mount Vesuvius). So now you know when to lie to me and when not to lie to me, all that remains is for me to stop lying to myself . . . P.S. Don’t do as I do, do as I tell you to do.

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here are few experiences more demoralising, crushing yet humanising, than full-scale Rejection. The more unexpected, the more sudden, the more brusque . . . the more devastating. From the annihilation of self-worth resulting from not being cast in the school play to the wounded pride and unsatisfied lust of Sexual Rejection, the feeling is a major downer, second to none. True success is arguably only experienced in the lofty, rarefied atmosphere of ‘life’s lottery winners’. Rejection and consequent dejection on the other hand, unify us all in a common body: losers in love . . . corporate rejects and redundants . . . sporting fumblers and failures . . . those destined permanently to eat lunch alone in life’s playground. But is this a group with which anyone wishes to identify? I think not. Never at the time of humiliating defeat have I wallowed pleasurably, musing ‘Ah . . . what a welcome rival is the bitter over the sickly sweet!’ Never, when a tentative but hopeful ‘How ’bout it?’ has been met with the legendary ‘Let’s be friends . . .’ have I rejoiced in that piquant frenzy of passionate needs unmet. Never, when shifting from one Dunlop-Volley-sandshoed foot to another, scanning the grass for four-leaf clovers and ‘plum puddings’, have I leapt victorious at the realisation that, once again, no-one wanted me on their softball side. No, each time the excruciating deepening of self-knowledge has been as unwelcome as it seemed uncalled for.

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Getting Dumped

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‘Why?’ The cry echoes mockingly through the hollow caverns of the soul. ‘Why not . . .’ ‘What if . . .’ ‘If only . . .’ ‘Maybe . . .’ As ‘denial’ emerges, after jostling with ‘shock’, ‘anger’ and ‘bargaining’, (à la Elizabeth Kubler-Ross’s stages of grief), we may go through a phase of inappropriate glee and insouciance. The loss of pride makes us feel surprisingly unfettered, extraordinarily free even . . . until we realise just what we have lost, no more, no less, and we plod slowly, leaden-of-foot, towards sober acceptance. So what does it take to achieve a sound and unequivocal Rejection? Well for a truly satisfying, hearty, wholesome and flattening one, you need to start off with at least some delusion that success is possible. With Sexual Rejection, there ought to have been a glimpse of a promise at some early stage, be it in the form of a barely arched brow or a lingering sidelong glance. To make your Rejection genuinely memorable the blowoff might preferably be: ■ ■ ■ ■

public vigorous vehement, emphatic and repeated just at that point when you have your blouse threequarters of the way off.

The one who has the honour of repulsing your inept social/sexual advances may do this in a variety of ways: ■

roughly, rudely, with unprovoked invective and poorly restrained physical aggression;

■ ■

■

■

Of course the very worst of these, which one prays never to encounter, is the last. For such luscious ‘sweet and sour’ dishes simply leave you panting for more. ‘At least give me something to hate!’ you cry. ‘Let me abhor you and feel that at least one part of me has rejected one part, albeit small, of you!’ No, these last ‘gentlemen’ are actually the most savagely inhuman of them all. For in fobbing us off they only succeed in securing yet more enduring devotion. And that is what we must strive to overcome! To be a ‘Successful Reject’ (if such an oxymoron is permissible) one must attempt to serially reject those parties which have rejected us and cast them henceforth from our minds (and our beds). Let us call it officially ‘The Sour Grapes Policy’. Those of you who are familiar with Aesop’s fables will remember the fox’s immortal words when, after much

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■

mercilessly, with sadistic psychological cruelty; with dismissive arrogance, haughty disdain and smug, presumptuous conceit; with snide and abrasive condescension; with disturbingly expansive, off-hand delight. The unapologetic message is as bright and breezy as it is cruelly and incisively clear; with feline caprice and subversive petulance. A taunting, teasing ‘No, yes . . . no . . . maybe . . . but then again . . . no’ is as ambiguous as it is tantalising. This mercurial thrill-seeker cannot help but mingle heartless flirtation with compulsive deceit; with winsome gentleness, generous sensitivity and selfdeprecating, good-humoured charm.

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■

salivating and leaping up at the grapes which dangled just beyond his reach, he finally deliberated ‘I bet those grapes are sour anyway!’ This opportunistic self-deception can be most productive when suitably employed. Just to get you started we could try: ‘I didn’t wanna be in that damned play anyway. Shakespeare is for pansies.’ Or similarly: ‘All people who play softball are brain-deads. I’d much rather get my exercise pacing the bedroom floor seething/putting hexes on my classmates/collecting bindieyes to put in the catcher’s mitt.’ Once you get into the swing of things, so to speak, you are ready for the far less puerile joys of: ‘He’s obviously got no taste. I would’ve been wasted on him. Look at the slag he’s with now. By the time he realises his folly it’ll be too late . . . this little Maria will be firmly and finally ensconced in one of Vienna’s better nunneries.’ OK so let’s face it. However agile your mental shenanigans and warped attempts at self-deceit, rejection’s the pits. Just try to put it into perspective, learn what you can and ‘ava bit of a larf’. You deserve it and so do your friends.

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ejection itself can be a simple matter requiring few words and sometimes as little as an arch expression. It’s what goes on before and what comes after that makes or breaks. Now have you ever been dumped? We could be talking anything from the decadelong (although it seemed much longer) relationship that ended with an unworn white dress in mothballs . . . (yeah you know, the guy-you-thought-you-were-going-to-go-greywith who instead has just made you prematurely grey) to the guy who never called after one night of ecstasy (chemical or otherwise). Not to mention the guy who did not dump-you-afterhaving-used-you-for-sex . . . who in fact refused to use you for sex and wouldn’t let you use him for sex either. Still some not-outs? OK, ever been turned down for a job/pay rise/promotion? School play/sporting team? Dolly magazine ‘search for a supermodel’ competition? NO? Not invited to Tori Spelling’s birthday party? OK let’s go right back — missed out on a seat in musical chairs? NO? Sarah O’Hare-types, you’re the only ones still shaking your heads in confusion.

Pandora’s BOX PEOPLE

Rejection Revisited: what to do and what not to do when you’re dumped!

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We’re talking — Melbourne Cup Day 1998, you bet on the wrong horse (Tie the Knot wasn’t it?) — how do you feel? OK now multiply that by 150 000. Yeah. Real bad. So whaddya do? Hold your horses — let’s start off with what not to do. On pain of sentencing to ‘serial reject-ship’, rejection-recoverers must not: 1. Obsess. This includes obsessing about not obsessing. 2. Indulge in compulsive behaviours: Mars-barmarathons/smoking several ciggies simultaneously. Nailbiters — stop before the elbows. Trichotillomaniacs (for the uninitiated: tricho=hair, tillo=pulling) — at least spare the eyelashes and eyebrows. Manic house-hygienists — please abstain unless you happen to be my houseguest. 3. Make exhaustive lists of ‘things to feel thankful for’; e.g., ‘Well I’ve still got most of my teeth,’‘At least my cat loves me’. These will only make you feel more pathetic. And in this polyester and acrylic world, how are you going to ‘touch wood’? 4. Think how perfect it would have been if it had worked out. Ditto for thinking ‘Well at least he/she loved me once . . .’ 5. Ask the dumper repeatedly ‘But why?’ 6. Stalk him/her. 7. Ring up ‘Love Song Dedications’ and hope he/she is listening. 8. Place soppy Valentine’s message in Sydney Morning Herald.

10. Meet someone called ‘Trog’ in an Internet chat room . . . agree to visit him/her in Norway . . . and elope. 11. Spread nasty rumours about the dumper making sure they reach dumper’s:

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9. Move back in with your Mum.

b. boss c. mother d. potential new girl/boyfriend. 12. a. Turn gay/straight/bi (whatever you weren’t before). b. Turn ‘tri’ (willing to try anything). c. Turn ‘pre’. Turning pre-sexual is the most serious form of sexual regression. Also known as ‘born again virgin syndrome’. 13. Join one of Austria’s better nunneries. (It worked for Maria!) 14. Join the police. You won’t stop with ‘Book ’im Danno’; you’ll make sure he/she gets a comprehensive bodycavity search as well. 15. Tell everyone you actually dumped him/her first. The giveaway here is that you are crying. 16. Globally regress. Thumbsucking, bedwetting, speaking in a baby voice with frequent ‘Oo yucky!’s ,‘Um aaah!’s and assorted quotes from the ‘Teletubbies’ will ensure you get plenty of attention. You’ll either embarrass the dumper or make him/her feel incredibly guilty. 17. Develop an eating disorder — great for the allimportant attention-seeking. 18. Gain a lot of weight (look what it did for Liz Taylor).

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a. friends

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19. Lose a lot of weight . . . all from your face/neck/bust (think Mary Tyler Moore/cadaver). 20. Moan a lot about stretchmarks. 21. Obsess about hair loss/grey hairs (we’re talking scalp here). 22. Bleat a lot about excessive hair growth (we’re talking lower face/upper body . . . in women). When people say ‘What’re you on about?’, demonstrate extensively but refuse to do anything about it. 23. Finally dye it . . . luminescent orange. 24. Shave it and repulse people with the stubble when you insist on kissing them . . . in the French way: left/right/left/right/left. 25. Jump straight into an ‘on-the-rebound relationship’. 26. Find some obsequious sucker type to do the dump on yourself (Feel the Power). 27. Become very cynical. Wear black widow’s type gear to your friends’ christenings/weddings/engagement parties and talk loudly about pre-nups and how divorce takes years off your life. 28. Insist that being a loner is ‘in your genes’. You yourself were actually the result of a lab experiment by a hermitscientist type. 29. When you go to shake new acquaintances’ hands, forget palm contains: a. knuckle dusters b. can of mace with which you ‘accidentally’ squirt them c. mucus — you have a cold. 30. Start wearing voluminous maternity/Quaker/Demis Roussos pre-diet-type clothing. The lure of the body is just so false.

BUT SERIOUSLY FOLKS . . . concentrate your mind and spirit on what to do: 1. 2. 3. 4.

Get on with your life. Put things in perspective. Re-acquaint with friends. Put away all pictures of him/her/the two of you . . . especially anything bigger than 10"x8" or in which you/he/she is smiling.

5. Meet new people but not necessarily with a view to potential relationship. 6. If his/her name comes up, limit yourself to one sentence and less than five expletives.

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31. Gradually discover that these clothes are fitting rather snugly. Let them out. 32. Don’t get dressed at all. Just traipse around the house all day sprouting dialogue you heard on ‘The Bold and the Beautiful’/ ‘Party of 5’ (especially Claudia’s). 33. Pretend you have cancer. The ‘guilt’ card: it’s indispensable (see ‘Party of 5’ for authenticity tips). 34. Pretend you have a serious STD. This gets at both the ex and his/her potential (not for long!) new squeeze. 35. Make nuisance calls at times when he/she is likely to be: a. asleep, b. in bed with company, not asleep. 36. Fax bombs are easily created with a loop of paper . . . all for the cost of a single phone call. 37. Email bombs are an abuse of the technology. 38. Remember that these are the things not to do.

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7. Letters/cards/CDs/tapes/dried rose petals . . . put them where they ‘can’t hurt you any more’. 8. Think realistically about his/her/the relationship’s shortcomings. 9. Enjoy your independence and freedom. 10. Start doing all the things he/she discouraged/prevented you from doing. 11. Live a little! The night is young and so are we . . .

Trust

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he other day I got home and blazed across my mindscape were the words: ‘Trust is overrated. 99.9 per cent of times, it is totally unwarranted.’ It must have been a bad day. ‘I’m gonna write about this,’ I snorted to myself. ‘Yeah!’ Then I reconsidered. ‘People will think I’m a sourpuss misanthropist sent to earth to spread ill will. Very unbecoming.’ Like it or not, polite society demands that ‘love and peace’ should be your bywords, not ‘suspicion and vigilance’. But if you ask me, it’s best to be armed with all four at all times. How we trust and how this is flung in our faces! The degree of disappointment is directly proportional to the extent of trust outlaid at the outset. Expect nothing and

Yes, in a way, I probably get a warped view of life and relationships because I tend to be the port of call once things have gone wrong. I see the guilt and shame that racks the offender, who then wants to be screened for sexually transmitted diseases. ‘Test me for everything!’ is the usual

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get nothing: no hard feelings. Expect the world and get chunk of earth with worms in: feel distraught. In relationships, it’s classic. The more you put yourself out on a limb, the more discombobulated you feel when that limb is unceremoniously lopped off. Getting hitched is a major trust undertaking. You declare love and devotion and swear it’ll last as long as you both shall live. Not only that, you do it in front of all the people who could razz you for it afterwards. You even sign bits of paper. But even without the written contract, starting any kind of presumedmonogamous relationship is an extension of trust. How do you know it’s really monogamous? Many private detectives spend their days and nights in the pursuit of answers to this very question. But even they can’t always be sure. If you see ‘Suspect A’ having an affair, you know they are having one. If you don’t see ‘Suspect A’ having an affair, you still can’t be sure they aren’t having one. But the more you go on making decisions based on that trust and presumption of monogamy, the more you feel peeved and sociopathic when betrayed. The decision to stop using condoms requires a leap of faith. He has to trust that you’ll keep popping your contraceptive pills. You have to trust that your partner won’t be sleeping around and bringing home infectious nasties. At the surgery all the time, I see the casualties of such trust misplaced.

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catchcry. ‘Even if I bled you dry there wouldn’t be enough blood to test you for everything. But 10 ml, some urine and a swab up the you-know-where should be ample to test you for the STDs,’ is my cheerful and hopefully comforting response. I also witness the distress and anguish of the one whose trust was abused. These moments of torment are seared into the memory banks far more indelibly than the frothy stories of ecstatic love and happiness. (Besides, who goes to the doctor merely to report that they are blissing out? Manic depressives in full-blown mania aren’t even that silly.) It makes me a wary one. In a way, once the trust has been blown, at least you know where you stand. Once betrayed you know it’s for real. It serves no-one to pretend they have deceived you unless they really have. On the other hand, for as long as you still trust someone, you could always be wrong. It’s never in the other party’s interests to let you find out what they are really up to. Spoken like a true paranoid. No wonder I am still single, or as has been levelled at me recently, terminally celibate. In my personal experience I have never actually been ‘cheated on’ as the expression goes. (Not to my knowledge anyway.) No, my feelings of misplaced trust are more to do with when I feel let down by the people I expected to be able to hold high in my esteem. The people I wanted to trust: superiors at work, directors, teachers, relatives and, yes, friends and lovers. For me, the breakdown of trust is when someone I thought to be honourable and far-sighted turns out to be underhanded and petty. When I look to someone for guidance and direction and the advice they

Top ten things we wouldn’t need if we could trust everybody: 1. No need for locks, bolts, safes or security passes. (No more locking yourself out of the house or locking your keys inside the car.) 2. No need for keyrings, since no need for keys. (An end to an industry that survives on kitsch.)

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give me is contradictory or clearly invalid, I am dismayed. When I wait expectantly for someone to come through with something I consider vitally important and they let me down, brushing it off as inconsequential, I feel aggrieved. In truth, for me trust has little to do with sexual misdemeanours. It is more to do with people living up to my expectations, which are always set high. I want and hope for people to be as wonderful, honest, principled, loyal and incorruptible as I think they are. I do give people the benefit of the doubt. That’s why I am so regularly disappointed. I trust without realising that’s what I am doing. That’s why I am always surprised and ‘shocked to my very foundations’ when my trust is betrayed. I hope I am never so cynical and hopeless that I will cease to be shocked and appalled when my trust is abused. I wish that people would always expect the best from me and really let me have it right between the eyes if I let them down. Trust me. If I let you down, bust me.

3. No need for burglar alarms or car alarms. (No more being kept awake in the wee hours by an alarm that keeps going off that everyone ignores.) 4. You’d write your PIN on your keycard. (No more sweating in front of the ATM, feverishly plugging in random digits after you’ve forgotten your number.) 5. We could ditch the blindfold in ‘Blind man’s bluff’. (No hope whatsoever of pinning tail on donkey.) 6. Banks would leave the money on the counter for you to take at your own discretion. (No more queues at the bank.) 7. No need for speed cameras or red-light cameras. (People would just turn themselves in.) 8. No need for lie detectors. (Scientists could stop working on the ‘truth serum’ and start work on the ‘youth serum’.) 9. No bars on the cells in the gaols. (Decorative mobiles and macrame pothangers could replace the austere looking metal bars.) 10. No need for suspicion, vigilance, wariness, doubt or scepticism. (Paranoid schizophrenics would have to find a new disorder.)

1. Sexual abuse: any unwanted sexual overtures ranging from intercourse to forced body contact (i.e., touching your breasts or genitals, forcing a tongue in your mouth, forcing you to touch or fellate him). Any sexual contact that is unwilling or coerced or succumbed to through threats of violence or blackmail, is sexual abuse. It’s no longer about eroticism or intimacy, it’s about power: abuse of power. 2. Emotional abuse: mental and psychological torment that could range from unrelenting barrages of insults to repeated accusations of infidelity or deceit. Emotional abuse encompasses any kind of degradation, denigration or threatening, however subtle or insidious. Possessiveness, jealousy, checking up on you constantly, blaming you for everything, making all the important decisions without consulting or listening to you, accusing you of lying and being continually suspicious: these are all hallmarks of an emotionally abusive person. Through psychological manipulation and

Pandora’s BOX PEOPLE

Sexual abuse, emotional abuse, physical abuse, economic abuse and social abuse

Pandora’s BOX PEOPLE

warfare, he makes you feel constantly afraid, guilty and impotent. Feel like you can’t do anything right? Maybe the right thing to do is leave. 3. Physical abuse: physical violence or threats thereof. This could encompass actual bashing, causing severe injury, or simply a hand raised menacingly and lowered with barely concealed rage. It includes shaking, punching, hair-pulling, kicking, slapping, pinching, burning, drugging, poisoning, starving, hitting with objects, throwing objects at the victim or throwing the victim against the wall; refusing access to toilet, washing facility, medication, water, bed or resting place; refusing access to medical care for injuries or illness. Sounds shocking? Imagine how the victim feels. The worst is when the victim is no longer surprised; she expects it. She may even believe she deserves it. 4. Economic abuse: stringently controlling and tightly scrutinising spending. Perhaps all your pay is confiscated or you are not allowed to work. He makes all the financial decisions and if you have any access to money at all you are forced to account for every cent and he accuses you of lying, overspending and stealing. He takes money from your purse. You have no say in how the money is spent or invested and have no money even to use a pay phone. This is not economising. This is cruelty. 5. Social abuse: anything that is done to isolate you and minimise your access to relatives, friends, workmates or services. Does he discourage or prevent you from going out? Does he refuse to let your family or friends come over? Does he disconnect the phone or scrutinise your

What do these five things have in common? All five may be perpetrated by the people who claim to ‘love’ us. All five are crimes, which should not be tolerated. All five usually result in the victims feeling ashamed, depressed, fearful, guilty and to blame. The victims often feel as if they must have done something to deserve the abuse; that somehow they are at fault and brought it on themselves. No-one ever deserves to suffer any of these abuses. This shame and guilt are just two of the ways by which the perpetrator attempts to control and manipulate the victim. This evil assertion of power by the abuser is at the root of the abuse. The only way to break this spell is to seek help and stop the abuse by getting away. You can’t work it out. It won’t go away. It won’t get better. It is likely to get worse. You may say ‘Well he hasn’t hurt me seriously’ or if he has, you may say,‘Well he hasn’t killed me’. Wait around and maybe he will. More than likely the iron fist of control will tighten further and further and your power to resist, struggle and assert your rights will crumble and diminish, just the way he wants it. Why ‘he’? Well it just happens that abuse of women by men is the most common, with one in four women suffering some form of domestic abuse (physical, sexual,

Pandora’s BOX PEOPLE

phone use? Does he make you feel guilty for spending time or maintaining relationships with others and does he try to oversee and undermine what contacts you have? Does he hound you about what you did, what you said, what they said? Does he interrogate you as to why you want to see or speak to others and then try to stop you? You are being socially abused.

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emotional, economic or social) in their lifetime. But it is true that men can abuse men, women can abuse men and women can abuse women. It’s just that these don’t occur with the same frequency as men abusing women. In practical terms, getting away from the situation can sometimes be complicated and scary. Usually you need outside help and the perpetrator will do everything to deter you from getting this. He may make you doubt the validity of your story and attempt to convince you that no-one will believe you, he may blackmail you with threats of harm to children or other loved ones, or he may threaten to harm or kill you for ‘betraying’ him. A lot of women succumb to this form of blackmail, remaining in intolerable, oppressive and violent situations because they are convinced the abuser will come after them, stop them and punish them for their attempted escape. They think maybe this is their lot. He won’t change; she has to just learn to put up with it. One thing is true: he is unlikely to change. Believe that. But never believe that you have to put up with it. You don’t. This emotional blackmail is just one more way in which the abuser uses his power over you to make you believe he really has total control over your life, you are completely dependent on his will and any transgression will be regretted. If you believe this, it becomes true. Some abusive people really can harm or try to kill you if you try to leave. There is no point ignoring that basic fact. But the police, your GP, your friends and family and numerous legal, financial, medical, crisis, counselling and accommodation services can help.* Perhaps he has

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forbidden you from maintaining contact with friends and family. Perhaps he has deprived you of money, transport, access to phones or other communication. Perhaps he spies on you or gets people to spy on you. Perhaps you feel totally and utterly trapped and helpless. If necessary you may have to be very sneaky to override the restrictions in order to get in contact with someone who can help. All it takes is one person, one phone call, one escape plan. Your first attempt may not be fully successful but may give you the strength and courage to complete your exit next time. Your life depends on it. Get all the help, advice and protection you can, but don’t delay in getting away. When children are involved it can be more difficult in terms of practical issues, such as finding housing, child care and making your way financially. But in fact having children makes it even more vital and urgent to remove yourself and them from the abusive person. Even children who are not themselves abused, but are made to witness abuse of another, can be damaged psychologically. You don’t want your kids to witness, suffer and ‘learn’ that it is okay to treat women like that. Abusive people may try to demean you and crush your self-esteem and confidence. They may do this insidiously by playing on fears and insecurities they know you already have. They will try to ensure these insecurities grow to increase your dependence on them. ‘Who else’d want you, you fat/ugly/stupid/uneducated/boring person. You’re lucky you’ve got me. You don’t deserve me. I’m too good for you; you’d be nowhere, nothing without me.’ They may criticise and alienate your friends. They insult them to you and insult

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you to them. They undermine your relationships with family, workmates: basically any potential lifelines. They instil distrust of authority figures such as doctors and police to discourage you from seeking help from them. They make sure they are present whenever you are with others, especially doctors, so they can control the interaction and prevent you from saying anything that might incriminate them or raise suspicions. They may try to prevent you from seeking help for the injuries you have sustained at their hand or may force you to collude in lies such as ‘I walked into a cupboard, I’m so clumsy’ or ‘I fell over. What a hopeless klutz!’ They put you down, because they think it makes them look good. They may, intermittently or in front of certain audiences, show extreme affection and caring and tenderness which you, starved of such warmth and love, may lap up, thinking ‘He really does love me. I really do love him. I need him. Everything will be all right. He doesn’t mean it when he hurts me.’ This is all part of the manipulative con. Don’t get sucked in. Anyone who truly loves or cares for you will not hit you, force sex on you, or try to control and restrict you by depriving you of social freedom, adequate financial freedom and freedom from insults, threats and psychological oppression. Perhaps you think he cannot help his high sex drive and ‘needs’ sex like a crazed sex maniac from a movie. He cannot control his temper because he is high-spirited or hot-blooded. This is completely delusory. Stop making excuses for him. Wanting something is not the same as needing it. There is never any excuse for forcing any sexual

Where to get help Police — can help you get an AVO (apprehended violence order) against your abuser. AVOs are designed to prevent the abuser from harassing you or coming near you. If the abuser violates the conditions of the AVO, he can be criminally charged. (AVOs can also be obtained at the local court.) The police can lay charges against your abuser if you wish to make a statement. Police can provide you with protection from the violent abuser. Doctor — can look after your medical wellbeing and assist you in finding resources to cope. Can offer counselling and support. Can encourage you to leave the abusive situation. Can put you in touch with and help coordinate other help services. Sexual Assault services/Rape Crisis centres — can counsel and support you ongoingly after sexual abuse.

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overtures onto another person, even if that person is the spouse. You are not a sex slave. You are not an object. You are not there to be manipulated or hurt. Demanding respect is vital. Not getting it is reason to get out. You may live in a free country but that does not stop your partner from creating a Nazi state within your home or bedroom. You don’t deserve this. Get advice and assistance to get away. If all you take are the clothes on your back, that’s okay. Forget the mementoes and the kids’ toys and books. They are of lesser importance. Besides, you can possibly retrieve them later. Nothing is worth as much as human life and personal freedom.

Can do tests and treat for STDs. Can do forensic tests if you are considering laying charges. Can help you if there are concerns regarding pregnancy. Local hospital or ambulance service — can deal with emergency medical problems, including rape. Domestic Violence Help Line — provides info, counselling and referral. Child Protection and Family Crisis Service — as above, when children are involved. Kids Help Line — for kids aged 5–18 years. Translating and Interpreting services — if English language is a hurdle. Accommodation — Department of Housing for emergency accommodation advice; refuges for women and homeless people exist in each state. Domestic Violence Help Line can provide referral. Legal assistance — ‘Domestic Violence Advocacy Service’, ‘Women’s Legal Resources Centre’ and ‘Legal Aid’ can provide help. Financial help — Centrelink social worker, Salvo Care Line, St Vincent de Paul Society, Smith Family Welfare Assistance. Counselling and referral services — Women’s Information and Referral service [Department for Women 1800 817 227;TIS (translating and interpreting service) 131 450;TTY (for deaf or hearing impaired people) 1800 673 304]; Lifeline; Community Health Centre.

*See page 452 and your White Pages for some useful contact numbers.

MIND

Pandora’s BOX

Relax!

MIND

‘Don’t you dare fuckin’ tell me to relax! I am fuckin’ relaxed! I’m totally fuckin’ relaxed, okay?’ Anonymous (or was it me?), 2001.

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elling someone to relax may encourage them to calm down. In some cases however, it may simply enhance tension or even provoke an angry outburst. Being relaxed, laid back and ‘cool with that’ is a state that is admired and aspired to by many a stress bunny. Achieving this psychological Nirvana is easier said than done, but there are some techniques anyone can learn that, with practice, can lead one closer to that yearned for condition: relaxation. Relaxation is a state in which anxieties, worries, stresses, fears and tensions are minimised, and the mind and body are allowed to settle into a calming state of repose. Relaxation of the muscles sends messages to the brain that affect the whole nervous system, fostering a feeling of calm and peace. Thus, learning to voluntarily relax the muscles assists in gaining control over excessive tension psychologically and mentally.

Pandora’s BOX MIND

There are definitely times when tensing up can be of benefit, such as when you are playing goalie and a ball is coming your way. Being tense can sharpen your reflexes and enhance alertness and keenness. In this way, a bit of tension may assist in some performance-related activities where you need to be on your mettle, such as for an exam, interview or stage appearance. Too much tension, however, may impair your performance. Your muscles may seize up excessively. You may startle easily and get distracted by insignificant noises or sounds. Being alert is good. Being hyper-alert and anxious is bad. When the tension is maintained long after its useful purpose has been served or when the tension is too great for the activity, or serves no purpose, the person may become accustomed to being tense all the time such that tension feels ‘normal’ to them. Their levels of muscle tension are so perpetually high they no longer know how to monitor them, much less how to turn them down. Far from assisting, the tension hinders normal activities and may cause chronic back, neck, shoulder or other pains. Learning to relax requires the individual to learn to recognise tension and practise letting it go. Face, jaw, fists, neck and shoulders are common places to hold muscular tension. The muscles may feel sore, tired, hard or knotty. Learn to find where the tension is, purposely tense that area for seven seconds while inhaling, then relax the area while exhaling and thinking the word ‘Relax’ simultaneously. Breathe calmly and smoothly. Relax the muscle area for a good ten seconds before moving onto the next muscle group.

Pandora’s BOX MIND

Progressive muscle relaxation is a fantastic, tried and true way of relaxing the whole body and mind. It takes 15–20 minutes and needs to be performed once or twice a day for at least eight weeks to really get results. You need to sit comfortably in a supportive chair, in a quiet room where you will not be disturbed. Tell flatmates or family that you do not wish to be bothered for half an hour and take the phone off the hook if possible. Try to clear your mind of conscious intrusions and ignore any thoughts that do float by. Don’t react to them emotionally, don’t elaborate on them, just register them passively and let them disappear. Practise breathing slowly: three seconds in, three seconds out and let the tension float out of you with each exhalation as you think the word ‘Relax’. Now gradually work your way through each of your body’s muscle groups, alternately tensing and then relaxing them. Tense the muscles moderately but not to a painful degree and follow a set order, starting with the hands, wrists, elbows, shoulders, neck, forehead, eyelids, jaw, tongue, chest, abdomen, upper back, lower back, bottom, thighs, calves, and then finally, feet and toes. The idea is not to fall asleep during the course of this, so don’t do it lying down unless you are about to go to sleep anyway. After performing progressive muscle relaxation, sit still for a few minutes to enjoy the calm and stillness of total body and mind relaxation. When you resume your activities, take that feeling of peace and tranquillity with you and incorporate it into your routine. The more you practise, the more sustained and habitual this feeling will become, such that you become used to being relaxed and will easily detect

It is important to prioritise your relaxation time so that you can do it regularly, one to two times daily, and keep it

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any incipient tension. When you perceive an area of tension, immediately target the tense area for some relaxation exercises. By keeping muscle tension in check, you learn to maintain a near-constant state of relaxation. Being relaxed does not mean you cannot tense up and react appropriately if something does happen that requires ‘high alert’ status, such as an imminent car accident or mugging (whether you are being mugged or doing the mugging). There is no need to be afraid of being relaxed. When you are relaxed you are actually more in control and it is a sensation to be enjoyed. Learning to relax and noticing the benefits may take longer than expected, especially in people who have been chronically tense for a long time. Impatience is one of the prime symptoms of high tension and anxiety. Learning to be patient is essential to learning to relax. Just as fuming at red lights or ‘Don’t Walk’ signals does not make the lights change any faster or make long queues any shorter, getting impatient will not speed up your relaxation progress and may, in fact, strongly inhibit it. Don’t feel guilty about taking time-out to relax. It is a vital form of therapy, just as important as having physiotherapy or even chemotherapy. It enhances not just your physical but also your psychological wellbeing. It may be the only time you devote entirely to yourself all day but you won’t be the only one to benefit: when you are relaxed it is far more pleasant for everyone around you too and you will be more efficient as well as happier.

up. Be flexible and find the time; even ten minutes is better than nothing. Schedule relaxation at a time that does not interfere with other favourite activities. Better still do it at times when you usually do feel stressed, or before or after activities you find stressful, such as meetings, social gatherings or presentations. Learning to relax doesn’t happen overnight and it won’t happen without some effort, motivation and follow-up from you. The advantages of being serene are immense. The feeling of being deeply relaxed is profoundly satisfying and enriching: you come back into contact with your body and start to notice more subtle sensations. You owe it to yourself: your mind, your body and your poor shattered nerves, to learn how to tune out and turn off tension and anxiety. Some people use meditation, tai chi, yoga, other forms of exercise or even hypnosis to achieve this. Others may use progressive muscle relaxation or the like. Do whatever works for you. Do it daily. And enjoy! I plan to do it myself one of these days. Serenity. Aaaah!

O

ne of the most popular words in the English speaking world is ‘f**k’. I have considered this fact (pronounced ‘f**ked’) long and hard and come to the following conclusions. The sound ‘f**k’ is a pleasant and satisfying one. Similarly, de facto (pronounced ‘de f**k to’) and defecation (‘de f**k ation’ — the process of becoming ‘unf**ked’) have a snappy something about them. They are a delight to both tongue and ear. The word ‘functional’ when spoken with a profoundly blocked nose, sounds to all intents and purposes like ‘f**k shonal’, which has a subtle but arousing ring to it. Makes having hay fever or a nasty cold, not so nasty after all, when you can repeatedly ask shop assistants in the small appliance department ‘so this button here, what’s its f**kshon?’ But whence the attraction of this addictive single syllable? Well, the vowel sound ‘aaah’ is a very natural one that springs spontaneously to one’s lips. For example, when falling off a cliff, nine out of ten people will scream ‘AAAaaaaaaaa-aaaaa-aaaaa-aaaah’. One out of ten will cry ‘Why, heavens to Betsy!’ Just to be different. If it is a relatively low cliff,‘Why heavens to . . . splat!’ will more likely be heard.

Pandora’s BOX MIND

Why ‘f**k’ is such a good word

Pandora’s BOX MIND

Phonetics aside, there is of course, the ‘forbidden fruit’ quality. As any child and many an adult knows, one way to get ATTENTION is to type in CAPITAL LETTERS, or, better still, use the BOLD F**KSHON. The other way is to use prohibited language. I frequently utilise this to great effect when arguing with my mother. If all else has failed, one economical and foolproof way to get a rise out of her is to call for my favourite chicken dish:‘Fowl Language’. ‘I didn’t slave my guts out for you to send you to a good school to have you talking like a wharfie! No daughter of mine uses THAT WORD!’ she cries, outraged. ‘Which word?’ ‘THAT word!’ ‘But which one do you mean? How can I avoid using it if I don’t know which one you mean?’ ‘I’m not going to say it! I’m a refined person!’ ‘Well if you won’t say it I won’t know what you mean. Sorry.’ Hmmmm. Is it pathological to be proud of such behaviour? I hope not. I just like using the one and only word my mother detests with every fibre in her being. Is that so unusual? I’m convinced if she didn’t hate it so much and react so dramatically and predictably every time, the word would lose much of its charm and all of its power. And my power to irritate would be devastatingly decreased. Tragic, I know, but unlikely to ever happen. Many people, supposedly with limited (but fortunately, well chosen) vocabulary, use the word ‘f**k’ as a multi-purpose adjective, noun, verb and punctuation mark, e.g.,‘F**k! I f**kin’

My father, once clumsily hit his thumb with a hammer and shouted a hearty ‘F**k!’ to soothe his woes. My mother was immediately onto him. ‘Don’t you dare swear in front of the children!’ she admonished with the diligence of Orwell’s Thought Police.

Pandora’s BOX MIND

f**ked the f**king daylights out of the f**ker and f**k, f**k me dead if the f**kin’ f**ker didn’t f**king turn the f**k over and hit me in the f**kin’ head! F**k!’ in response to which the audience will breathe in unison an awe-struck ‘F**k!’ It’s a response that is appropriate and openly interpretable in virtually any situation, especially those requiring sympathy or a semblance of empathy. When a patient tells me a particularly woeful tale at the surgery, I regularly show my understanding of the depths of dreadfulness concisely and convincingly with a single syllabic response:‘F**k!’ The patient immediately knows how completely I have understood and how deeply I commiserate. Nodding emphatically and gratefully they confirm the appropriateness of my response with saucer eyes and murmurs of assent. With elderly or notably straitlaced patients I limit myself to ‘Wow’ or ‘Gee’, but it never conveys the same intensity of feeling. ‘Wow’, ‘gee’ and ‘golly’ simply don’t have the power of ‘f**k’. Letting ‘f**k’ slip out by accident in formal company is easy enough to do but a definite no-no since it suggests poor mind and tongue control and that most serious of blights, a ‘limited vocabulary’. This is when the ‘f**k conversion’ comes into play. ‘Faaaar out’ is a good save. ‘Far, a long long way to run’ was Julie Andrew’s contribution, also useful in a remarkable number of circumstances.

Pandora’s BOX MIND

‘I wasn’t swearing,’ Dad was good at thinking on his feet. ‘Yes! You said the four-letter word!’ ‘No! I said “Far”.’ ‘“Far”? What do you mean “Far”?’ ‘Ignorant! I am speaking Chinese! I mean “Far” as in “Far Tsai”! Prosperity!’ Mum’s narrowed eyes revealed her suspicions but she let it pass. ‘Gee. Man cannot even shout “Prosperity” in his mother tongue! In his own home!’ Dad moaned, disgruntled and self-righteous. ‘All I am saying is “prosperity”. What is wrong with that?’ Hmmmmm. Don’t push it Dad. But I fully understand. It’s f**ked.

Top ten uses for the word ‘f**k’: 1. When ‘shit’ is just not enough: ‘Oh f**k!’ 2. During intercourse, to convey enthusiasm: ‘F**k me! F**k me, baby!’ 3. To express dismay: ‘F**k’ (downward inflection). 4. To express disappointment: ‘F**k’ (soulfully). 5. To express delight: ‘F**k!’ (brightly). 6. To express awe: ‘F***k!’ (extended, with brows raised heavenwards).

7. To express surprise: ‘F**k!’ (with a backwards body jerk). 8. To express anger: ‘F**k!’ (with a threateningly slammed fist). 9. To express rebellious stance: ‘F**k you!’ (with middle finger raised in defiance). 10. When you really don’t know how to react but feel the need to say something: ‘F**k . . .’ (softly, with a furtive glance around at others to see how they are taking it).

Note: For a scholarly study and collection of sexual euphemisms, curses, proverbs and similes in all languages, see Maledicta: The International Journal of Verbal Aggression (The Journal the World Swears By).

Pandora’s BOX

Being assertive

MIND

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hat is assertiveness? Well I guess it’s somewhere in between being aggressive and being a pushover. Assertiveness means being able to express your feelings, wishes and needs directly, with the idea being that this is a good step towards getting those needs met. As my Mum always says,‘If you don’t ask, you don’t get’. Or something like that. Do you feel as if your needs are not being met? Do people walk all over you? Or, in getting your needs met, do you find yourself rubbing people up the wrong way? Do people frequently seem resentful or insulted by your behaviour? Maybe you could consider working on how you communicate and find the middle ground between passive and aggressive: assertiveness. Being able to transmit your feelings and opinions and stand up for your rights and beliefs is vital. It allows you to have more control over your life. But it should not require offending others, or infringing or denying the rights of others. Don’t let people take advantage of you, but try not to take advantage of others either. Directness and honesty, as well as respect and recognition of the rights of others, are the keys to assertiveness. People who habitually employ a ‘passive’ style, humbly let others make all the decisions. They think this is the way to ‘be nice’, to make life simpler, and avoid conflict. But internally, they may be writhing.

Passive people may find it easier to go with the flow and not cause any waves by agreeing with others and minimising their own opinions and needs. Perhaps they lack confidence or can’t be bothered expending the energy to assert themselves. Perhaps they feel they are not important or clever enough to be considered. Passive types may mistakenly believe their ‘easygoing’,‘it’s okay, tread right over me’ stance will be appreciated and one day rewarded. Their passivity might be appreciated by pushy, self-centred types, who only care about getting their own way, but are they the sort of people you wish to attract? As far as being rewarded is concerned, you will be rewarded with a reputation for having no mind of your own. Over time, passivity can lead to feelings of frustration and resentment at one’s needs, feeling and opinions being repeatedly overlooked and disregarded. Simmering beneath the surface of calm indifference (‘What’s your name?’ ‘Suchitra’ ‘What? Look, I’ll just call you “sweetie”, okay?’ ‘Sure, fine.’) may be a spitting cauldron of anger. Passive people may lose the respect of others through their seeming lack of backbone, substance, personality

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Passive Patty: What movie shall we see? Assertive Annabel: I really wanna see Fight Club! Passive Patty: Oh, I don’t mind. You decide. Assertive Annabel: Okay then. Let’s see Fight Club! Passive Patty: Oh . . . okay. (Has seen it. Walked out halfway and had to vomit because it was so violent. Doesn’t mention this until she is retching again, quarter-way through the movie.)

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and guts. Worse still, they risk losing their own self-respect. Aggressive people know how to stick up for themselves but tend to do so in a domineering, inconsiderate and pushy way. They tread on other people’s toes but justify it by selfish, ruthless rationalisations. Their over-developed sense of entitlement will lead them to push in, take first pick, choose the biggest, take the most and, ignoring the needs of others, leave nothing behind. They may get their way by being rude, obnoxious, intimidating and overbearing. They may not mean it, but they can hurt feelings and irritate profoundly. This kind of offensive, aggressive behaviour causes people to lose respect too. The aggressive person may wonder why people shy away and don’t want to be friends. ‘Why? What did I do wrong? You snivelling bunch of pusillanimous pansies! I’ll give you until the count of three to be nice to me! One! Two! That’s it. Time’s up. You bastards!’ Assertive types are capable of recognising both their own rights and the rights of others. They treat people with politeness, kindness, patience and respect and this is how they themselves expect and wish to be treated. If however, they are met with rudeness, ill-temper and disrespect, they call what they see unacceptable, unjustified and inappropriate, remaining calmly and firmly assertive but not aggressive. Rather than scrupulously avoiding conflict, they look for ways of resolving it that accommodate the needs of all involved. They don’t give in all the time but strike a balance between giving and receiving depending on the situation. They are flexible and choose the behaviour

Recognising that one’s behavioural and interactional style may bear some improvement is the first step towards enlightenment. Then one may need to motivate oneself to change by recognising the potential benefits.

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style and degree of assertiveness that seem appropriate. They don’t give in simply because they feel it is expected and they ‘have to’. In this way, they are able to establish a degree of integrity and intellectual and moral consistency. This is vital in developing both self-respect and the respect of others. By being assertive, one feels ‘in control’, rather than controlled, blackmailed, manipulated and provoked by others. Many people learn to be passive from parents, teachers or siblings. Perhaps they got used to being shouted down or ignored. Maybe they were punished for talking back or expressing a difference of opinion. Perhaps they were perpetually told ‘Shut up, peanut gallery’ or ‘What would you know, pipsqueak?’ or worse still: ‘Nice girls don’t talk back. Be sweet and charming at all times.’ If one is brought up to believe that conflict is bad, dissent is ‘not ladylike’ and vigorous, rigorous discussion is offensive and ‘unfeminine’, one may spend a lifetime swallowing garbage and wondering why one feels perpetually nauseated. Others may learn from childhood experience that the only way to get one’s needs met is by bullying, threatening, shouting, pushing and shoving. As adults they may take these meagre and maladaptive skills into the workplace and social scene and wonder why their company is universally shunned and their needs are still unmet.

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Benefits of being less aggressive and more assertive: 1. less violent conflict; use reason instead of force 2. less destruction of relationships

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3. less time spent feeling angry, shortchanged and desperate 4. remain calmer and more serene 5. people listen to you more and take more notice of what you say 6. earn respect rather than eliciting fear

Benefits of being less passive and more assertive: 1. have your feelings and wishes considered and accommodated 2. reveal true self, your opinions, nature and personality 3. interactions become more honest and real 4. learn to resolve conflict rather than simply avoid it 5. feel more powerful in relationships and in life in general 6. decrease resentment and frustration which can otherwise build up to a boiling point with ugly results

Brigitta the borrower: Oh God! I love your dress! I’m going to a ball next week, can I borrow it? Passive Patty: Ohh. Sure. It might be a bit small but I can add an extra panel. When do you need it by? Aggressive Agnetha: As if I’d let a fatso like you wear it. You’d split the seams! In any case I know what a piss-pot you are: red-wine stains pickling the thing — no way! Assertive Annabel: This is my favourite dress too, Brigitta. I’d rather not lend it to anyone. Perhaps Patty feels that as a friend she is obliged to accede to any request from a friend. True friendship however is not based on obligation. Nor can it be earned simply through slavishly bending over backwards. Some people feel uncomfortable being overly indebted to another person anyway, so instead of getting closer they may draw away. In order for friends to feel comfortable asking or being asked favours, there must be a genuine choice and not a compulsion to comply.

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So how do you do it? Well it’s mainly an issue of accepting that you have rights and that it is your responsibility, not that of others, to defend and uphold those rights from time to time. At the same time you recognise the rights of others and respect them. Make a list of your rights and practise asserting them when the occasion arises. For example, saying ‘no’ is something we can all practise. The trick is to say no without feeling guilty but without being unnecessarily nasty. Say enough but not too much. For example:

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Agnetha seems not to really give a stuff and is likely to abort many friendships with these sorts of insulting retorts. She brings out the big guns, as if she is being threatened, when she is not at all under fire. A simple request requires a negative or affirmative, tactfully phrased. Saying yes resentfully and then regretting it is more likely to damage a friendship than simply saying no in the first place. If you really value the friendship, preserve it by being honest about how you feel. No point pretending you don’t mind when you do. You needn’t feel guilty for simply wanting to retain your personal property. We all have our boundaries and we are entitled to maintain them. Saying ‘no’ can be really hard. We are inclined to feel bad and wonder if people will think we are mean. We may offer all sorts of reasons and excuses for our decision. If these are genuine and you feel it is vital that you explain yourself, fine, but making up a false story, even if we don’t get found out, creates extra tension and unnecessary stress. You don’t have to make excuses. You are allowed to say no.

Assertiveness rules: 1. You can say no. 2. You don’t have to explain or give ‘excuses’. 3. You can ask a favour. 4. You can take ‘no’ for an answer without taking it personally.

7. You don’t have to know everything to have an opinion. 8. You need to express your feelings, so people know what they are and that they are important. 9. It is up to you to decide what you do and what you believe. 10. You don’t have to apologise if you have done nothing to apologise for. If you suddenly start being assertive from a base of being rather passive and easily manipulated, the people who have been riding you habitually for ages will get an unpleasant shock and may feel threatened. This is their problem, not yours. Try out your new behaviour gradually if you like but don’t be afraid to assume what have always been your rights. If you suddenly start being assertive from a background of aggression, people who have been avoiding and cowering from you will be pleasantly surprised. It may take some time for the bad reputation to be overridden but nothing succeeds like persistence. Most importantly of all, by being assertive, you will learn to like yourself more. Jesus said ‘Do unto others as you would have them do unto you.’ Unfortunately being a pushover and giving in to everyone will not necessarily result in everyone bending over backwards to please you. It might simply result in your

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6. You can be mistaken.

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5. You can change your mind.

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getting a rep as a gormless, spineless person who is easy to take advantage of. Do unto others as you feel befits the situation. Trust your own judgement. Be responsible for your own behaviour, not that of others.

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Pathological liars: personality disordered or just creative?

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an’t tell the truth to save your soul? Don’t see the difference between elaboration and confabulation? See ‘yes’ and ‘no’ as more or less interchangeable? Don’t sweat it. You’re not alone. You’re simply one amongst the ever-growing ranks of Pathological Liars. Personality and morality largely determine a person’s tendency to lie. But circumstance of course, is a powerful moderator. Most people feel guilty when they tell untruths and self-flagellate or even confess accordingly. Pathological liars feel not a twinge of guilt. They are able to rationalise instantly whatever antisocial acts they commit and could indeed be termed a ‘remorse-free zone’. This trait of reckless and gay abandoned deceit is typical of those with an

antisocial personality disorder. Such persons are usually unconcerned by the havoc they wreak and blame others for any misfortune that befalls them. Not surprisingly, they are frequently in trouble with the law. How do you know if you are one? Well, take this quick quiz:

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1. Do you instinctively deny when asked about recent activities, e.g.,‘Have you had breakfast? Opened your bowels? Murdered your flatmate?’ 2. Does the suffering of others leave you unmoved or occasion mirth? 3. Do you take pleasure and pride in your ability to lie seamlessly? 4. Does the idea of a ‘truth serum’ make you shudder or do you regard it merely as a challenge? 5. Is Long Bay your home away from home?

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Did you answer ‘Yes’ to one or more of the above? Tell the truth now. Fibber! At least be honest with yourself: you’re a pathological liar! What can be done about this? Well there is often little that can be done, but the aim of treatment, if such a person can be induced to submit to it, is to encourage insight and a sense of consequence. Failing that, a deeper recognition of the repercussions of the antisocial behaviour can be instilled, e.g., if you keep doing this, you’ll soon be doing time. The hoped for response is of course ‘well then I’d better stop doing that’ although a more frequent response might actually be ‘well next time I’ll do it better so I won’t get caught, pinhead’.

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More importantly for the rest of us, how do we recognise such people and evade their grasp? A really good liar is hard to pick and particularly if he/she is smooth, suave and sophisticated, we may get sucked in big time. Well, gullible beware. Take the following advice and you’ll be paranoid (but safe!) in no time:

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1. Do police record check on all acquaintances and potential dates. 2. When holding hands, furtively check your date’s pulse: this is how crude lie-detecting devices work. 3. Don’t let on that you don’t believe them, but subtly cross-reference and see if they flinch, for example,‘So you were raised by Eskimos . . . how is it then that you shook hands with that guy just now . . . shouldn’t you have rubbed noses?’ 4. Consider the likelihood of various events having taken place (for example, a thirty-something guy who claims to have won Gold in the Melbourne Olympics). 5. Maintain an open mind. A mind open to suspicion, that is. Obviously we are all capable of lying and most of us will do so with little hesitation when faced with such questions as ‘Okay, who farted?’ or ‘Isn’t my baby just gorgeous!’ Children may mould their responses, regardless of truth, according to the situation and what they think the desired or required response might be. The aim for them is unsophisticated and touchingly simple: keep the oldies happy and don’t get ‘In Trouble’.

Deceitfulness in an actor, writer of fiction or advertising guru should be more tolerable since theoretically,

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Experiments on young children, where they are left in a room unattended with a large bowl of jelly beans and the single instruction ‘Don’t eat any jelly beans until I get back, okay?’, have yielded interesting but unsurprising results. The children will, after a few moments of indecision, start dipping heartily into the sweeties. When the adult returns and asks ‘Did you eat any jelly beans?’ the children will invariably reply, obligingly, ‘Oh no. Didn’t eat any.’ ‘Really? Are you sure you didn’t eat any?’‘Nup. Didn’t eat any.’ This kind of behaviour is not a marker for a criminal mind. It is simply part of the normal developmental evolution of morality. Truth for the young child is not so much what is but rather what the child would have it be or indeed what the child perceives the adult would like it to be. The child basically aims to please, even if only in the short term. This pragmatic approach to truth, so guileless and natural to children, is frankly maladaptive in the adult. The repercussions of being found out in the adult world are vastly more dramatic and embarrassing. Bill Clinton’s famous statement ‘I never had sexual relations with that woman’ and Hansie Cronje’s vehement denial of bribe-taking and match-fixing should act as potent disincentives to would-be liars. In adulthood, being known as a liar is a massive black mark against your name, particularly if you are in a position of authority, such as judge or politician, or if you are a role model, such as a sporting hero.

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dissembling and ‘telling tales’ are their tools of trade. But when Hugh Grant ‘cheated’ on Liz Hurley, and Darville aka Demidenko faked her cultural identity, public censure was fast and furious. False advertising is illegal. How ironic, given that almost all advertising involves degrees of hyperbole bordering on deceit. Honesty and integrity are highly valued commodities that cannot be bought or sold; ask Alan Bond who is desperately seeking both in a most public manner. (‘I seek to regain your trust . . .’ Yeah and pigs’ll fly.) Most people pride themselves on their honesty although I tend to immediately distrust anyone who emphatically tells me how honest they are. It is like the husband who buys his wife flowers and tells her he would never, ever, ever cheat on her. Not ever. Well hardly ever.

Guilty parties: soirées for the conscience oppressed

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ot the guilts? Here’s how to shift ’em! Anyone other than the most hardened criminal and certain other recidivists (Bill Clinton pre-Starr springs to mind) will occasionally get a dose of the guilts. Not being Catholic myself, I don’t claim to be an expert, but

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I’m certainly a more-than-occasional sufferer. From bedwetting to littering to over-eating, there are myriad everyday lapses and oversights that inspire shame and contrition from cradle to grave. Guilt has a perfectly healthy and important role to play as the foot soldier of the conscience. ‘Inability to experience guilt or remorse’ is a feature of the Antisocial Personality Disorder (let’s call it ‘APD’ for short), along with ‘tendency to blame others or offer rationalisations for one’s own antisocial behaviour’. APD people tend not to learn from experience, including punishment. Not surprisingly, Long Bay has a number of these personalities, but you need go no further than into the realms of big business, law, dare we say . . . politics, and believe it or not medicine (Asian female GPs excluded) to find plenty of other examples. So if you’re guilty of a tendency to feel guilty: relax! You’re probably one of the good guys! Suffering an excess of guilt is not healthy either. The hyper-alert conscience may not only stop you from taking the full dozen eggs through the ‘8 items or less, Express Lane’ at Coles, it may also plunge you into anxiety and depression. The guilt complex is a common feature of both of these disorders. Feeling like ‘everything’s my fault’ happens to all of us occasionally. That’s because occasionally it is. But feeling personally responsible for World War I, the Holocaust, cancer and the fad of hipster-flares-with-platforms smacks soundly of delusion. No-one could be that bad. I’m sure even Thierry Mugler had his conspirators.

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So, how do you find the happy medium between gutwrenching self-flagellation and devil-may-care, APDdevilry? Well to start with we have to try and use guilt constructively. That doesn’t mean ‘try to construct elaborate excuses to defend behaviour requiring delicately balanced construction of lies’. Nor did I say destructively as in self-mutilation, self-induced vomiting, self-loathing, trashing of hotel rooms, wife-bashing or any of a number of other common destructive pursuits. No. Dealing with guilt functionally and constructively requires careful and sober consideration of the facts. Attribution of blame should be done as objectively as possible, preferably in discussion with an unbiased party. The most important thing is to think about what it is that has brought about this lapse in behaviour if you do indeed find yourself to be at fault. What can you do in future to avoid a recurrence? How can you compensate your ‘victim(s)’ and redress the situation? Focusing on how rotten you feel is good as long as it is not prolonged. For the average person with a conscience, the feeling of guilt is the most excruciating non-physical pain one can experience. (Right up there with childbirth and kidney stones — not that I have experienced either, but I can imagine, OK? — which are, respectively, supposed to be the worst pain a woman and a man can feel.) Even a single, fleeting trouncing from this insidious aggressor can have a startling aversive effect. The non-intellectualised response might well be: ‘Gee, I’m not sure if it was wrong and I don’t know why I did it, but I felt so awful afterwards I’ll sure as hell never do it again’. That’s a good start.

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Sexual guilt is a very specific form of guilt that you probably have to be Catholic to truly understand. I’m not and I don’t. Apparently Catholics are supposed to go to hell and burn for even thinking sexual thoughts let alone laying hand on flesh — even their own. While I can certainly see how masturbation in certain circumstances (e.g., inside a confessional, polling booth, family crypt) might justifiably provoke guilt, I’m sure there must be some places where it should be above board. Ditto for sexual thoughts: I am prude enough to wish that people abstain from erotic contemplation during certain activities (e.g., whilst conducting breast examinations, giving mouth-to-mouth, doing Pap smears) but I feel there are some instances in which one would be surprised, if not even a little offended, if there was not at least a glimmer of a glint in the eye of the beholder. In fact thinking lustful thoughts during non-sex-based activities (e.g., funerals, will readings, christenings) is probably no worse than thinking about non-sex-related things (say football, shopping, Kentucky Fried Chicken) during sex. In the context of a relationship there are a number of sources of guilt. In fact I think this is one of the main things being single has going for it: absence of guilt. No longer do you have to feel guilty for fantasising about the Diet-Cokespunk look-alike at work whilst doing the business with your beloved partner. Nor do you have to torture your conscience worrying about your beloved whilst trying to enjoy a fling with Himbo Hunk from Personnel. No more guilts about whether you love your beloved enough,

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whether you love him the ‘right way’, for the ‘right’ reasons. No more feeling guilty for not wanting to spend time with his friends, relatives, workmates, pet snakes. No more. Once your beloved becomes the dearly departed beloved, you’re scot-free. Free of relationship-related guilt that is. Now that you don’t have to feel guilty for wanting time on your own . . . you start to feel guilty for spending so much time on your own . . . ruminating about what you did wrong to end up alone. Certain influences (couples, parents, the media) have a tendency to make you feel guilty for being single. That’s when you go from feeling guilty for having sex to feeling guilty for not having sex. The list goes on. ‘Feeling guilty for not having children’ is the Big Daddy of ‘feeling guilty for not liking children’. Both are common enough. Then there’s ‘feeling guilty for not spending enough time with the children’, which competes with ‘feeling guilty for not spending enough time with the spouse, the parents, the in-laws and the psychotherapist’. And that’s when it’s got to stop. The bottom line is that there’ll always be forces telling you you’re not up to scratch and you ‘could try harder in class’. It’s up to you to decide what’s right, what’s wrong and what’s OK. When you pull up short, learn what you can from your mistakes and move on. Guilt is like the tympani section of an orchestra. At the appropriate moment it provides highlights and accents. It can have enormous impact in bringing passages to a close. However, tympani playing incessantly, intrusively and fortissimo throughout not only gives you a throbbing headache, it obscures the melody itself. If allowed to drown

Anxieties, fears, guilt feelings . . . and interruptions

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he biggest impediments to sexual development and enjoyment are guilt, fear and anxiety. Practical issues like interruptions or basic lack of suitable time, place and opportunity can usually be overcome with a bit of willpower and creative nous. They are merely external factors. It is the internalised obstacles, the invisible, intangible psychological barriers, that can really inhibit you. Identifying them can be challenging. It is in many ways similar to being a ‘Ghost Buster’: one has to believe in ghosts to find ’em. One has to be able to find ’em to bust ’em.

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out all the other elements of the symphony, it will transform beautiful evocative music into oppressive cacophonous noise. Just as the occasional use of ethics can make you feel like a moral superstar, so can the occasional and judicious application of guilt render you righteous without being selfrighteous, conscientious without becoming hack-ridden. And to all the APDs out there reading this and scratching your heads: don’t worry — you wouldn’t know what I was talking about.

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Guilt can come from religious or moral input that stems from childhood. Fears are usually based on a degree of ignorance and a tendency to catastrophise. This tendency to catastrophise may be learnt or innate. One way or another, catastrophising involves a disproportionate belief in the possibility of the worst imaginable scenario evolving combined with a propensity to morbidly ruminate about this. Anxiety may be a product of fear and guilt or may be the result of disastrously low self-esteem, which may be confined to low sexual self-esteem in an otherwise highly functional, capable and confident person. Even though our society glorifies and romanticises intimacy, and many people claim to seek it, in fact the experience of true intimacy can be extremely confronting and anxiety-provoking for many individuals. Intense eroticism and intimacy between two people is difficult to sustain and indeed many couples would prefer to evade it because of the high anxiety it commonly evokes. This is because true intimacy and eroticism require each person to reveal untested parts of themselves often unexpectedly with no guarantee of how the partner will react. An honest reaction may be negative and the individual who has revealed this uncharted region of themselves needs to be able to self-soothe and cope with whatever the reception might be and still maintain the courage to continue to explore their partner’s and their own eroticism, which may be full of other surprises of varyingly pleasant and unpleasant nature. We are highly moulded by society and media to expect and respect certain norms in sexual behaviour and

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preference. The true spectrum of sexuality is actually far broader, more eclectic and eccentric however. Intimacy involves deep and accepting self-knowledge in the presence of another. It requires a great degree of differentiation such that one’s personal discoveries and self-actualisation are not dictated, restricted or repressed by or in deference to one’s partner. Knowing and learning to appreciate each other’s individuality and differences can be confronting and scary but without this willingness and desire, true intimacy cannot evolve and a barrier is erected, preventing both individuals from genuinely developing sexually and thoroughly experiencing their untapped eroticism. Fears of abandonment may inhibit one from getting extremely close to another person. Anxiety in the experience of closeness may trigger a fleeing response. Subsequent loneliness may cause anxiety that forces the person to rush headlong back into another precipitously enmeshed relationship such that a person may seem to bounce from one intense, short-lived maelstrom to another, while not necessarily learning anything about her/himself in the process. An aversion to both closeness and singledom may arise, leaving the individual in a near-permanent state of anxious discomfort and desire to flee. The fact is that loneliness need be neither a cold nor rigor-inducing condition. Many people dislike loneliness because they are unable to separate the ‘alone’ state from the anxiety it engenders for them. The ability to appreciate the potential for peace, calm and clarity of thought and feeling that being alone can grant, does not come naturally to all, particularly those who have been conditioned to

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regard togetherness as the Holy Grail of human experience. Being alone offers the opportunity for reflection and appreciation of what it is one is and wishes to be. It allows for the development of an understanding of our existential separateness. It teaches us how to self-soothe. Being alone, we learn how to be alone. And paradoxically, this is essential for us to be able to sustain the intensity of intimacy and eroticism. Just as humans have a natural urge to socialise and form emotional attachments, we also have a need for solitariness. Society tends to idolise the group, the family and the couple and often ignores or worse still, pities the highly individualised individual. Spending time on one’s own is automatically viewed rather negatively with murmurings of ‘Are they depressed? Sick? Social rejects?’ Being unable to be alone engenders an unhealthy dependence in subsequent relationships. A degree of dependence will arise regardless but if the dependence is based on an inability to confront, accept, nurture and take responsibility for oneself, then the dependence is not one that will foster increasing intimacy and eroticism. Conversely, it will inhibit the development of intimacy since anything that threatens the status quo will engender anxiety, anger and fear, stultifying further growth and reinforcing the individuals’ belief that they cannot soothe their anxieties unless the partner responds in a prescribed way. The resulting stagnation and smothering effect usually causes further withdrawal from intimacy. Learning to deal with anxieties requires a recognition that such anxieties exist. Development of this self-awareness

may require help in some cases. Nutting out the root of the anxiety involves honest introspection. Disconnecting the anxiety from its provoking factors requires challenging of the automatic thought processes that are habitual and practised perhaps over years or even generations. Understanding and learning how to interpret and soothe our anxieties is not something we should delegate to others. Anxieties, our own and others’, muddy the waters between us and make it impossible to see each other clearly. Relying on others to soothe our own existential angst stands in the way of the development of true intimacy. In true intimacy, each one, aware and appreciative of his/her essential separateness and aloneness, shares the pleasure of being with and learning about the other, while confident in his/her ability to separate, such as is inevitable eventually, through sickness, death or desire for change. Acknowledging all this, without anxiety, may be a life’s work, in which a couple learns to be both separate and a couple, together and alone.

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Suicide: it brings on many changes but it’s not painless

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Dave: You could shoot y’self. Gaz: Where’s he gonna find a gun from round ’ere? You wanna find y’self a big bridge, you do. Dave: Yeah, like one o’ them bungy jumps only w’out the bungy! Lumper: Can’t stand heights, me. Dave: Drowning. Now there’s a way to go. Lumper: Can’t swim. Gaz: Yer don’t have to fuckin’ swim yer divvy! That’s the whole point! God! Yer not very keen are yer? Dave: I know. Yer could stand in the middle o’ the road and get a mate to drive smack into yer. Lumper: Haven’t got any mates. Gaz: Listen you: we just saved yer fuckin’ life so don’t tell us we’re not yer mates, orright? Dave: Yeah, me and all. I’d run yer down as soon as look at yer. Lumper: Oh serious? Ta. Thanks a lot. From the movie The Full Monty.

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very year in Australia, 80 000 people under the age of twenty-five attempt suicide. Over 400 are successful, giving Australia the fourth highest youth suicide rate in the industrialised world. These suicides usually occur in the context of depression, recent emotional or interpersonal crisis or drug use. Not all suicides are preventable. Sometimes it seems that no-one was aware the person was even depressed. Prior to suicide, some previously depressed people become suddenly and deceptively happy and feel a sense of peace. This is because they have made the decision to die. They may start giving away their most prized possessions and make detailed but secret plans using means that are sure to be lethal, with minimal means of intervention or discovery by others who would stop them. Fortunately however, in many cases, the signs of depression and deliberate self-destructive behaviour are there, if only someone can recognise them and step in. Depression is very common. About 12 per cent of men and 25 per cent of women will suffer at least one episode of major depression in their lifetime, with onset usually beginning in the twenties but possible at any age at all. Some studies have suggested that up to 24 per cent of adolescents will have experienced a major depression by the age of eighteen. While it is normal to feel deeply sad or unhappy from time to time especially in response to bad news, disappointment or relationship breakdown, usually this low mood is transient and resolves when the situation changes or when the person manages to modify, adjust to, or accept the situation. ‘Clinical depression’ or ‘major depression’ is a

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more severe and pervasive form of low mood which lasts much longer and affects both mind and body. In clinical depression the symptoms persist for at least two weeks and may consist of: ■

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■ ■ ■ ■ ■ ■ ■ ■

feeling sad and tearful losing interest and pleasure in usual activities feeling worthless, guilty, pessimistic disturbance of sleep and appetite low self-esteem low libido inability to concentrate, difficulty thinking clearly and marked indecision feeling constantly fatigued resulting in low activity or slowed movements thinking about or engaging in self-destructive acts or suicide attempts

Sometimes the depression will be accompanied by anxiety. Other times the person will simply seem more irritable. The depressed person may withdraw socially, their school or work performance may decline, they may display antisocial or delinquent behaviour or increase their use of drugs. Sometimes they will complain that they are bored and everything is ‘boring’, ‘flat’ and ‘not worth it’. This lack of motivation is typical. In severe cases, the depressed person feels that life itself is just not worth living. It is vital to recognise depression since it is eminently treatable. Psychological treatments along the lines of counselling and cognitive behavioural therapy (CBT) are

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the first choice of treatment. Cognitive therapy involves helping the person to think more positively by examining and challenging distorted and negatively biased views. Individuals are encouraged to reframe the way they think about failures, and take credit for successes. Positive perceptions and optimistic thinking enhance positive emotions and elevation of mood. Behavioural therapy may involve scheduling regular activities, setting goals and learning new social skills as well as structured problem solving. Problem-solving techniques are explored and the person learns how he/she can exert some control over aspects of life that are stressful. In more severe cases, CBT can be supplemented with medication. Modern drugs are effective within a matter of weeks and usually have few side effects. The doctor can tailor the drug choice according to the individual and his/her response. The drugs work by readjusting the chemical imbalances in the brain. In really severe cases, unresponsive to the above treatments, ECT or electroconvulsive therapy is both safe and extremely effective. Although no-one really knows exactly how it works, ECT gives dramatic and rapid results in many cases where the person might otherwise have died. The person is given a muscle relaxant and short-acting anaesthetic before a brief electric current is administered by an experienced doctor and anaesthetist. The currents are applied to particular sites on the scalp and produce a minor seizure in the brain and body. Common side effects include headache, confusion and short-term memory loss but there are no long-term ill effects. Even though it sounds scary and

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rather bizarre and many people feel both sceptical and fearful, it is amazingly effective for really bad depression for which other treatments don’t work. Depending on the severity of the depression, treatment may need to go on for prolonged periods. CBT is usually a short-term intervention and at least a partial response is expected within weeks although less intensive counselling may be required on and off for months or years. Drug therapy is recommended for at least six to twelve months but some people end up needing it for longer, even decades. ECT is usually given three times a week for two to five weeks only. Regardless of the treatment, relapses are common. Fifty per cent will suffer one or more recurrences. About a third of adolescents who suffer depression will attempt suicide in the next two decades and about 3 per cent will complete it. What can be done? Well first of all it is important to recognise the symptoms and signs of depression and encourage the person to seek help from a doctor or community health centre and cooperate with treatment. Even listening to the young person and providing a caring, sensitive response is useful but promises of secrecy must not be made if there are suicidal thoughts or plans. It is vital to specifically ask about suicidal thoughts. Asking about suicidal ideas will not inspire a non-suicidal person to commit suicide. Ignoring the possibility, however, may allow suicidal tendencies to go unchecked and may result in missing the opportunity to help prevent a tragic death. Talking about suicide may seem hard but the depressed person will usually feel greatly relieved that they are able to

unburden themselves of the pressure of such thoughts. Knowing that your friend or loved one is suicidal may provoke feelings of fear, anger, denial or even guilt in you. This is normal. You are entitled to react emotionally but try not to let your personal reaction interfere with helping the suicidal person whose situation is urgent and may be dependent on your clear thinking. Get in contact with a doctor, hospital, community centre or responsible adult. Don’t leave the suicidal person unattended if possible. The doctor or health worker can assess the risk of suicide and negotiate a plan of management. The risk of suicide is highest when the person has set a time, has access to a truly lethal method (e.g., gun, drug overdose) and plans to do it in such a way that minimises the chance of help from others. Never ignore notions of suicide in yourself or others. Seek help. The life you save could be your own or that of someone you care about. Depression is treatable and life can be so much better. The only way depression can’t be cured is if you kill yourself first.

Pandora’s BOX

Dreams ‘I slept and dreamed that life was Beauty; I woke and found that life was Duty.’

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Ellen Sturgis Hooper, 1816–41.

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t is a little-known fact that I have had sex with Michael Hutchence. Last night in fact. He was extraordinarily gentle and quite humorous actually. He was particularly enamoured of my . . . Well anyway it was good. Isn’t it wonderful how in dreams you can experience things you never could in real life — sex with Michael for example — and even things you never would have imagined. I never even knew he was attracted to me that way, y’know? Seeing as we never met and all. ‘Need you tonight’ has taken on a whole new flavour for me. Dreams are our subconscious way of working out or elaborating on issues touched on and not resolved during the day. They allow us to confront fears and indulge passions. They reveal our deepest, secret desires, kept hidden from our conscious mind and in doing so they may help us realise our innermost ambitions. Freud believed that the fact that we cannot remember most of our dreams protects us from our own subconscious.

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Elements of dreams may be symbolic and many people spend exorbitant amounts of time interpreting them. Some dream themes may be recurrent or common to many individuals. Dreaming of losing teeth is quite common and is thought to represent feelings of low or threatened self-esteem. Dreams of being naked are common too and are thought to suggest feeling vulnerable or emotionally exposed. Dreams are often illogical and they may uncover things we were completely unaware of. That’s why it’s called your subconscious, not your conscious. Dreaming takes place during the fifth stage of sleep, the REM stage. During REM sleep, the eyeballs of the snoozer, which are usually still, start jerking around rapidly as if watching Forrest Gump play ping-pong. That is why it is called REM: rapid eye movement sleep. It is during this phase and only this phase of sleep that we dream. Each night we pass through the five sleep stages many times, in cycles lasting about ninety minutes each. We start at stage 1, the lightest type of sleep from which we may be most easily roused, and we gradually get into deeper and deeper sleep as we move from stage 2, to 3, to 4, which is ‘dee-eep slee-eep’ (say it in your dee-eepest voice: Dee-eep Slee-eep. Catchy isn’t it?). We then go back up through stage 3 and 2 into REM sleep: the Dreamtime. This completes the first cycle for the night. Usually in the first cycle, most of the time is spent in stage 4, ‘dee-eep slee-eep’. With each subsequent cycle, less and less time is spent in dee-eep slee-eep and more and more time is spent in REM and stage 2 sleep.

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Since nearly all the dee-eep slee-eep is acquired during the first four hours of sleep, you usually get virtually the same amount of dee-eep slee-eep in four hours as you’d get in eight hours. It is thought that the dee-eep slee-eep phase, stage 4, is the most vital and important portion of sleep in terms of the body’s restorative needs. That is why this stage of sleep is acquired first and foremost. Once the dee-eep slee-eep has been had, we get more time for the mind’s playtime: dreaming! Yay! Some people claim that they never or hardly ever dream. This is not true. That is not to say these people are liars but it would be more accurate to say that these people simply do not remember their dreams. Usually most dreams will not be recalled on waking in the morning unless the sleeper was woken, even only partially, during the REM stage. ‘Light sleepers’ may remember more dreams, since although they pass through all the same stages, from light to dee-eep slee-eep, like everyone else, they are simply more rousable at all times. They are more sensitive to minor noises or disturbances that other people may be able to sleep through. If they are woken during or just after the REM phase, they may become conscious of what they have just dreamt and still remember it in the morning. It depends too on how memorable and striking the dream contents are. For example, I recalled Michael Hutchence. The Bay City Rollers however may have been easily relegated to oblivion. Speaking of nightmares, these are often recalled, seemingly with greater frequency and clarity than the really nice dreams. That is because nightmares usually come during

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the second or latter half of the sleep period or nap and may be so distressing as to actually waken the sleeper, who then has a startlingly vivid and lucid recall of the fearful events. Nightmares evoke intense anxiety and terror as they invariably involve threats to one’s survival, security or selfesteem. During the nightmare, pulse rate and breathing rate may increase and rarely, body jerks (e.g., when nightmare involves falling off cliff) or screams (e.g., when about to get stabbed or about to stab someone) may rouse the sleeper, saving him/her from a fate worse than death: staying asleep! The first sensation on waking is usually intense relief: ‘Thank God it was only a dream!’ About 50 per cent of adults will recall occasional nightmares, usually only one or two a year. Nightmares with a similar theme or storyline may recur over and over again. Nightmares are more frequent in children and may relate to their emotional development. In adults, an increased frequency of nightmares may be an indication of a vulnerable or sensitive nature. In late adolescence however, sudden increases in the frequency of nightmares can indicate impending psychiatric disorder of serious nature (psychosis). Certain drugs and medicines may induce particularly vivid, frightening or even erotic dreams. The nicotine patches currently used for smoking cessation can give nightmares to some people. If the nightmares are very disturbing the person can simply remove the patch before bed and put on a new one on waking. Some sleeping pills can give nightmares. Other sleeping pills may actually suppress REM sleep such that the person experiences a ‘REM-rebound’ after cessation of the drug. During the REM-rebound, the

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person has increased REM sleep and enhanced dreaming and possibly more nightmares. In post-traumatic stress disorder, a severely traumatising event in real life may be re-experienced over and over again during sleep. These terrifying experiences are extremely disturbing and often accompanied by high emotion and shouting which waken the person as well as any bed partner. Extensive counselling and psychiatric care is often needed in these situations. Night terrors, or sleep terrors as they are also known, are similar to nightmares in that they involve nocturnal terror and panic. They are however more intense than nightmares and occur in the first third of the sleep period as opposed to the last half. The night terror lasts from one to ten minutes. During a night terror the person will scream and struggle physically, as if trying to escape. Pulse, breathing rate and perspiration are markedly increased. Sometimes the person may risk real physical injury when they attempt actual escape e.g., out the window. Attempting to rouse the person from a sleep terror is unhelpful since the person is too disoriented to understand that you are trying to help and your intervention may simply increase the sleeper’s panic and alarm. If they are about to leap out the window from ten floors up, however, it is still in their interests if you intervene. When the person wakes from the sleep terror, he/she usually has no recollection at all of what happened or at best a few sketchy images, unlike with a nightmare where recall is crystal clear. There is no harm done to the ‘night terrorist’ but his/her sleep partner may feel rather perturbed and intrigued.

Some cultures have held the belief that life itself is just one big dream: ‘And one day there will come a great awakening when we shall realise that life itself was a great dream’ (Chuang-Tzu, c. 350 BC). Some American Indian cultures believe that our dream life is our real life and this conscious

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Sleep terrors are similar to sleepwalking in terms of causality. It is thought that both result from a disorder of arousal whereby the person is partially aroused, without full consciousness but with activation of the motor (movement) system. Both sleep terrors and sleepwalking tend to run in families. Both conditions may occur for the first time during periods of high fever. Both conditions are more common in children and tend to resolve in adulthood but some people may start getting sleep terrors in adulthood during periods of high stress, or in old age, with the onset of dementia. Some parents manage frequent sleep terrors and sleepwalking by waking the child one hour after sleep has commenced in order to alter the sleep structure and abort the attack. This is often successful. Getting sufficient sleep and having a regular bedtime and waking time may also help. Resolving stressful issues, especially in adults, is vital. Occasionally medication is needed to help with severe sleep terrors. These medications work mainly by suppressing the deep sleep stages. The majority of people will never experience sleepwalking, sleep terrors or even excessive nightmares. For most of us, sleep will be largely composed of tranquil, light to dee-eep slee-eep and REM dreaming. Sadly, most of these dreams we can’t remember, but the ones we can give us a taste of how sweet these dreams may be.

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life, in which we strive and struggle, storm and stress, is just a mere bagatelle. One thing is true, that is while our conscious life is influenced highly by external factors and other people, our dreams are entirely originated and fabricated by our own minds. And the things our minds come up with! Our conscious life has numerous restrictions and logistic impossibilities that are insurmountable. Only in our dreams can we be anyone, do anything, go anywhere and find gold, splendour, adventure and mystery. We can die and come to life. We can give birth, to angels or demons, and we can be reborn. If there’s anything you want that seems quite out of reach, at least you can have it at night. In your dreams.

ONEIROLOGY — THE STUDY OF DREAMS Common dream symbols and possible meanings: Babies — burgeoning creativity? Baldness — anxiety about one’s sexual attractiveness? Barefoot — sense of freedom from convention? Black — depression? Blood — healing and renewal? Boats — journey of discovery, search for connection?

Climbing — ambition and desire for advancement or progress? Exams — feelings of self-doubt and need to prove oneself? Famous people — desire for excitement? Fish — spiritual or sexual evolution? Flying — success, joy and power? Food — sensuality? Green — yearning to re-connect with nature? Gun that doesn’t work — feeling impotent? House — state of repair represents your health status? (e.g., if house dilapidated and falling down, you may be getting run down yourself) Islands — feeling isolated? Keys — finding them may symbolise confidence; losing them, frustration? Mirrors — some crisis of identity? Missing the train, an appointment, forgetting a telephone number or PIN — frustration or anxiety? Nakedness — emotional vulnerability? Orange — happiness and fulfilment? Paralysis — being emotionally smothered? Pearls — pleasure and pure delight?

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Calm water — contentment?

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Bridges — life change or transition?

Rainbows — renaissance and fresh hope? Scissors — decisiveness? Snow — inhibited emotions? Spider spinning a web — creativity? Strangers — represent repressed or unrecognised aspects of oneself? Swimming — sex? Teeth falling out — diminished self-esteem? Telephones, especially difficulty with — frustrated communications and trouble being assertive? White — optimism?

Evelyn Waugh 1903–66: Decline and Fall (1928). ‘Last night, I didn’t get to sleep at all, all, all. The sleeping pill I took was just a waste of time, I couldn’t get to sleep ’cos you were on my mind, because last night . . . I wore the wrong T-shirt! I didn’t get to sleep, no I didn’t get to sleep. No, I didn’t get to sleep a-at alllllll!’ My big brother at age five, to the tune of a pop song of the era.

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leep’s a big deal. Not getting enough or good enough sleep’s a major pain that seems to behove one to tell as many people as possible all about it and hypothesise lengthily as to what one thinks may have caused the devastation. Whether you wore the wrong T-shirt, the rough bed socks or the tight G-string or whether you chose the wrong bed partner or simply the wrong bed, all these things may be important factors. The sleep environment can be very important in determining the quality of your sleep. Excessive noise, light or

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‘I haven’t been to sleep for over a year. That’s why I go to bed early. One needs more rest if one doesn’t sleep.’

MIND

Sleep problems

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disruptions will mar a good night. Shut out noise and light by employing curtains and blinds, window and door latches, as well as earplugs and eyemasks, if necessary. Sometimes soundproofing the bedroom may be an option. Don’t leave the TV or radio on overnight. Even though you may be able to fall asleep, the noise and light will interfere with your sleep patterns and disrupt your rest. Take loud ticking clocks or very bright digital clocks into another room far, far away. Make sure your bed surface is clean, smooth, flat and firm but soft. Have adequate but not excessive covers. Multiple thin cotton layers are preferable to a single overly heavy doona where it is ‘all or nothing’. If you wear night clothes ensure they are loose enough but not so voluminous you will get tangled up, strangled or smothered in excess folds. Have a soft but supportive pillow (or two) so your neck is not overly bent or twisted and your head rests comfortably. Don’t have too many books, pamphlets, toys, dishes or stuffed/live creatures on your bed surface. Certainly sharp or breakable objects should be kept well away. Cutlery, food and drink are equally unwelcome in the bed where they could give a sleepy body (maybe yours!) a nasty surprise. The whole bedroom if possible should be cleared of any belongings that do not relate to sleep (or sex). This will not only create a calmer, more serene, uncluttered atmosphere in the slumber chamber but will also decrease the excess dust accumulation that can trigger asthma and hay fever. If feasible, avoid any activities in bed other than sex and sleep. Masturbation is fine too. But that’s my final offer. Nothing else, okay? Eating, working, watching TV, arguing, weight-lifting and volleyball should be practised elsewhere

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(unless these activities are directly involved in your sex play. Or masturbation.) Make sure you are not hungry, itchy, dirty, too hot, too cold or in pain when you try to fall asleep. Have a snack such as a warm milk drink or banana before bed. These foods are rich in tryptophan, an amino acid thought to play a role in inducing and maintaining sleep. Have a warm bath or relaxing shower before bed and dress according to the climate and your comfort. Take a mild pain reliever such as paracetamol, if necessary, to quell aches and pains and consult your doctor if these are persistently troublesome. Avoid caffeine* containing drinks and foods, such as coffee, tea, chocolate and cola drinks. If you want to have these, consume them in moderation and never after about 4 pm or at least stop having them about seven hours before your expected bedtime. You can get into a vicious cycle whereby you consume too much caffeine, have disturbed sleep, feel tired the next day and therefore drink more caffeine to stay awake which further upsets the following night’s rest. Try to have no more than about 200 mg of caffeine each day and make sure you have it early in the day. Try not to use caffeine to keep you awake. It will keep you awake all right: all night. Nicotine in cigarettes and cigars causes release of adrenaline into your system and stimulates your mind and body to alertness. It is preferable if you don’t smoke at all but at least desist for the two hours before sleep so the nicotine effects can wear off. If you wake at night and feel like a cigarette: don’t. The nicotine will make it even harder to get back to sleep. There is the additional risk that you may set the bed and your bedmate on fire. That will really disturb your rest.

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Excessive alcohol leads to fragmented sleep and proportionally less deep and REM (rapid eye movement) sleep. While a little alcohol may help you relax and feel drowsy initially, the sleep may not be maintained and the quality may be poor. If you drink too much you risk dehydration since alcohol is a diuretic. You may be up to the toilet multiple times and also wake up with a hangover. If you wanted to feel refreshed, this is not the way to achieve it. Using sleeping pills can, in the short term, help with sleep difficulties and anxieties but tolerance to these medications develops quite quickly, such that bigger and bigger doses are needed to get the same effects. If you use them for too long, it gets harder and harder to get off them and stopping them can bring on even worse anxiety and insomnia than you had to begin with. Try not to resort to sleeping pills. If you do need them occasionally, use them as sparingly and infrequently as possible and come off them as soon as you can. Follow your doctor’s advice and don’t ‘doctor shop’, getting prescriptions from more than one doctor, otherwise no-one can keep track of just how much and which drugs you are taking. Regular exercise can help regulate sleep patterns but avoid strenuous exercise in the three or so hours before bed or the increased arousal may impair your ability to fall asleep. Try to get into a routine of winding down before bed by doing something relaxing and stress-free such as listening to music (not heavy metal) or watching TV (not ‘Beauty and the Beast’ re-runs and not those dastardly advertorials. You might be tempted to ring up and buy some unnecessary exercise equipment or a new set of

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saucepans.) This is not the time to start rustling together your taxation papers and wondering what happened to the receipt for the computer. Try to set aside time during the day to think about and discuss problems. Make a list of issues to deal with and an itinerary of what you plan to do and when. Set this paper aside and don’t think about it any more once you start winding down for bed. It will still be there in the morning and you will be in a better frame of mind to deal with it all when you have had a deep and restorative sleep. Don’t keep putting off pressing decisions and actions. Procrastination will only extend your feelings of anxiety and worry. Work through a problem-solving process with or without support from a friend or doctor. Sometimes uncertainty and indecision are more torturous than any possible outcome could ever be. This distress can markedly disturb your sleep. If you are lying in bed worrying or simply feeling very awake, get out of bed and go into another room to do something else for a while until you feel sleepy. Try knitting or reading something boring such as the dictionary. Start at ‘A’ and don’t start hopping around looking up words like coprophilia, coprophagia, nymphomania or necrophilia. If at all possible, avoid napping during the day even if you are tired because this may compromise the following night’s sleep. Also maintain the same waking time regardless of when you went to sleep. That way you will be ensured of a good sleep the next night because you will be pretty tired. By waking at the same time every day regardless of whether you

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have to work, go out or not, you will establish and maintain a steady sleep rhythm that will facilitate regular, good quality, golden slumbers. Don’t try to go to bed when you are not tired. Prepare for bed but wait until you are feeling slightly drowsy before actually trying to go to sleep. Feeling frustrated, because you feel you ought to be asleep but aren’t, is not conducive to sleep. If you go to bed late, still wake up on time the next morning but go to bed earlier the following night if you get tired sooner. One excellent soporific, for those with the inclination, is sex. Masturbation is a great substitute with the added benefit of no need to say ‘Thanks for that’ or ‘I love you’. This will set you in the right frame of mind for good sleep and hopefully, adventurous and perhaps erotic dreams. Most importantly, go to the toilet before bed and avoid drinking too much fluid before bedtime. Hopping in and out of bed to tread the cold tiles and sit your warm botty on the icy seat can be a strain. The alternative, wetting the bed, is even more disruptive. Not to mention embarrassing. Sleep tight and don’t let the bed bugs bite.

*Caffeine content of common drinks: Instant coffee: 60–100 mg per cup (depending on how much you put in) Freshly brewed/ roasted and ground/ percolated coffee: 80–350 mg per cup (depending on type of beans, strength of brew and style of coffee making) Decaffeinated coffee: 2–4 mg per cup (packet will indicate usually) Tea: 8–90 mg per cup (depends how strong and what type of tea) Cola drinks: 35–250 mg per 250 ml

African cocoa: 6 mg per 60 ml South American cocoa: 42 mg per 60 ml Chocolate: 20–60 mg per 200 g (dark chocolate usually has more caffeine)

MIND

Some cough, migraine and slimming preparations bought over the counter at the chemist: 20–100 mg per dose (check the label or ask the pharmacist about the contents)

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Hot chocolate: 10–70 mg per cup (depends how strong the cup)

What happens if I don’t get enough sleep?

W

ell the short answer is: nothing. No, you won’t start growing hairs on your palms . . . or even dates. You won’t go crazy or lose brain cells or get cancer. You’ll just get pretty tired. The world record holder for the longest period of continuous wakefulness is held by Randy Gardner who stayed awake for 264 hours (eleven days). After this long spell of being up he went . . . to bed! He slept for only 15 hours. The next night he had 10.5 hours, 9 hours the next night and then back to 6 hours after that which was his usual sleeping time. So in the three nights following his ‘Big Day Up’, he only had 16.5 hours extra sleep to make up for 66 hours of lost sleep during the 11 days when he didn’t get any sleep at all!

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How was he able to make up for his sleep deprivation? Well in the three recovery nights, he made up for his deep sleep and REM sleep first by having a much greater than usual proportion of deep sleep and REM sleep in the recovery sleeps. Usually about 20 per cent of an average night’s sleep is deep sleep, 60 per cent is light sleep and 20 per cent is REM sleep. When Randy had his recovery sleeps, he had on average: 35 per cent deep sleep, only 30 per cent light sleep and 35 per cent REM sleep. Goodness knows what motivated Randy to stay up so long. Must have been watching the Olympics or something. Numerous studies have been done over the years, examining people who are deprived of sleep for anything from 70 to 205 hours. The studies have found, naturally enough, that the main symptom sleep-deprived people suffer is extreme sleepiness, difficulty concentrating and lack of motivation, especially with boring, repetitive tasks. After the person is allowed to sleep again, all these effects disappear. Concentration and motivation go back to original levels. There is no apparent long-term effect such as madness or illness. That’s right! When your mother tells you to ‘Go to bed this instant!’, she may be reassured to hear that sleep deprivation will not make you any madder or sicker than you already are. When kept up for prolonged periods, one needs constant stimulation to prevent drowsiness from taking over. The minute we are left undisturbed we will nod off directly. Sleep deprivation makes you feel tired (Der!) and a bit listless and irritable but it causes no major damaging effects mentally or physically and when you really need to sleep, you will not

People with only modest sleep needs could either go to bed a lot later, get up a lot earlier or a bit of both. I think not needing much sleep is a boon and if I was such a person I’d love it and I’d be sure to make the most of it.

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be able to stop yourself. Just make sure that when this irresistible sleepiness takes over, you are not behind the wheel. Otherwise you may need considerably more than just recovery sleep. Despite science knowing that sleep loss will not really harm you in any sinister way, many people get extremely uptight about lack of sleep. That is largely because the time they are not asleep is spent cursing and stressing about being awake and worrying about how deleterious this will be to their long-term mental and physical health. It is in fact the worrying that is the damaging part, not the sleep loss. If you really need the sleep, you will fall asleep anywhere, let alone in a warm comfy bed. Tossing and turning, stressing about not sleeping, is more likely than anything to cause arousal and alertness, which inhibit sleep. If you are not sleepy you can either just lie there and ‘rest your eyes’ or else get out of bed and do something pleasant. Why not wallpaper the bathroom? (NB, Must not wallpaper inside shower!) While the average person likes to get seven to eight hours a night, some people simply need less sleep than others. The older you get the less sleep you need but even young people may be lucky enough to require very little sleep. Napoleon for example only slept two hours a night. How did Josephine cope I wonder?

There’s more to do than playing ‘Patience’ all night! It can be good to get to know a few other people who are night owls, or even people who are nocturnal or regularly do ‘night duty’, with whom you can share your night-time vigour. So much more time to pursue hobbies, practise your art (regale the neighbourhood with your trombone or drum practice!) or even sport. Golf is not ideal as a night sport but why not consider a nocturnal ping-pong tournament in your basement with all the other night spirits you know. Fluoro glow-in-the-dark balls. Yes!

DRUGS

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Marijuana: pot, grass, dope, mull, cannabis, hash, hashish, hash oil, weed, yarndi, THC ‘What hashish gives with one hand it takes away with the other: that is to say, it gives the power of imagination and takes away the ability to profit by it.’ Charles Baudelaire (1860).

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he term ‘marijuana’ (also spelled ‘marihuana’) was coined after the Mexican-Spanish word for ‘intoxicant’: ‘mariguana’. It is a word which rhymes with ‘mañana’, another Spanish word, which means ‘tomorrow’. Not that that has any relevance. My father pronounces it ‘marreejewanna’ which is pretty funny and my Mum calls it ‘wacky tobacky’ which she pronounces with a distinctly Yankee twang. Which is funny since she is Chinese. In fact there are so many terms used to refer to this drug, one becomes convinced of the richness of our language.

When grass is smoked, the THC gets into the brain within minutes and a ‘high’ is felt which can last up to five hours. When eaten, the effects take longer, say one hour, to come on but last for longer too, up to twelve hours. The drug is absorbed and stored in the body fat and slowly released

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Reefers (hand rolled cigarettes), joints (ditto), bongs and cones (water pipes) and snowcones (when ecstasy is sprinkled on top of the cone), hash cakes and cookies are the commonest ways of taking marijuana, with smoking being the most common of all. Pot is derived from the dried flowers, buds, stems and leaves of the Cannabis Sativa or Indian hemp plant. It looks greenish grey to brown in colour and resembles tea leaves or dried herbs. The active chemical in marijuana is called delta–9-tetrahydrocannabinol or THC for short. The concentration of THC is highest in the flowers or buds of the plant. (Gives a whole new meaning to ‘Bill and Ben: Flower “Pot” Men’ and their dear friend, ‘Little Weed’.) Different batches of dope will contain varying concentrations of active drug. In the past, most samples of marijuana were found to contain about 1–2 per cent THC at the most but recently concentrations have been found to be as high as 4–5 per cent. This is thought to be due to increased inclusion of buds and flowers. Hash oil, a concentrated liquid marijuana extract, has been found to contain 11–28 per cent THC. Cannabis was used as an intoxicant and medicinal herb as far back as 2737 BC. In the last century, however, its use has been largely recreational since other drugs with more selective action and more predictable effects have been developed to supplant its medicinal uses.

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back into the blood. It can take many weeks for the THC to completely disappear. The typical features of being ‘stoned’ or ‘high’ include feeling unusually happy, relaxed and disinhibited, and talking and laughing freely. Speech may be fragmented, however, with disjointed patterns of thought and loosening of associations. Things that are usually considered unrelated may seem connected, and vice versa. Insights of seemingly stupendous proportions may be gained while stoned but the ability to analyse and assess the quality of such insights is vastly impaired such that following the ‘high’, the insights turn out to be mundane or useless. Memory, problem-solving ability, concentration, balance and coordination are significantly impaired while stoned. Both short term and long term memory are affected, especially short term. This difficulty with recall is thought to be due to the increased imagery and thought flow arising from the intrusion of extraneous associations. There is little evidence that retrieval of information learned prior to getting ‘high’ is affected once the person comes down. Interestingly there is some evidence that some information acquired whilst stoned may not be recalled after coming down but may be recalled more easily when the person gets stoned again. Physical effects of pot include increased heart rate and red eyes. Blurred vision and headaches are experienced by some. Effects on appetite and sexual experiences are variable and seem to be related to cultural expectation. In Australia and North America, users frequently report an increase in appetite, especially for sweets (‘the munchies’), and consequent weight

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gain. In addition they claim to experience enhanced sexual stimulation while stoned. In many countries including India, however, pot is used as a sexual depressant, while in Jamaica it is used to suppress appetite. Even those who experience enhanced sexual experience with low doses of pot usually experience decreased libido and even impotence with high doses or prolonged use. The commonest adverse reaction to pot, especially to unaccustomed high doses, is panic attacks. Anxiety, confusion, restlessness, hallucinations and feelings of dissociation are also common. Cannabis-related psychosis has been described. Whether the psychiatric disorder is caused, triggered or exacerbated by the pot is uncertain. With chronic use of pot, there is significant risk of lung damage and cancer. Long term use may also lead to decreased motivation, concentration, memory and learning ability in some people. In men, testosterone level, sex drive, sperm count and motility are reduced, and in women menstruation may become irregular and fertility is reduced. Using pot during pregnancy may cause smaller babies and foetal abnormalities including leukemia. Tolerance and dependence develop with long term cannabis use. Tolerance means bigger doses may be required to achieve the same degree of high. The dependence is primarily psychological, consisting of simply a strong compulsion to use. On cessation of drug use, very high dosage users (10–20 joints per day) may experience a withdrawal syndrome, consisting of nausea, vomiting, sweats, tremor, irritability, insomnia, headaches, depression, anxiety, loss of appetite and diarrhoea.

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The effects experienced will depend largely on how much and how often you use it, your general health (both physical and mental), the social setting in which you use it and whether or not you mix it with other drugs. Mixing pot with other drugs can increase the intensity and toxic effects of all the drugs and is very hazardous. There is however no proof that using pot will necessarily increase your use of other drugs or lead you to so called ‘harder drugs’ such as heroin. Even without going on to other drugs however, frequent pot use can result in a number of social and financial problems. Pot is expensive and besides that, is illegal to use, possess or sell. Even giving pot to someone else is illegal. The same applies to any equipment used for pot consumption such as a bong. Driving under the influence of pot is extremely hazardous. If you are stopped by the police, the breathalyser will not pick up marijuana but if they are suspicious of your behaviour or demeanour the police can take you to hospital for blood and urine tests which will detect pot as well as other drugs. Being caught driving under the influence of any drug, including pot, could result in loss of licence, fines or imprisonment. The commonest social problem resulting from frequent pot use is that users find that their social life becomes centred on pot and other pot-head friends; other activities and priorities slide into oblivion. Sleep, work, study and other relationships may start to suffer as they all take a back seat to scoring and getting stoned. Most people who smoke a lot start realising at some stage that their pot use is excessive but may find it hard to cut

It is worth recalling that it is still an illegal substance although the personal use of small amounts of pot has been decriminalised in South Australia and the ACT. Despite the

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down. In fact stopping ‘cold turkey’ is often perceived to be easier and more effective than trying to wean off gradually. It is a good idea to set a quit day and start thinking about alternative activities that can replace the pot smoking, while still enhancing relaxation and sense of wellbeing. You may need to change your routine and get back in touch with some of your old friends who don’t use drugs. Tell people that you don’t do pot any more and resist peer pressure to go back to the old ways. Try exercise, meditation or a new hobby to absorb stresses and frustrations. Calculate how much time and money you are saving by not having to go out and buy that expensive, illegal substance any more. You will probably notice how much more clearly you can think and you may find yourself feeling more consistently peaceful, relaxed, happy and positive. Despite the potential risks and adverse affects (mainly associated with heavy or frequent use), many people find using pot rewarding and pleasurable. Individuals who are not highly anxious about loss of control usually find the unpredictability, ambiguity and variability of perceptions, loosening of traditional associations, intrusion of new and unrelated thoughts and lack of familiarity pleasantly novel, inspiring feelings of creativity and insightfulness. But not all individuals enjoy the experience and many who do have difficulty practising the moderation and discretion which are vital in minimising the risk of serious harm.

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illegality it is still the most commonly used drug in Australia, after alcohol and tobacco, with 39.3 per cent of people over 14 having tried it and 17.9 per cent having used it recently*. Pot’s been around since before Christ and despite being outlawed numerous times over the ages, it looks like it’s going to stay.

DRUGS

*Figures based on the 1998 National Drug Strategy Household Survey.

Ecstasy: E, MDMA, ecky, vitamin E

A

few times, at dance parties, I would see patients of mine larking about. They would come up to me and take my hands before saying adoringly ‘Oh, Dr Cindy! I love you. You are the best doctor. Hey! Chrissy/Geoff! Come here! I want you to meet my doctor. Isn’t she beautiful?’ Then I would have two or three acolytes worshipping me. I can’t say I didn’t enjoy it. With any luck, one or two of my friends would be present to witness these emotional outpourings of gratitude and they would be deeply impressed. None of them had any idea I was even competent let alone so charismatic.

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‘Gee, she must be good?’ they would murmur sceptically. I would pretend it was all in a day’s work and secretly I’d think ‘Gee, I must have really helped them, a lot!’ It wasn’t until ages later that I realised the gushy adulation was probably (I only say probably) less to do with my excellence, and more to do with the drug ‘ecstasy’. Ecstasy has the reputation for inducing very warm, loving and close feelings towards people, even virtual strangers. For this reason, it has been called ‘the Love Drug’. Users claim it makes them feel more friendly, outgoing, open, trusting and empathic. Some feel it enhances communication, understanding and insight and for this reason it was used by psychotherapists in the seventies to help their patients get in touch with their emotions, open up and relate to their partners. Ecstasy is said to induce feelings of euphoria, relaxation, wellbeing and happiness. As well as having speed-like, stimulant effects, it also has LSDlike hallucinogenic effects. Sensations may be heightened such that things look, feel and sound amazing, people appear incredibly beautiful, one’s own dancing may seem stupendous. One has a sense of increased confidence, energy, power and talkativeness. Hallucinations and perceptual distortions and even religious or transcendental experiences have been reported. These effects last about four hours when the drug is swallowed; less when it is snorted and even less when injected. No wonder ecstasy has been received so ecstatically by so many, at least initially. But along with these positive effects there are also negative effects: increased blood pressure, pulse and temperature, muscle tension, spasm or locking,

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jaw clenching, tiredness, insomnia, sweats, blurred vision, loss of coordination, anxiety, nausea, confusion, panic and at higher doses, vomiting, irrational behaviour, paranoid or even suicidal thoughts and convulsions. In the come-down period, usually the next day, users may feel exhausted, depressed, anxious, paranoid and irritable. The user may experience muscle aches and difficulty concentrating as well as loss of appetite and insomnia. This come-down will be more intense with bigger doses or if the ecstasy was injected or taken with other drugs. Most people find that as they continue taking ecstasy, the positive effects decrease and the negative effects increase. Tolerance to ecstasy builds up with repeated use so that to get the same intensity of effects, larger and larger doses are required. Not only do the negative effects increase, so do the risks of life-threatening events. Most of the fatal incidences with ecstasy have involved overheating and dehydration. Ecstasy directly affects the temperature control mechanism in your body so your body’s thermostat doesn’t work properly. In addition, the environment of a hot, humid, overcrowded club, in which hundreds of people are dancing vigorously and not drinking enough fluids, exacerbates the problem. Drugs like alcohol and speed taken in conjunction with E make the dehydration worse. It’s advisable to drink about 500 ml of water or juice per hour if you are dancing and around 250 ml per hour if you are not dancing. This fluid should be sipped and not guzzled since drinking excessively, say more than one

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litre per hour, can cause the brain to swell which can lead to coma and even death. If you start feeling hot, faint, confused or nauseated, develop a headache or have difficulty speaking or thinking properly, these could be signs of severe dehydration or overheating. Passing very little to no urine or urine that is dark in colour, having a fast heart rate, or not sweating despite vigorous activity are also bad signs. You need to cool down and sip water and most importantly, get a friend to stay with you until you recover. Go to the First Aid area or local hospital as soon as possible, if necessary by ambulance. Never be afraid of seeking medical help. Doctors are interested in your wellbeing and are not required to contact the police. If there is a death or serious accident however, obviously the police will become involved. Driving after having taken ecstasy is extremely dangerous since the sense of over-confidence may lead to recklessness, risk-taking and speeding. Also blurred vision or hallucinations may come on while you are driving. Being caught driving under the influence of ecstasy (or indeed any other drug) can lead to loss of licence, fines and imprisonment. Taking, possessing or supplying ecstasy is illegal in itself and penalties include gaol and fines of up to $500 000. When you buy ecstasy you can never be sure what you are really getting. Even if the tablet or powder looks the same as what you have had before, it may contain other substances which might have unpleasant or harmful effects. In 1996, six people in South Australia died after taking what they thought was ecstasy. The drug was actually a toxic form of amphetamine called PMA.

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Since ecstasy is illegal and its ingredients are often hard to acquire, manufacturers substitute many other substances from caffeine, pseudoephedrine, glucose and bicarbonate of soda to ephedrine, MDA, MDEA, MBDB, ketamine and PMA. Some tablets have been found to contain small quantities of heroin, speed, cocaine and LSD. In police seizures during 1996 and 1997, most of the supposed ‘ecstasy’ examined was found to contain only 28–40 per cent ecstasy and some contained none at all. When you buy something illegally you have no recourse to complain when you get ripped off. Worse still, if you have a bad reaction you cannot even be sure what it was you reacted to. Some people advocate always buying from the same dealer, avoiding scoring from a party or club and only taking stuff when someone you trust has already tried the same batch. These are logical steps to take but of course they are absolutely no guarantee of safety. The bottom line is that whoever you are scoring from is a drug dealer who is involved in an illegal practice probably to make money or supply their own drug habits. Your wellbeing is unlikely to be their primary concern. Even though ecstasy has been around since 1912, when a German chemical company developed it as an appetite suppressant, it has only really become popular in the last decade or so, so not much is known yet about its long-term effects. Studies suggest that it can have damaging effects on the heart, liver and brain, in particular the memory and the ability to process complex thoughts. Depression and sleep disturbance are also thought to be possible long-term hazards.

Relationships with family, friends or loved ones may deteriorate, either because of your erratic behaviour and moods or because they are worried about your drug taking,

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Some studies have suggested that few people use ecstasy for long periods, probably because of the increase in negative effects and longer ‘hangover’ periods with repeated use. One of the problems with the ‘hangover’ or comedown period is that some people start taking other drugs or more of the same drug to try to deal with it. This tends to compound and worsen the problem. People who use ecstasy regularly may be inclined to get run down, have reduced energy levels and reduced resistance to infections. It can take the whole week to recover from the physical and psychological effects of the weekend’s partying. If you then use again the following weekend, you are more or less constantly under the effects of the drug. Ecstasy can cause a multitude of other problems of a social nature. Ecstasy-induced friendliness, flirtatiousness and trustfulness may lead to people taking advantage of you. You may be less discriminating about having sex and fail to take adequate precautions. In the period following ecstasy use, when feeling depressed or not thinking clearly, you may make rash decisions you subsequently regret such as leaving school, Uni, work, home or your partner. Your ecstasy use may interfere with functioning or attendance at work or school. If you are paranoid or hallucinating as a result of ecstasy use and attend work or Uni in this state, your aberrant behaviour may result in expulsion or firing.

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leading to frequent arguments. Ecstasy is expensive and spending money on E can mean running out of money for rent or food. Some people resort to stealing from parents or flatmates to pay for drugs and others shoplift or start dealing themselves. People’s reasons for taking ecstasy are many and varied, from desire to experience a different state of consciousness to desire to lose control. Curiosity or peer pressure or even social anxiety or shyness may be contributing motivating factors. The initial instinct is rarely a purely destructive one. Nonetheless the use of ecstasy can have self-destructive and harmful effects and users can lose insight and be unaware of how adversely the ecstasy is affecting them. People from all walks of life use ecstasy, from teenagers at school to middle-aged professionals including doctors, lawyers and academics. About 3 per cent of Australians have tried it and about 1 per cent have used it in the last twelve months. Only a fraction of these will end up in hospital or get in trouble with the law. A significant minority will experience severe adverse reactions in the short term. As far as long-term effects are concerned, we simply cannot be sure at this stage what the degree of brain or other organ damage will be. The drug is illegal and known to be potentially hazardous but this has not stemmed its popularity. In the knowledge that, despite the discouragement from medical and legal authorities, people will still continue to use ecstasy, the advice is to use minimal doses infrequently, swallow or even snort rather than injecting (which involves risk of blood vessel blockage, as well as transmission of HIV, Hepatitis B and Hepatitis C), use in the presence of other responsible,

The most popular drug in the world ‘Lechery, sir, it provokes, and unprovokes; it provokes the desire, but it takes away the performance.’ Macbeth, Act 2, scene 3, Shakespeare.

T

he most popular psychoactive substance worldwide today is alcohol. It has been around for yonks with evidence of production by the Egyptians more than 5500 years ago, and in what is now Western Iran 7500 years ago. Although at first taste almost everyone dislikes the flavour, developing a palate for it is commonly succeeded by developing a passion for it. Even elephants, chimpanzees, baboons and horses have been noted to show preference for water containing a small percentage of alcohol over

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trustworthy friends who can help if you get in trouble, don’t drive and don’t take any other drugs. Calling a drug ‘ecstasy’ has got to be one of the cleverest marketing moves ever. Unfortunately like most marketing gimmicks, this drug doesn’t necessarily live up to its moniker. In the words of Mr Mike Brady of the ‘Brady Bunch’, remember ‘Caveat emptor: buyer beware.’

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pure water and some birds prefer fermented over unfermented berries. Alcohol is a product of fermentation which can occur even accidentally when certain yeasts, moulds and bacteria act on sugar in a variety of fruits (wine) and grains (beer and distilled spirits). The majority of alcohol drunk by humans, however, has been carefully formulated and meticulously prepared to ensure consistent quality in terms of taste, aroma, colour and, most importantly, alcohol content. The alcohol content is specified in terms of proof, which is exactly double the actual percentage of ethyl alcohol (ethanol) contained. Ninety proof whisky for example, is 45 per cent ethanol. Of course not everyone is so fussy. Chronic alcoholics on the skids frequently resort to the cheaper alternative of ‘meths’ (methylated spirits) despite the devastating consequences. So what makes this product of gone-bad vegetation so popular? Why do 80.7 per cent of Australians over the age of fourteen drink it? Well basically because it makes you feel good. It enhances social and physical pleasure, relaxes you and decreases inhibitions. It gives a warm, flushing sensation by increasing circulation to the skin and in some people it enhances appetite. At low doses it increases psychological sexual arousal. However, it decreases physical sexual arousal, that is vaginal and penile vasocongestion (engorgement with blood). In other words, while a small amount will turn you on mentally, the more you drink the less capable you are of doing anything about it. In the long term, heavy drinking can cause impotence, shrinking of the testicles, decreased testosterone levels and problems with sperm production.

About one-quarter of ‘social drinkers’ and about 90 per cent of alcoholics will experience occasional to frequent blackouts with very heavy drinking bouts. They have complete amnesia regarding the period of intoxication.

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Drinking moderately, say two standard drinks* a day for gals and three for guys, with at least two alcohol-free days a week, is considered low-risk drinking. In fact numerous studies looking at the relationship between alcohol intake and mortality have shown that those who drink one to two drinks a day have lower mortality than abstainers. Heavy drinkers (more than three a day) have the highest death rate with mortality increasing dramatically with higher intake. The higher mortality rate with heavy drinking is due to the increase in liver disease, cancer and car accidents. The health and longevity benefits of sensible drinking are thought to accrue from benefits to the cardiovascular system as well as perhaps quality of life and stress relief factors. It is important to remember that while one or two drinks a day may be beneficial, saving them up for a weekly binge of fourteen drinks all at once is still extremely bad for your health. You have to spread them out or you still damage your liver and other organs. Probably the most precious organ of all, the brain is gravely endangered by excessive drinking. With chronic alcohol consumption the brain shrinks. The ability to think undergoes what has been described as a ‘premature aging’ process, with impairment of reasoning, problem solving, memory and ability to learn new things. Alcohol exerts a toxic effect on brain cells (neurones) and when these neurones are lost, they never regenerate.

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They may come to in a strange place, perhaps with a strange person, with or without their car, handbag or wallet and with or without the realisation that their drinking has become problematic. Alcohol induces an unnatural sleep in which the REM stage, in which rapid eye movements and dreams are most marked, is greatly reduced or absent. The hangover effect experienced the morning after excessive drinking is caused by a number of factors including this disturbance of normal sleep patterns. Alcohol is a diuretic, which causes dehydration, a major factor in the hangover. Low blood sugar and build up of acetaldehyde (a product of alcohol metabolism) in the brain also contribute to the hangover. Unfortunately, while some people have feelings of remorse after such an experience, others attempt to ‘cure’ the hangover with ‘the hair of the dog’ (that bit them). Other ill effects of alcohol excess in the long term include malnutrition, frequent infections, poor immunity, depression, relationship troubles, incapacity for work, financial and legal problems. While sensible drinking can undoubtedly bring untold pleasure and epicurean delight to some, there is simply no end to the amount of damage a person can do to him/herself and others as a result of alcohol excess. So what makes an alcoholic? What causes this compulsion to drink excessively? Well first of all, alcohol is tolerance inducing: over time, people need larger and larger amounts of alcohol to derive the same effect (be it happiness, tipsiness or drunkenness). Also it is physically addictive. Cessation of alcohol after chronic heavy intake causes a

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withdrawal syndrome consisting of anxiety, weakness, tremor, raised blood pressure, pulse and breathing rate. In severe cases, convulsions may occur with headache, fever, nausea, agitation, confusion and severe psychiatric disturbance including hallucinations. This constellation of symptoms is known as delirium tremens or the DTs and typically occurs two to four days after heavy drinking ceases. This withdrawal period may be fatal because of the potential for convulsions and respiratory arrest, so medical treatment is essential. Alcoholism can affect all socioeconomic groups and all races although Asians tend to drink excessively less often, possibly due to the inability of many Asians to metabolise alcohol properly (specifically, the metabolite acetaldehyde) because of an enzyme problem that causes facial flushing and nausea, which puts them off. Men outnumber females in alcohol addiction in a ratio of six to one. There does seem to be a genetic predisposition for alcohol addiction, which is thought to be related to other compulsive behaviours like gambling, other drug use and even eating disorders. One-third of alcoholics however have no family history of alcoholism and only 30–40 per cent of sons of alcoholics follow in their parents’ footsteps. Different cultures have different per capita drinking rates and the correlation with rates of alcoholism is variable. In France, Italy and Greece the per capita drinking rate is high, but whereas France has a high rate of alcoholism, the alcoholism rate in the other two countries is low. The USA and Sweden by contrast have relatively low per capita drinking rates however their rate of alcoholism is high.

Examining this data along with comparisons of drinking habits and attitudes in different cultures has led to the suggestion that alcoholism rates are likely to be lowest in cultures where drinking is not perceived as a mark of virility or adulthood, where abstinence is regarded as socially acceptable and excessive drinking is not, where alcohol is served in small or diluted quantities predominantly with food and when children are brought up with alcohol in a religious or family setting with parents setting a good example of sensible and controlled drinking. Engendering a healthy attitude to drinking, incorporating both appreciation for the finer aspects and respect for the potential hazards, is vital to making the most of what can be an extremely rewarding (and legal!) drug. On an individual level, each person needs to monitor and control his/her level of drinking, and on a broad scale, the culture which approves, sanctions and encourages excessive drinking, to the extent that it becomes competitive, coercive, compulsive and a pathetic badge of manliness, needs the courage and wisdom to change.

*A guide to ‘standard drinks’ A standard drink, containing about ten grams of alcohol is approximately equivalent to: one schooner (425 ml) of light beer (2.7 per cent alcohol) one middie (285 ml) of ordinary beer (4.9 per cent alcohol) one glass (100 ml) of wine (12 per cent alcohol) one nip (30 ml) of spirits (40 per cent alcohol) one glass (60 ml) of sherry or port (20 per cent alcohol)

‘Cocaine is God’s way of telling you, you have too much money.’ Robin Williams, U.S. actor and comedian.

C

oke, cocaine and crack are different names for essentially the same drug, derived from the leaves of the coca plant. It is illegal to use, possess, sell or give this drug to anyone else and if you are caught, you could be fined up to $500 000 and/or get gaoled for anything from two years to a lifetime. Despite the illegality and potential punishments, many people still use cocaine, with 4.3 per cent of the Australian population having tried it and 1.4 per cent having used it in the past twelve months. Because of the illegality, you will often find people using it in the loos if they are in a public place such as a bar, club or restaurant. In private premises, however, the lounge room, bedroom or really anywhere might serve as the coke den. Cocaine comes in three main forms: ‘Cocaine hydrochloride’, which is the commonest form in Australia, is a white powder which people snort, typically using a rolled-up fifty dollar bill as a pseudo-chic delivery system. It can also be injected. This form cannot be smoked since it is destroyed by high temperatures.

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Do things go better with coke?

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‘Freebase cocaine’ is a different form of coke which can be smoked. It tends to have a faster onset of effects and therefore increased risk of faster development of addiction, tolerance and dependence. ‘Crack’ is a form of freebase coke which is usually smoked. It comes as crystals called ‘rocks’ and is not commonly available in Australia yet. It tends to be cheaper and produces a rapid-onset, intense high, which makes it extremely addictive. When you buy it from a dealer or ‘friend’, you never really know what you are getting or how pure the stuff is. It could be ‘cut’ or mixed with anything from talc to castor sugar to other highly dangerous substances that look similar. Buying illegal substances from people who are, by definition, criminals, since they are involved in and are involving you in criminal activity, is always a risky business. If you get caught, you’re in big trouble. If you don’t get caught you could, in the long term, be in even bigger strife. So why do people get involved in cocaine sniffing, smoking and injecting? Well probably for the same reasons people get into any illicit or ‘recreational’ drug use. Peer pressure may play a part. Desire to try something new and experience a different mind-set may be the motivation. Perhaps because coke is so expensive, using it may be seen as a kind of status symbol. Perhaps you try it because your ‘friend’ or someone you are in awe of does it and says it’s cool. Perhaps someone gives you some and it seems like too good an opportunity to waste. Perhaps alcohol or other drug use has affected your judgement and nothing really seems like a bad idea any more. You throw caution to the

1. Tolerance — you need more to get the same effects. 2. Dependence — coke becomes a very important and indeed vital part of life; you think about it, how you can get it, when you can use again, how to get more, how to finance your use and so on, and other things — e.g., job, relationships, health, family, sleep, nourishment, money, responsibility, even survival — seem much less important than maintaining your coke supply. More than 10 per cent of users become heavily dependent. 3. Addiction — if you try to cut down or stop, you suffer withdrawal symptoms which may include intense, persistent cravings, nausea, vomiting, anger, aggression, depression, shakes, fatigue, weakness, voracious hunger, disturbed sleep, excessive sleeping, suicidal impulses, muscular aches and pains. These symptoms will go away eventually (usually a few days) and if you desist from further use, your addiction is temporarily cured.

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wind. For whatever reason, you decide to give it a go, rationalising your decision with such reasoning as ‘Well I’ll just try it once. Once can’t hurt. Everyone else is doing it and they seem okay.’ Later on you may justify your continued use with such rationalisations as ‘I enjoy it’, ‘it’s my only vice/luxury/ relaxation/social outlet/pleasure’, ‘I need it to relieve my stress; I work so hard I deserve this’,‘I can give up anytime’, ‘you’re only young once’,‘it’s not doing me any harm’. Later still, you may find that you can’t give up and that becomes your rationalisation for continued use. The long-term effects of cocaine use include:

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You may still experience cravings however, especially if you return to the environment where previous use took place. If you give in to the cravings, the addiction returns, reinforced. Addiction usually occurs one to two or even four years after first use but withdrawal-type symptoms may be experienced a matter of hours or days following heavy use and the person’s mood and behaviour may not return to ‘normal’ for several weeks. 4. Aggressiveness, violence, personality changes, neglect of one’s responsibilities — these often result in relationship problems, trouble with the law, poor work performance, financial problems and disordered lifestyle. 5. Psychiatric problems — including psychosis where you basically lose your hold on reality, depression which in severe cases may result in suicide and paranoia, where you are convinced that everyone is out to get you. (The police and debtors probably really are.) 6. Nasal problems — from snorting, including bleeding, infection, sinus problems and serious damage to the lining and internal structure of the nose. The nose tissue may degenerate, the septum (wall dividing the two nostrils) may perforate and basically the whole nose may cave in. This is because the coke makes the blood vessels in the nose constrict so the nasal tissues are deprived of blood and oxygen, without which, the tissues die. Also the coke has a local anaesthetic effect so you may not feel the damage when you pick or scratch your nose vigorously. 7. Extreme loss of appetite — leading to weight loss and nutritional deficiencies.

So with all these frightening potential effects, why do people pay good money and risk life imprisonment to get the stuff up their noses? Well in the short term, in small doses, there can be some perceived beneficial effects. For a few minutes or even a few hours (but usually around thirty minutes), you may feel more confident, bright, happy, alert, vibrant and sexual. You feel more competent, capable and important. Your thoughts seem clearer, more perceptive and profoundly significant. Coke decreases your appetite temporarily so, for people such as models for whom weight control is an issue, this may be perceived as a boon. Coke can also make you more aggressive, domineering and daring. Your temperature, pulse rate, blood pressure and pupil size increase; you move more quickly and your reflexes may be sharper. It is a stimulant, with similar effects to speed (amphetamines), so it basically picks you up, speeds you up and makes think you are Superman or Wonder Woman, capable of anything. For a short time, you are flying high.

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8. Infections including HIV, Hepatitis C, Hepatitis B — as well as septicemia (potentially fatal blood infection) or boils, with injecting cocaine. 9. Blood vessel damage (from injecting) — including blockage which can in turn cause severe damage to vital organs including the heart, brain, liver and kidneys. 10. Skin problems — from coke-affected people picking and scratching their own skin so drastically they sometimes require skin grafts. 11. Lung damage — from smoking cocaine or crack.

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Taking bigger doses will increase the likelihood of nasty effects such as headache, dizziness, chest pain, heart attack, fits, loss of sensation on one side of the body, hallucinations, hearing voices, suicidal thoughts, irritability, tremor, visual disturbance, loss of libido, listlessness, loss of concentration, anxiety, panic and paranoia. A common tactile hallucination is feeling as if bugs or ants are crawling all over one’s skin. Eugh! It is because of this sensation that coke users often pick and scratch mercilessly at their skin resulting in horrendous scabs and destruction of the skin. Overdose can result in death. Short of that, you may suffer brain haemorrhage, heart failure, irregular heartbeat or breathing difficulty. All in all, a pretty tragic scene. Even if you only take a ‘small’ amount, you could still overdose if the potency of the batch is a lot stronger than what you’ve used in the past, if you are more sensitive to the drug than others or if you are using coke in combination with other drugs. There is also the risk of poisoning if the coke is ‘cut’ with dangerous other drugs. Needless to say, you can’t exactly complain to any authorities that you got given or sold a bad lot, when the whole transaction is completely illegal. Mixing coke with any other drugs multiplies the risk of adverse effects from all the drugs used including any prescription drugs you may be taking. Alcohol in particular increases blood levels of cocaine thereby increasing toxicity. It will increase and prolong the psychological effects as well as the risk of heart attack while at the same time decreasing the judgement and discretion that might have provoked you to cut back or stop. Mixing coke with a

Driving under the influence of coke is obviously illegal and can result in loss of licence, fines and gaol. If you don’t get caught, the penalty may be higher since you are likely to

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narcotic such as heroin (a ‘speedball’, to use the lingo) is common and commonly fatal. John Belushi died of injecting heroin and cocaine after a heavy night on the turps. A whole constellation of celebrities including Janis Joplin, Jimi Hendrix and even Elvis, are thought to have died from drug cocktails containing anything from hash to heroin, booze to coke. What a waste. It is common for coke users to binge, using the stuff every ten to thirty minutes (to maintain the high) for several hours or even days, basically until their supply, money, credit or all three, run out. Users frequently find that the more they use, the greater becomes their compulsion to use, although as with ecstasy, the pleasurable or fun effects of the drug actually decrease the longer you use. You crave it more and more even though you ‘like’ it less and less. This is the classic sign of addiction, although many will deny it is so because it seems so illogical. Denial is a prime symptom of addiction. Some people use other drugs to deal with the bad effects of the coke. Insomnia or disturbed sleep may prompt use of ‘benzos’ (benzodiazepines, which are minor tranquillisers), pot, alcohol or heroin to ‘assist’ sleep or basically bomb them out. After the ‘uppers’, they want ‘downers’ and before they know it they are up, down, turned around and no-one knows where they are up to. Users may employ a whole cocktail of drugs just to get through each day. Each drug mixture increases the risk of overdose and death.

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take risks and have accidents. If the police suspect you are drug affected they can take you to hospital for blood and urine tests. After a binge, the breakdown products of cocaine may be present in urine for up to ten days. Coke use during pregnancy may cause miscarriage, stillbirth or premature delivery. The baby is likely to be small and may have physical or developmental abnormalities including skull defects, retarded brain growth, poor attention and behavioural problems. There is an increased risk of SIDS (sudden infant death syndrome) and the baby may suffer cocaine withdrawal at birth. What a way to start a life. In the 1980s coke acquired a reputation as an aphrodisiac, enhancing sexual pleasure, boosting orgasm and causing spontaneous ejaculation. However, it is known to induce erectile difficulty in men and cause problems with female orgasm because of its constrictive effects on blood vessels. Long-term use is often associated with impotence and frigidity. A lot of cocaine abusers are also alcoholics or at least have heavy alcohol intake. The two drugs are often found in the same context. Also cocaine and alcohol enhance each other’s effects leading to concomitant use and addiction. Management of cocaine addiction is similar to managing alcohol addiction in the sense that the first, most vital step is to get the compulsive user to admit he/she has a problem. If the individual can admit he/she is ‘outta control’, the next step is to change the prime force in life from acquisition and ingestion of coke to avoidance thereof.

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Quitting is often not the main problem, so much as preventing relapse. A coke-head may stop using, go through a few days withdrawal, then relax and think he/she is on easy street. Intense cravings days or weeks later may provoke taking it up again. ‘It’s easy to stop. I’ve done it heaps of times’ may be the glib rationalisation. The irony and intrinsic illogicality therein may escape them. Self-help groups, doctors, psychiatrists, psychologists and drug rehab specialist units may all provide support and advice. Avoiding the social cues and environments that trigger use is important. Management of depression or other psychiatric conditions is also important. Dealing with concurrent drug addictions (commonly alcohol, speed, heroin) is vital too. Over the years many different medications and even immunisations have been tried to assist with cocaine cessation. At this stage none of these seems particularly successful. The most important and useful approach is through counselling and social and behavioural change. Or you could just not start in the first place. At least one benefit of being on the poor side, or even the stingy side, is that you are that much less likely to ever get into trouble with coke. ‘Coca-Cola’ maybe, but not cocaine, since cocaine is usually exorbitantly expensive. Of course some people may resort to crime to fund their habit but typically, coke is the drug of the ‘rich and famous’. Perhaps you need to be rich and famous to be cocky enough to believe that you can handle it and won’t suffer the ill effects. Perhaps you are so busy being rich and famous, you don’t have time to find out about the potential hazards.

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Perhaps you want to create the aura of being rich and famous, even though you are poor and unknown, by hanging with the cocaine crowd. Taking coke certainly won’t make you rich, but as a drug addict or convicted criminal you may acquire a certain infamy. If that’s what you’re after. Coke has been around for millennia, with archaeological evidence of use of ‘coca’ leaves (which contain small amounts of cocaine) by early humans as far back as 3000 BC. Even llamas are known to chew coca leaves and South American Indians have been chewing coca for centuries, to alleviate fatigue, hunger and depressed mood. When early European explorers of South America effectively enslaved the natives, they made use of the natives’ coca predilection to bribe them to do hard labour. The coca leaf contains only small amounts of cocaine, with minimal potency compared to the strength of the refined powder or crystals sold today on the black market. Also, taking it orally (as opposed to snorting, injecting or smoking it) results in much slower absorption and minimal accumulation in the brain. For these reasons, the South American Indians and the llamas rarely suffered addiction or ill effects. In the mid-1800s Europeans started producing refined cocaine from coca extracts and use became increasingly prevalent in the late 1800s with even Sherlock Holmes, the famous detective created by Sir Arthur Conan Doyle, injecting between solving crimes. Robert Louis Stevenson wrote The Strange Case of Dr Jekyll and Mr Hyde in six days and nights, under the

So from Freud to prehistoric man to the lovable llama, coke has ‘added life’ to many as well as causing the downfall

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influence of cocaine. The drug that transformed Dr Jekyll into the murderous Mr Hyde is thought to have been inspired by coke. Indeed personality change, aggression and violence are quite typical of heavy cocaine use. Perhaps most famous of all coke-heads is Dr Sigmund Freud who investigated the drug for its effects on depression and fatigue using mainly himself and a few friends as subjects. He tried to cure a friend’s morphine addiction with coke. Unfortunately, he only succeeded in transforming his friend from a morphine addict into an insatiable coke addict. Well, you win some . . . In 1884 Freud, a heavy user himself, wrote a 25-page report ‘Über Coca’ detailing his findings. He thought, at least initially, that it was a ‘wonder drug’ that would establish his reputation as a great physician as well as providing him with a diverting recreation. It became clearer and clearer around this time that coke had a number of seriously deleterious effects and Freud eventually gave it up around 1895. Speculation exists regarding to what degree the cocaine use contributed to his prodigious writing, capacity for introspection and selfanalysis. One thing is certain, his self-analytical ability did not extend to being able to quit smoking. He chain-smoked cigars despite suffering severe heart disease and oral cancer for which he underwent numerous operations. The man who discovered ‘denial’ was nonetheless susceptible to it and unable to avoid its consequences.

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of thousands. Deaths related to coke may be the result of cocaine-induced suicide, accidental overdose (e.g., swallowing a condom-full for the purpose of smuggling), combination with other drugs, homicide, cerebral haemorrhage, heart attack, heart arrhythmia, or simply lethal dose (one gram in an hour or equivalent thereof). Most people who start coke do it for fun, for a lark, for kicks. Most are unaware of the potential hazards. If they really knew the dangers, I would imagine, they might never start. Or perhaps they would. After all, Freud was not the only one affected by that insidious ego-defence mechanism: denial.

Trippin’

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here is an intriguing class of drugs known as ‘hallucinogens’ or ‘psychedelics’. The word ‘psychedelic’ is derived from the Greek for ‘mind manifesting, expanding and revealing’. At various doses psychedelics may have the ability to induce hallucinations and distort perceptions, alter thinking, body image, mood, sense of time and sense of space. This psychedelic experience is known as ‘tripping out’. Psychedelics have played a role in the rites and ceremonies of various cultures and aboriginal groups for centuries. The

Initially LSD was used to study psychosis. This research petered out in the mid–1950s as scientists realised that the LSD-induced psychosis was markedly different to the naturally occurring psychoses (schizophrenia and mania) they were out to investigate.

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Native American Church used peyote (mescaline), derived from the cactus; a number of Indian tribes in Mexico ingested sacred mushrooms (psylocibin), which are nowadays called ‘magic mushrooms’; South American Amazon Indians used yage or hoasca (harmine) and tribes in Central West Africa use iboga (ibogaine). Some of these practices continue even today for healing and sacramental purposes. The use of the drugs is thought to promote spirituality, mystical experience and group cohesiveness in these social and religious contexts. The most predominant and famous psychedelic of all, LSD (lysergic acid diethylamide), was synthesised in 1938 by a pharmacologist called Albert Hoffman while working with several ergot derivatives. Ergot occurs naturally in some fungi and it is believed that one of LSD’s naturally occurring ‘cousins’, an ergot fungus, was responsible for the hallucinations and weird sensations reported by the victims of the Salem witch-hunt in the 1700s. Five years after creating LSD, Hoffman ‘accidentally ingested’ some (now how does that happen?) in his lab and experienced a psychotic reaction. He had taken what he considered a trivial amount: one quarter of a milligram. He discovered that LSD is one of the most potent drugs known to man, with the ability to exert significant effects at doses as low as 50 micrograms (0.05 milligrams), about the weight of a grain of table salt.

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In 1953, Freudian and Jungian psychotherapists started using LSD to ‘assist’ in therapy, hoping to facilitate regression to get in touch with childhood memories and get difficult or obsessive patients to open up and loosen up. LSD was used in the 1960s to manage alcohol and drug addiction as well as to treat the emotional and physical distress of terminally ill cancer patients. Difficulties in assessing LSD’s efficacy in all these applications, and doubts as to whether it really had a useful therapeutic role, led to the waning of LSD therapy in the mid–1960s. Around the same time, hippy culture was growing. These young people — ‘hippies’ — opposed traditional, conservative values. Part of the counterculture included non-medical use of LSD. ‘Turning on, tuning in and dropping out’ was hip, cool and trippin’. The government viewed this recreational drug use as a public health problem and banned LSD, peyote, mescaline and associated psychedelics with the result that LSD became just another illegal but popular and highly used and abused drug. Unofficial psychedelic therapy still goes on and since the 1990s there has been a fresh move in the U.S. to increase human research and development into therapeutic uses for psychedelic drugs. The sixties and seventies were the real heyday of psychedelic culture with social tripping being widespread and voguish. Even today, in Australia, LSD and magic mushrooms (psylocibin) are quite widely used, with 10 per cent of Australians having tried a psychedelic and 3 per cent having used in the last twelve months. Psylocibin is sold as dried mushrooms, mushroom preparations or in its pure

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state as white powder. The wrong mushrooms can be poisonous, causing permanent liver damage or death within hours. LSD is also a white powder in its pure state but is usually sold on the street as little squares of paper with simple, colourful designs. LSD or ‘acid’ may also come as liquid, tablets or capsules. It is odourless and tasteless. It is made, sold and distributed illegally so the strength and purity will obviously vary. It may contain other drugs from ecstasy to aspirin and other potentially toxic additives. Fines of up to $550 000 and gaol sentences from two years to a lifetime are the penalties for using, possession or supply. The quality, purity and dose of drug taken will affect the ‘trip’. The individual’s expectations, previous drug experience, mood and health will affect the trip too. The social setting in which it is taken and whether or not it is taken with other drugs will also alter the nature of the trip experience. There is no way of guaranteeing a good trip. Trips will vary from person to person and occasion to occasion. Even a ‘good trip’ (that is perceived as pleasant or engrossingly interesting) may end in disaster if disorientation, hallucinations or distorted thinking lead a person to take risks or attempt impossible tasks such as flying off a cliff, diving off a bridge or stopping trucks with a stern look. LSD-related accidents and deaths do occur, particularly when the tripper undertakes to explore the outside world in hallucinating mode; bridges, water, traffic, precipices, machinery and driving are especially hazardous. Many people enjoy the ‘lucky lottery’ aspect of unpredictability with LSD. One trip might be deeply

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spiritual or religious. The next might be stirringly sexual or sensual. Some people claim to develop insights about themselves, the meaning of life, the universe and everything through a transcendental experience which leaves them feeling more at peace with themselves and their surroundings. Mood changes are common with feelings ranging from euphoria and omnipotence to extreme sadness, anxiety and paranoia. Self-destructive feelings can lead to suicide attempts. Synaesthesia or mixing of sensory perceptions may occur such that sounds are seen and images are heard. Colours may be brighter or more intense, sounds may be sharper, time may slow down, déjà vu feelings may be elicited. Body image and bodily sensations may be altered, with feelings of being heavy or so light one is floating. The boundary between one’s body and the surroundings may disappear or change. One may feel one has become part of an amazing technicolour kaleidoscope, like ‘Lucy in the Sky with Diamonds’ as described by The Beatles. Like a dream, things may seem both logical and illogical, anything can happen, there is a story line but it may make little sense; on the other hand, it may be revelatory and even profound or life-changing. Bad trips can occur any time to anyone but particularly if a larger than usual dose is taken or if the LSD is highly contaminated with impurities or adulterants. The person on a bad trip may feel ‘outta control’ and fear they can never escape the trip, like a nightmare from which you can never awaken. They may suffer panic, anxiety and paranoia. The

‘Flashbacks’ are brief episodes of recurrence of the trip experience that occur spontaneously, unpredictably and uncontrollably weeks, months or years after the original trip or last LSD experience. They usually consist of visual

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perceptual distortions may make them see both their own bodies and their environment as grotesque, threatening and terrifying. Rarely, this leads to violent or aggressive acts but usually the fear is so paralysing the person is deactivated by his/her own distress. Usually the effects wear off after six to twelve hours but mental confusion, poor concentration and sensory distortion may continue for weeks in some people. Rarely, LSD use may trigger ongoing emotional problems or psychiatric disorders such as mania or schizophrenia-like conditions that go on for years. A number of people who were involuntarily administered LSD between 1953–1973 as part of unethical U.S. government-funded experiments have attempted to sue the U.S. government for alleged mental and emotional damage as well as violation of constitutional rights. Some people were administered the drug as part of an army service experimental project, others were given it without their knowledge as part of a CIA-subsidised psychiatric research program. These suits have been unsuccessful or settled out of court because the causal link between the psychiatric disturbance and the LSD administration is difficult to prove. Perhaps these people were always going to be prone to mental ill health. In addition, there is a doctrine that ‘precludes governmental liability for injuries to servicemen resulting from activity incident to service’.*

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distortions or hallucinations such as geometric, coloured images, illusions of movement in stationary objects, flashes or trails of colour or prolonged after-images. They may be triggered by stress, exertion, lack of sleep or entering a dark environment. Regular users are more likely to suffer flashbacks, which are usually perceived as distressing but occasionally as simply strange and kinda cool. In the short term, bad trips are the main problem. The person on a bad trip requires constant reassurance and may need medical intervention if they become suicidal, violent or extremely paranoid. If everyone is tripping or ‘off their faces’, this kind of care may be impossible, leading to potential disasters. With regular use, tolerance, where more drug is needed to create the same effect, and dependence, where the drug use becomes all important and central to the person’s life, develop insidiously but rapidly and predictably. Tolerance to LSD will also cause tolerance to other psychedelics, such as mushrooms or peyote. Addiction is psychological not physical and cessation of use is not associated with a withdrawal syndrome. While there are numerous reports of behavioural, emotional and psychiatric changes following LSD use, including long-term difficulties with memory and concentration as well as bizarre behaviour, paranoia, schizophrenia, mania and depression, it is not fully understood as to whether LSD causes these or simply hastens the onset in predisposed individuals. One known hazard of LSD use however is risky, self-destructive or suicidal acts while tripping, which have resulted in multiple fractures, quadriplegia and of course death.

LSD in pregnancy increases miscarriage risk and probably causes foetal malformation although this has not been conclusively proven. All in all, while LSD effects certainly sound enticing and tantalisingly mind-blowing, the risks are considerable and unpredictable. It is like taking a mystery tour with no idea whether you will enter a tropical paradise or a bloodsoaked war zone. You may emerge with a new tranquillity or you may emerge in hospital casualty looking like a bus has run over you . . . because it has. Worst of all, you may make a sudden, unscheduled return trip at any time, whether you like it or not. Personally, I feel that dreams and nightmares, my regular ‘trips’ and explorations into the unknown and psychedelic world, are enough for me. I close my eyes and in the land of slumbers I can fly, I perceive things differently and my outlook may be refreshed and enriched. It’s still a lottery because you never know if you’re gonna get a fabulous dream or a spooky nightmare. Either way, it makes you wonder and is ‘mind manifesting, expanding and revealing’. It’s also restorative and refreshing. Compared to tripping on drugs, dreaming is cheaper and healthier. What’s more, it comes naturally. It’s as easy as falling asleep. Instead of ‘Turning on, tuning in and dropping out’, I’d rather ‘Turn in, tune out and drop off.’ G’night!

*Supreme Court finding in case ‘U.S. v. Stanley ’, 107 S. Ct. 3054 [1987]

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Heroin: H, horse, smack, skag, hammer

DRUGS

he word ‘heroin’ is derived from the Greek word ‘hero’, meaning . . . ‘hero’, because of the drug’s effects on self-esteem. Heroin is just one of a group of drugs known as opioids or opiates, named after the opium poppy, the flower from which all these drugs are derived. Opioids or opiates are also called ‘narcotics’. This term is a derivation of the Greek word for ‘stupor’:‘narke’. As a class, narcotics have the effect of promoting sleep and suppressing pain as well as inducing euphoria. Little wonder they have been popular and widely used drugs for at least 7000 years.

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Opium poppy seeds have been found in 3000-year-old Egyptian tombs, presumably with the idea being that the dead person could still enjoy his opiates even in the afterlife. In sixteenth century England, an opiate called laudanum was used as a universal painkiller. Indeed, up until the early 1900s a wide variety of reasonably cheap, over-the-counter ‘tonics’ and ‘elixirs’ contained anything from opiates to cocaine as well as alcohol and other potentially addictive substances. Presumably opiate dependence was widespread but must have been reasonably mild since quantities were small and the route of administration was by mouth, which generally gives less potency than injecting, snorting or smoking the stuff.

In 1979, a graduate student in the U.S. was making a batch of ‘meperidine’, a heroin-like narcotic. His haphazard methods and inexperience led to the production of the now famous chemical MPTP. He and several other students injected this

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Later however, governments became concerned about drug dependence and in the U.S. the Harrison Act was legislated in 1914. This Act deemed all narcotics to be illegal unless prescribed by a physician for medicinal purposes. In this way, people just continued getting the same drugs they always had, except they now got them via a doctor. Officials got savvy to this and started prosecuting doctors for treating addicts, since in those days addiction was not seen as a genuine medical condition. As a result, doctors had to stop supplying to their addicted patients and thus began the thriving black market. Needless to say, the illegality and high demand allowed these entrepreneurial druggists to dispense their wares at highly inflated prices. The more the governments tried to tighten the laws and increase the penalties, the higher the narcotic dealers boosted their prices, in a vicious cycle that has escalated ever since. With narcotics getting dearer and dearer, users turned to crime or dealing themselves in order to support their habit. Unable to afford nutritious food or adequate shelter or clothing, many became physically unwell. Produced by dodgy black marketeers with an eye on profits and less care for the user than the original, legal, chemist manufacturers, narcotics became less and less pure. All kinds of potentially toxic adulterants were added to the drugs with devastating results. Illness and death from poisonous but cheap and indistinguishable additives became increasingly common.

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MPTP and developed a terrible neurological disease identical to Parkinson’s disease, which consists of tremors, loss of facial expression, partial or complete paralysis and deeply stooped posture, among other things. Other ‘street’ manufacturers have also accidentally or intentionally mixed the wrong potion with disastrous results for their unsuspecting customers. With increasing expense and decreasing availability, people started smoking, snorting or injecting in preference to swallowing, in order to intensify the effects. Of course injecting anything brings with it a whole host of other dangers. Damage to veins and serious infections from dirty needles, syringes, spoons, water, swabs, filters or tourniquets: these are in many ways more hazardous than the drug injected itself. HIV, Hepatitis C and Hepatitis B as well as tetanus and septicaemia (blood-poisoning) are commonly transmitted through sharing of contaminated injecting equipment. A number of opiates are used medicinally for pain control. These usually require a prescription from a doctor, except for drugs containing very small, ‘safe’ quantities of codeine, which are available over the counter and even in supermarkets. For certain forms (morphine and pethidine), a government authority is needed. Morphine and codeine (derived from the poppy) and pethidine (made synthetically) are usually reserved for severe, chronic pain states, such as in cancer or in the terminally ill. Methadone, another synthetic opioid, is used to treat opioid addiction. These drugs are all legal as long as they are prescribed by a doctor who has the authority to use them.

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Heroin is made from morphine or codeine and is much stronger. It is illegal. Using, possessing or selling is penalised with fines (from $2200 to $550 000) or gaol (from two years to life). You get a criminal record, which makes employment, travel and getting credit a big hassle. Driving under the influence will lead to loss of licence, fines, sometimes gaol and again, a criminal record. This is all pretty tame compared to overseas (especially Malaysia, Singapore and Thailand) where you may be put to death. Heroin comes as white powder in its most refined state, or as a lumpy pink or brown powder called ‘rocks’. It has been tried by 2.2 per cent of the Australian population and is currently used by 0.7 per cent.* It is very rapidly absorbed into the blood which transports it to the brain within seconds of injecting, snorting or smoking. Heroin is a depressant drug so it slows central nervous system activity, decreases blood pressure, pulse rate, rate and depth of breathing, and body temperature. It also slows down the gastrointestinal tract resulting in constipation as well as nausea and sometimes vomiting. It decreases perception of not just physical pain but also ‘psychological pain’, so that anxieties, feelings of inadequacy, hostility and aggression are washed away temporarily. For a short time (usually a few hours) you feel like a ‘hero’ or ‘heroine’. It decreases the cough reflex thereby suppressing coughing. You feel sleepy, your pupils contract (‘pinpoint pupils’), your eyes and mouth become dry and you may feel itchy, flushed and warm, even though your actual temperature has dropped. You feel extremely relaxed and happy but you lose your sex drive and guys commonly find they are impotent.

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With long-term use, erectile dysfunction (‘can’t get it up’) is extremely common but often by then, heroin has reached such primacy for the person that it hardly matters to him. His non-addict partner may feel differently of course. Female users will find their periods become irregular and infertility is common. Boils, lung infections, heart problems and malnutrition (from both poor appetite and lack of availability of good food) are common. As mentioned earlier, infections resulting from dirty injecting equipment can have devastating effects. Continued sharing of equipment leads to further propagation of infection. Despite all these potential medical problems, heroin users are often reluctant to seek medical attention. They fear discovery of their illegal activities. They suspect the doctor will try to decrease or stop their drug use. The narcotic decreases their ability to perceive the pain that would normally indicate the presence of a health problem anyway, so they may falsely believe that they are healthy. Some heroin users are under the misguided belief that the doctor may report them to the police. This is untrue. Police will only be involved in cases of death, overdose, crime or violence. The doctor is not an agent for the police and will not contact them unless these circumstances arise, say if you assault or steal from the surgery staff or, of course, if you die from overdose or other suspicious circumstances. One circumstance which does bring some female users to medical attention is pregnancy. Pregnancy inspires some women to try to kick the habit. Withdrawal during pregnancy can be dangerous for the woman and her unborn child and medical assistance is crucial. Often the

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woman will be encouraged to take methadone (by mouth) during and after the pregnancy to decrease the risk of adverse events from overdose and infection, as well as the crime-related adversities of acquiring heroin. Using heroin can increase risk of miscarriage, stillbirth and premature delivery. Babies of narcotic-dependent women are likely to be smaller, more irritable and excitable than other babies and they are at increased risk of SIDS (sudden infant death syndrome). After delivery, they need to be carefully monitored for signs of withdrawal. Both mother and baby may need extra support and care medically, psychologically, nutritionally and socially. In general, methadone Mums and babes tend to do much better developmentally and in terms of mother-baby bonding than those who are still injecting heroin and living the junkie life. The longer a person uses heroin, the greater their risk of developing tolerance (they need more drug to get the same effects) and dependence (drug use becomes central to and seems vital for their existence). Health, relationships, work, finances and legality assume less and less importance. Getting, using and getting and using more become the first, and later, the only priority. Overdose also becomes a greater and greater possibility with prolonged use although it is possible to O.D. even with one’s first dose since one has no tolerance and has no knowledge of how much his/her system can take. Purity and strength of different batches vary so much, it is impossible to know how much you are taking anyway. A person who has stopped taking for a short time may lose

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his/her tolerance and O.D. with the first dose when he/she starts back, even though it may be a much smaller dose than what he/she used to take. How can you tell if someone has overdosed? Well their breathing may become extremely shallow and slow and they may snore. Their skin feels really cold. Their pulse is slow and they may be blue, especially around the fingers, lips and toes. Their muscles may twitch and they may gurgle from vomit or saliva in the throat. If left, they may go into a coma and die. What do you do? Call an ambulance immediately and while you are waiting, keep the person awake as much as possible. Try walking them around, talking to them and arousing their attention however you can. If they are already unconscious, place them on their side (recovery position) and make sure their airway is clear (no vomit or foreign bodies in their mouth or throat). Check their breathing and if they stop, do mouth-to-mouth or mouth-tonose resuscitation. Don’t panic. Stay with the person and do your best as you await medical help. Whatever you do, don’t try injecting anything else and don’t try to feed or water the stuporous one — he/she might choke. If the O.D. sufferer convulses (has fits), move things away (especially sharp things) so as to minimise the risk of injury. Do not put them in the shower or bath. They could drown since their breathing and cough reflex will be depressed and they could easily inhale water. Mixing heroin with other drugs, especially alcohol or minor tranquillisers (e.g., benzodiazepines or ‘benzos’) is extremely dangerous and vastly increases risk of O.D. Don’t do it.

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So how do you get off heroin? Well this can be difficult and makes not starting in the first place look really good. But if you are already addicted, there are two main ways of getting off it. One is ‘cold turkey’: you just stop point-blank and go through a withdrawal phase, which is mighty unpleasant but finite. After the withdrawal, you are drug-free and all’s well unless you succumb to cravings, or peer pressure gets you back using. Sometimes the lifestyle of dealing, shooting-up, hanging out with other drug users and doing little else can be quite habit forming and a kind of addiction in itself. You need to address your lifestyle, social, financial and employment issues as well as the drug addiction itself. Withdrawal consists of symptoms that are basically the opposite of all the effects of heroin use. You feel depressed, irritable and ‘in pain’, both psychologically and physically. You feel restless, irritable and can’t sleep. Your temperature, blood pressure and pulse rate will rise and your breaths will be faster such that you may seem to be panting. You may sneeze. Instead of being constipated, you’ll have diarrhoea. Your nose and eyes will run. Your pupils will be huge. You may find you have spontaneous ejaculations and orgasms. (That’s the only good bit but not everyone gets it. Sorry.) This withdrawal may begin as soon as a few hours after the last injection. The withdrawal symptoms increase to a maximum after about three days and then subside gradually over the next four to five days. Some people find they are still suffering depression, weakness, poor self-esteem and inability to handle stress for months after withdrawal. Withdrawal is usually safe unless the person is simultaneously withdrawing from other drugs, such as

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alcohol or benzodiazepines, or is unwell in some other way. There are drug rehab and detox centres which will supervise withdrawal in some circumstances. The other way to get off heroin is by going on methadone or some other drug, such as naltrexone, buprenorphine or LAAM, to assist with heroin abstinence. Methadone is the most tried and true method of assisting heroin users to get off heroin and get out of the junkie lifestyle. It is also a narcotic but it can be prescribed legally and does not need to be injected. The methadone user takes his/her dose orally, as a syrup, each day, usually at the methadone clinic or community pharmacy. It helps reduce cravings for heroin and prevents withdrawal. It helps break the social and criminal habits and relationships that heroin use can entail. The risk of O.D. and toxicity from contaminated heroin is eliminated. The risks involved with injecting are removed. Using methadone requires a routine and means the person is in regular contact with health professionals. These factors can be helpful in establishing a more balanced, healthy lifestyle. No longer needing to forage for illicit substances and accumulate big money to pay for them, the person has time, energy and a clearer head to think about work, relationships, nutrition, health and getting a drug-free life together. Methadone is usually free (public programs are free; private ones cost — but not as much as heroin!) so money can go on food, clothes, rent and other important things rather than getting shot up the arm. Methadone treatment is voluntary and requires assessment by a doctor authorised to prescribe it.

After ceasing heroin use, the urge to use again is usually very strong for years, even decades, perhaps only intermittently, perhaps every day. Using again after a long period of abstinence holds a very high risk of O.D. It is unfortunately extremely easy to resume the addiction and

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The dose will vary depending on the drug history and it may take a week or so to find the right dose for you. The idea behind methadone is to get you off heroin and help you clean up your act. Some people try to get methadone and still use heroin. This is obviously unhelpful. If you are still getting strong cravings for heroin, you possibly need a bigger dose of methadone or perhaps you are simply not really committed to ceasing heroin. Your doctor will usually be able to tell if you are ‘cheating’ (using urine tests and other means) but most importantly, if you cheat, you simply will not get the benefits of heroin cessation. Some people stay on methadone for years. Some may have no intention of getting off methadone ever. This is okay and is probably the best way of minimising the risk of starting up with heroin use again. There is certainly no hurry to get off methadone, which is heaps less harmful than heroin by far. If you do decide, with your doctor, to withdraw from methadone, it is usually done gradually to minimise the risk of relapse into heroin use. You may need extra support from the doctor and other health workers. Fast withdrawal will lead to a withdrawal syndrome lasting up to a couple of weeks. During this time, the urge to use heroin is often irresistible and resumption of heroin use is common at this time.

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the lifestyle, and many people bounce in and out of junkie-dom like outta control yo-yos. Whatever you do, don’t start taking heroin in the first place if at all possible. If it’s too late for that, then think about stopping and seek medical advice on the best method for you. Lots of people manage to kick the habit and live full, productive lives as a result. Others keep going back and end up a statistic. There are myriad famous, narcotic-related celebrity deaths, from Billie Holiday to Kurt Cobain, Jim Morrison and Chris Farley. But for every famous or infamous heroin-related demise, there are tens of thousands of everyday people’s lives trashed by heroin. The opium poppy is a godsend when it comes to treating chronic or cancer-related pain. When it comes to heroin addiction and the associated lifestyle, one could almost believe the devil himself was behind it all. Opium and opioids have inspired all kinds of mischief from wars to intricate and powerful crime nexus the world over. They are responsible for petty thievery, grand larceny and murders. Perhaps the illegality of the heroin trade and governments’ tendency to treat narcotic addiction as a crime in itself are partly to blame for the dangerous lifestyle associated with heroin use. Legalising heroin is often discussed and might provide some solutions but is probably a long way from actually happening. In the meantime we need to deal with the situation as it is. Methadone treatment is a much maligned but very helpful means of getting people out of the junkie life. It is not however a panacea. The best bet is still to never get into

*1998 National Drug Strategy Household survey.

Smokin’! ‘There was a blackout. I saw his face only in the fitful light of a post-coital Craven A.’ Alan Bennett 1934– : Habeas Corpus (1973).

M

y major bête noire has gotta be smoking. I hate it! I hate the smell. I hate the way the smoke makes my eyes sore. It gives me a headache. It gets into my hair, my clothes, the upholstery, everything. Yuck. Most of all I hate the self-destructive mentality that drives it. That sucks the most, I reckon. People who smoke often say they want to give up and many of them do. Over and over again. Others say they don’t want to stop. They enjoy it. Fair enough. But if you

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it in the first place. Prevention is better than cure. But attempted cure is better than a life of crime and addiction ending in O.D. I reckon anyway.

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enjoyed drinking battery acid that wouldn’t necessarily make it a good idea. Unless you were a battery. Everyone knows how smoking has adverse effects on the respiratory and cardiovascular systems. It gives you increased risk of lung cancer, throat cancer, tongue cancer, laryngeal cancer, lip cancer, cervical cancer and cancer cancer. It increases the risk of osteoporosis, impotence, high blood pressure, stroke, heart attack, blindness, infertility, miscarriage, foetal abnormalities, SIDS (sudden infant death), asthma, wrinkles, bad breath, yellow teeth, yellow skin and peripheral vascular disease leading in severe cases to amputation. Smoking delays wound healing and creates free radicals that all the anti-oxidants in the world can’t mop up. Hey, basically smoking’s the pits. So why do we do it? Well for one thing it’s addictive. The nicotine hits your brain within seconds of inhalation and causes you to feel more relaxed immediately. So if you’re feeling tense, bored or anxious and light up, you feel good almost instantaneously, which reinforces the idea in your mind that you enjoy smoking and that you ‘need’ to do it to feel good. But that good feeling wears off pretty quickly and in between you feel more anxious and edgy than ever leading you to crave another ciggy and another one and so it goes, on and on until you’re in hospital awaiting your cardiac bypass. The other thing is that it’s habit-forming. People might start out smoking to look cool or have something to do with their hands but after a while it becomes habitual and without a ciggy in one hand and a glass in the other, they feel quite off-balance and out of kilter. It’s a social thing too.

So with all these irresistible qualities, I suppose it’s not surprising so many people get hooked on cigarettes regardless of all the known hazards to themselves and

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Hanging out with workmates in the fire escape or out the back of the building having a communal puff has a ‘secret society’/‘exclusive club’ feeling about it. ‘No Non-Smokers Permitted’ is the unspoken slogan and doesn’t that feel great to a societal group that has been banned and harried for decades with ‘Non Smoking’ this, that and the other springing up here, there and everywhere. The advertising is quite seductive too. Some of the ads are quite subliminal and may barely show a cigarette at all. They show images of people having a great time or uplifting images of flying or swans or something else quite tangentially related or completely unrelated to tobacco and it is not until the end that you read ‘Benson and Hedges’ or whatever and realise who paid for the lovely advert. I don’t even smoke but sometimes I find myself feeling really positive about a cigarette ad just because it looked so nice and had such great music. The way they wrap the little blighters is also rather attractive. The gold paper is so perfect and crisp and each individual cigarette is so smooth to touch, light, easy to handle and nice to play with. It’s no wonder people like them. In fact if all you do is play with them and never light them, they won’t actually do you any harm at all. But the urge to consume is great. If you ask a smoker to simply hold the unlit ciggy and fondle it but not smoke it, it’s torture. It’s like getting a beer-lover to hold a glass of frothing ale, swirl it around but not swallow any. Impossible.

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their companions. I feel sorry for people who are addicts and find it hard to break their addiction. Often they really hate their own habit but they just can’t get the monkey off their backs. They often curse the day they ever started the evil practice. Strangely enough for all those who are out there regretting having started and desperately trying to quit, there are others just taking up the habit! I always do a double take when I hear a fifty year old telling me he took up smoking three years ago and now can’t stop. It seems bizarre. I can understand people who started smoking as teenagers, when the hazards were less well known, continuing to smoke because of the addiction. But starting late in life? Weird. Also nowadays there is a trend for smoking cigars. People think it is very cool to go to cigar bars and mimic the Olde English toffs, showily sniffing and selecting the fragrant smoke bombs, snipping the ends and with the air of connoisseurs, puffing away like aristocrats. This kind of pseudo-genteel behaviour has its roots in idiocy. Spending a fortune to induce body rot and early death: why? The justifications people make for this kind of selfdestructive behaviour run along the lines of: ‘But I really enjoy it’, ‘It’s my only vice’, ‘I don’t do it that much’, ‘I need it to relax’, ‘I don’t care if I die young’, ‘I’ve got to have some pleasure in life’ and other flimsy rationalisations that are difficult to challenge. The underlying thought is actually ‘Yeah sure, I’ve heard about the risks, but it won’t happen to me’. But it does and it will. Each year, billions of people around the world die or are hospitalised because of smoking-related

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illnesses. Passive smoking damages the health of innocent bystanders, children and babies, including those not yet born. We now have so many aids for smoking cessation from patches to gum to puffers, all aiming to relieve the nicotine addiction gradually and painlessly. People kid themselves that they can’t do it, and smoke on or else kid themselves that they could do it ‘any day I like’ but still continue to smoke because that day hasn’t arrived yet . . . and possibly never will. You can fool yourself, your family and your doctor but you can’t fool the cells of your body, which are damaged irreparably by every single puff. People criticise role models, celebrities and people in public life when they are seen or photographed smoking. This is absolutely justified since such people perpetuate the myth that smoking is cool and set a bad example for the impressionable, especially young people. But it’s not just celebrities and sporting stars who have a responsibility to set good examples. Everyone has a chance to live as good a life as they possibly can and make the most of the body they were given. Why be so defeatist and self-destructive as to jeopardise your health and that of others by doing something so deeply harmful simply on the basis that you ‘can’t stop’ or ‘don’t want to stop’ because you ‘enjoy it’? I also absolutely detest that idiotic reasoning that ‘My uncle never smoked or drank and he still got cancer and died young’ or conversely ‘My Dad smoked like a chimney and drank himself into a stupor every night and he lived to seventy, no regrets’. This kind of ‘reasoning’ does not deserve the title of ‘reasoning’. It is like saying, ‘My Mum never drank and drove but she still got hit by a truck’ or

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‘I always drink and drive and I’m still standing’. Just because your Mum and your uncle are unlucky and you and your Dad are morons doesn’t defy the scientific evidence. All it proves is that life is fragile and ironically, some of the greatest idiots sometimes get quite a few chances before getting knocked out. So what? I make no apology for being rough on smokers. Why? Because some of my dearest friends and people I care about the most, smoke. It is really hard to have to hold your tongue out of respect for their personal freedom and judgement when you feel strongly that what they are doing is harmful to them and they are too precious to be ruining their health that way. So I bite my tongue, and as they smoke, I fume. Smokers, please stop. It’s not worth it. I wish you would stop, I know you can and I believe you would benefit greatly. And today I’m not biting my tongue.

‘I feel the need, the need for speed.’ Maverick (Tom Cruise) and Goose (that guy from ‘E.R.’) in Top Gun.

‘S

peed’ is the street name for a whole range of illegal drugs related to the chemical compound ‘amphetamine’. Amphetamines are man-made substances originally synthesised in the late 1800s. They act as ‘psychostimulants’, which means that they increase brain and central nervous system activity. These ‘stimulants’ make you feel as if all your functions have been ‘sped up’: your pulse rate, breathing rate, temperature and blood pressure all rise, you feel revved and hyped up, alert and ready for anything. Unfortunately amphetamines can also make you feel aggressive, violent, anxious or panicky and can induce nervousness, sleeplessness, headaches, dizziness, restlessness, hostility and even psychosis. From the late 1920s amphetamines were used medically for conditions ranging from asthma to narcolepsy (a rare but potentially serious disorder in which the person falls asleep repeatedly and without warning all day, despite

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Speed: amphetamine, go-ey, ‘ice’, shabu, crystal meth, base

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adequate sleep), ADHD (attention deficit hyperactivity disorder), depression and obesity. Currently the only accepted medical uses are in the treatment of narcolepsy and ADHD for which they are highly effective. In World War II, soldiers were given amphetamines to increase endurance, heighten mood and combat fatigue. Armed forces on both sides were issued the drug but whether or not it helped any of them is highly debatable. Potentially deleterious effects on judgement and perception may have cancelled out any physical benefits and they would have needed escalating doses to maintain the beneficial effects. This, combined with the inevitable stress of their circumstances, would have greatly increased their risk of addiction as well as psychotic reactions, with possible hallucinations, delusions and paranoia. Many historians note that Adolf Hitler was prescribed a variety of stimulants (including amphetamines) during WWII, by his physician Dr Morell. It is believed that his growing dependence on these ‘speed cocktails’ accounts at least in part for the increasingly erratic and bizarre behaviour and the rapidly alternating cycles of despair and elation, exhaustion and frenetic activity he displayed, especially near the end of the war. After the war, doctors frequently prescribed amphetamines for depression and weight loss. This did not work well for a multitude of reasons. For one thing, patients rapidly developed tolerance, requiring increasing doses to maintain the desired effects. For another thing, the side effects were a bummer: nervousness, agitation, disrupted sleep, malnutrition as a result of persistent poor

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appetite, hypertension and in some cases, worsening of depression and psychosis. Cessation of the drug resulted in a dramatic ‘crash’ consisting of extreme lethargy, depressed mood, hunger and exhaustion; in other words, the original problems came back, only worse, prompting cravings for ever-increasing quantities of the drug. Addiction was an almost inevitable consequence. But it wasn’t just these hapless overweight and depressed patients who used it. Truckies doing long hauls and students cramming for tests also plied unscrupulous MDs for amphetamine tablets. ‘Speed freaks’ injected the groundup tablets to get high. As awareness of the misuse and abuse grew, governments cracked down on pharmaceutical companies to restrict production. Other more effective and specific drugs were developed for depression. The number of legitimate medical uses for amphetamine was drastically reduced to include only ADHD and narcolepsy for which prescription is still tightly controlled and restricted to genuine cases as assessed by specialists. Amongst recreational users, coke (cocaine), which was then perceived to be much less harmful and lots more fun, became increasingly popular in the seventies, taking over from speed as the party-drug of choice. Since the late eighties, speed has experienced a major resurgence with illicit backyard manufacturers using various chemicals to create amphetamine-like drugs. Purity is highly unreliable, with concentrations of drug varying vastly from batch to batch, resulting in a high risk of overdose and toxicity (poisoning).

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The speed may be ‘cut’ (mixed) with anything from talc to sugar, bicarb, Epsom salts or pseudoephedrine. Mostly speed comes as powder, which may be fine and silty or coarse and crystalline. The colour may vary from white to yellow, beige, pink or orange and the taste is usually bitter and ‘chemically’. Speed also comes in tablet form. It is impossible to verify just what it is you are getting simply by looking, tasting or smelling. ‘Oxblood’ or ‘liquid red’ is a red, fluid form of speed which may come in capsules. ‘Ice’ is a form of smokable speed which causes more rapid onset and longer lasting effects. Speed is fairly easy to get and comparatively cheap. In Australia, it is the second most popular illegal drug, after marijuana. Recent surveys* suggest that 8.7 per cent of all Australians have tried it and 3.6 per cent have used it in the last twelve months. Most people first try it in their late teens with 20 per cent of all Australians aged 20–24 having used it at least once. Most people ‘snort’ or sniff it. This commonly causes nasal irritation, bleeding and sinus infections and sometimes severe nasal damage. Snorting is more dangerous than swallowing but users feel that snorting gives a quicker, more acute ‘high’. Less commonly ‘ice’ is sprinkled on cones and smoked (‘snowcones’) or tablets are inserted rectally (shelving). The most dangerous mode of administration is injecting. Users say shooting up gives a more intense ‘rush’ but the risks are significantly more dire. First of all, injectors tend to use larger quantities of speed, which results in faster development of tolerance and addiction. A higher ‘high’ usually also means a more devastating ‘crash’. HIV, Hepatitis B

Well like the girl with the curl, when speed is good, it can be very, very good although when it’s bad, it’s horrid. Some people taking even small amounts of speed can have a bad trip, feeling nervous, edgy and paranoid, but others feel

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and Hepatitis C are a big risk with injecting since any injecting equipment, from needles to syringes, spoons, bowls, water, swabs, tourniquets and filters can be contaminated. Damage to blood vessels, scarring, abscesses, clots and blockage of vessels leading to gangrene or even death are other frightening but genuine possibilities. Different people react very differently to the drug. Some people may be very sensitive to it and can overdose with very tiny amounts. Some people can use ‘casually’ for months without becoming addicted, while others become dependent, using compulsively every day, after just one or two hits. Overdose may result in psychosis (serious loss of touch with reality involving hallucinations and delusions), irregular, fast or thready pulse, heart attack, cerebral haemorrhage (bleed into the brain), dangerously high fever and rarely, death. Mixing speed use with other drug use increases the risk of overdose and toxicity. Speed users often find that they ‘need’ depressants like pot, heroin, alcohol or ‘benzos’ (benzodiazepines or minor tranquillisers) to help them come down, relax and get to sleep. Multiple drug dependencies can ensue, with several drugs being required just to function and several others to wind down. So with so many potential downsides, why do people keep taking the stuff?

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inexpressibly euphoric and elated, confident, powerful and energetic. This good feeling encourages them to try it again and again, even if subsequent goes aren’t so great. Even animals in experiments, if given free reign, will tend to self-administer increasingly large doses in an attempt to recapture the initial buzz. In some cases, animals have selfadministered to the point of overdose, resulting in convulsions and death. Despite hearing of the possible adverse effects, young people may like to try speed out of boredom, curiosity or peer pressure. The youthful sense of immortality and indestructibility may convince them that ‘it won’t happen to me’ or ‘I’m not the addictive type’, ‘I can control it’ or ‘I can stop whenever I like’. The enticing lure of an escapist, glamorous, exciting, continuous-party lifestyle may lead to injudicious, regrettable risk-taking. While the health risks are considerable, so are the legal, financial and career hazards. Being caught using, selling or giving speed to someone else can result in fines from $2200 to $550 000 and gaol sentences from two years to a lifetime. Speed users often find their relationships, studies, career and financial status all suffer from the erratic lifestyle induced by speed and other drug use. Driving under the influence of speed can result in loss of licence, fines and gaol sentences, not to mention serious accidents causing injury or death to others or yourself. Speed use during pregnancy increases the risk of miscarriage, stillbirth and premature labour. Babies of speed-users tend to weigh less and suffer withdrawal symptoms at birth.

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So if it’s such a nasty substance, why do doctors give it to kids with ADHD (attention deficit hyperactivity disorder)? In very small doses, under careful supervision, amphetamines (that’s the pure stuff, not the street stuff which could be anything and usually contains less than 5 per cent actual amphetamine and 95 per cent potentially poisonous chemicals that may or may not be amphetaminerelated) like ‘Ritalin’ (methylphenidate) are extremely helpful in reducing the hyperactivity and poor concentration which make learning and behaving so difficult for kids with ADHD. These kids find it impossible to concentrate on one task because they are distracted constantly by other things and they cannot sit still for long enough to actually accomplish the main task at hand. The prescribed medication, at the correct (usually extremely low) dose, reduces undifferentiated motor activity (hyperactivity) and enhances ‘on-task’ concentration. Only people with the condition ADHD will benefit from the drug and parents and teachers will notice marked improvement in their behaviour, concentration, learning, performance and achievement. People without ADHD will not derive any benefit and at such low doses, won’t experience any ‘kick’ either. So if you feel the need, the need for speed, take yourself for a run or get some rollerblades. Speed, the drug, is dangerous and simply not worth the risk. You’ve only got one brain and it’s a highly sensitive, delicate and vulnerable organ. Don’t treat yourself like an unattended experimental animal let loose in the drug cupboard. Guinea pigs don’t know any better. You do.

Get high on life by discovering and learning to harness your own natural energy, pep and zip. Nurture your body and brain to coax the best out of them. Natural endorphins from sustained exercise, satisfying relationships and fulfilling pursuits — creative, artistic and intellectual — are the best way to experience elation and genuine euphoria, with nothing artificial added.

*Based on the 1998 National Drug Strategy Household survey.

SEX

Pandora’s BOX

Fellatio

SEX

‘Talking is excellent exercise for the mouth’s all-important oral sex muscles.’ P. J. O’Rourke 1947– : Modern Manners (1984). There was a young man called Horatio, Who couldn’t get enough of fellatio. His girlfriend got sick of the ratio Of her giving head to Horatio To him giving her cunnilingus. So one afternoon on the patio, She put the idea to Horatio That if he wanted more fellatio, He’d have to increase the ratio And start giving her cunnilingus. Poor, conflicted Horatio, Head in his hands on the patio, Deeply desirous of fellatio, Contemplated the ratio And asked ‘Can I use my fingers?’ The girlfriend of Horatio, Despondent on the patio, Said ‘If you want my mouth On your areas south, Remember ‘lingus’ means tongue, not ‘fingers’.

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F

ellatio is like chocolate. It’s so universally popular, you really have to wonder about men who say they don’t like it. ‘What? You don’t like chocolate? But everyone likes chocolate! How could you not like chocolate?’ To be honest I have yet to meet a man who didn’t like fellatio. (Not that I make a habit of asking everyone.) But I have met a few people who didn’t like chocolate. And yes, they were a bit weird. But while men are virtually unanimous in their feelings about receiving fellatio, not all women are so very wrapped in the idea of giving it. Some women love it: they love to give their partner pleasure, they like the sense of power and control it gives them, they like the sensation itself. But not all women perform this sexual favour readily or willingly. Some feel that it is demeaning, not ‘real’ sex, gag-worthy, dirty and disgusting. Woody Allen might have concurred here, since he believed that unless sex felt dirty, you weren’t doing it right. Men have various ways of asking for fellatio. Hugh Grant pulled over and paid for it. But not all guys will be so direct. A gentle push on the partner’s head in the direction of south is one common signal. A hand held on the head gives the signal ‘No, don’t come up yet. Keep going. Good.’ Fellatio, otherwise known as a ‘blow-job’, ‘giving head’ or ‘going down’, comes from the Latin word ‘fellare’ meaning ‘to suck’. The fellator is the ‘sucker’ and the receiver is the ‘sucked in’. It has its advantages, such as low risk of pregnancy and decreased risk of sexually transmitted

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diseases, but the perception that it is a risk-free activity is false. Gonorrhoea is highly infectious via this route and can be harboured in the throat unbeknownst to the harbourer. The act of fellatio acts as a ‘Harbour Bridge’. HIV is thought not to be highly transmissible via oral sex but transmission is still thought to be possible particularly if there are cuts or open wounds in the mouth or on the genitals. Brushing one’s teeth vigorously before or after fellating someone is thought to increase the risk of infection because of the microtrauma brushing creates on the gums and soft tissues. It is advisable that condoms be used for fellatio but in practice this advice is rarely followed except amongst highly disciplined sex workers. Swallowing semen is very dangerous from an infection point of view and is highly discouraged. Many people still do it nonetheless. Some feel that swallowing semen is an act of intimacy that proves how much the swallower loves them. ‘If you really loved me, you’d swallow.’ Personally I think if you’ll swallow tripe like that you’ll swallow anything. I don’t go for tripe myself. If a person has cold sores or a history of cold sores, it is possible for them to give the herpes virus to the person they are fellating. Usually the strain of herpes harboured in the mouth area is Type 1 and the strain in the genital area is usually Type 2. But with the increase in the practice of oral sex over the past decade, there is now an increased proportion of genital herpes that is actually of the Type 1 variety. Using condoms for oral sex does decrease the risk of herpes transmission but does not eliminate it.

A lot of foods and especially sweets acknowledge and encourage this propensity to suck: lollipops, ice blocks, ‘All Day Suckers’ and ice-cream cones. Many popular foods come on a stick or in stick form and in eating them, one unwittingly performs a fellatio-like action: ‘Pluto

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A ‘69’er is the imaginative term for the process whereby each person faces the genitals of the other in a heads-totails fashion, so that fellatio and cunnilingus can occur simultaneously. In same sex couples, the ‘69’er allows for fellatio/fellatio or cunnilingus/cunnilingus encounters. It is a much vaunted and popular technique. It does rely on the two people being of comparable height of course. Although I imagine that where there is a will there’s a way. Each person’s idea of what is and what isn’t suitable for placing in the mouth changes dramatically through life. For most babies, nothing beats a mouthful of breast. The bottle and dummy soon replace that nipple and once at crawling stage most babies will put into their mouths anything they can get their hands on. My brother, it is said, enjoyed eating dead flies and clumps of dust and hair. He just couldn’t bear to see it going to waste. With age, we become more discriminating as to what we will suck on or suck down. The practice of eating substances normally considered inedible (e.g., dirt, pencil lead, sand etc.) is called ‘pica’ and usually indicates nutritional deficiency. Pica is more unusual and worrisome the older the child is. By school age the child is no longer routinely mouthing everything although the thumb-sucking habit may be a hard one to break.

Pups’, fairy floss, corn on the cob, drumsticks, Chiko rolls and hot dogs dripping with tomato sauce. So really there is plenty of opportunity to practise the art. Similarly if you need encouragement, application of anything from chocolate sauce to tomato sauce might help. After all almost everyone likes chocolate. Chilli sauce* might be more culturally appropriate for some and will ensure ‘hot’ sex. In summer, ice-cream, sorbet or frozen yogurt might be a welcome change to cool you both down. To fellate with grace and expertise takes dedication and desire. It is a skill that is said to improve with age. In fact it is said that one of the only advantages of losing one’s teeth in later life, is that one is able to perform fellatio without having to worry about masking one’s teeth.

*Some chilli sauces may burn the skin and delicate mucous membranes so steer clear.

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Cunnilingus: there’s no substitute for a cunning tongue Another word for cunnilingus Is the cute word ‘cunnilinctus’ Which suggests it soothes your cough While you and your gal are having it off. ‘Cunnus’ is Latin for vulva, ‘Lingere’ means to lick. When you put the two together It’s really a popular trick. If you want cunnilingus to go on for longer, Say ‘Please linger longer and “lingere” me stronger’; If your lingerer is getting a tired lingus, Give him a break: let him use his fingers.

I

t is a little known fact that pound for pound, the tongue is the strongest muscle in the whole body. This stands to reason, not because you carry your heavy grocery bags home with your tongue, but because the tongue protects the trachea (windpipe) and oesophagus (gullet) and stops anything going down there that’s not

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meant to such as whole peanuts or say, someone else’s tongue. Needless to say, this is a vital protective function. Other than playing bouncer to any foreign bodies that attempt premature or unwanted entry, the tongue also has the important function of taste-testing and feeling-up potential intruders. The taste and texture the tongue records determine whether the verdict will be swallow, spit or vomit. As an organ of sexual pleasure, the tongue is very important in the courting stage when it is so important that it says all the right things such as ‘My God, you’re beautiful,’ and ‘Did I tell you I think you’re really beautiful?’ (translation:‘Can we have sex?’‘Now?’) In the long-distance relationship, we rely on the tongue to sustain us through intercontinental phone sex that can range in content from ‘And now my lingus is on your cunnus . . .’ to ‘So who’s my poochy-woochy-smoochy bubba?’ All this ‘aural sex’ is however merely a warm-up for the versatile and highly sexually active tongue. Tongue-kissing and tonsil-volleyball may soon be succeeded by the incomparable language of love that cunningly speaks in tongues to women all around the world: cunnilingus. While the way to a man’s heart is said to be via his stomach, it has never been absolutely agreed as to what the route to a woman’s might be. Some have postulated that females don’t have hearts. Those practised in the art of cunnilingus beg to differ; they know that to bring a woman to her knees one simply has to follow the A, B, C. Writing the alphabet with your tongue on the appropriate area of

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the female anatomy will have the feistiest femme writhing like a goldfish in your mouth. The tongue is capable of darting, thrusting, parting, poking, washing, jiggling and tickling. It has all the strength and agility of the fingers without the hard and potentially sharp nails. The tongue is the original ‘iron fist in the velvet glove’ since it is at once powerful and gentle, strong and efficacious but soft and ever yielding. A tongue is incapable of causing harm but can do amazing good. Some men don’t like the taste of cunnilingus. Others just don’t like the concept. Others, however, simply adore it and comment knowledgeably about the flavour and texture the same way a wine connoisseur describes a good drop. Some men can tell from the taste of the vaginal fluids what she has eaten recently and when her period is coming. This could be useful for those using the rhythm method either to get pregnant or to avoid it. Of course accuracy is not guaranteed. Most women like to have cunnilingus performed on them once they get used to it (which could take anything from twenty tries to twenty milliseconds). It is quite possible for a woman to be brought to orgasm multiple times from cunnilingus alone. Most women like this. Cunnilingus can feel uncomfortable and unpleasant or even painful if it is done incorrectly since the urethra is very sensitive and susceptible to trauma. Urethral trauma can lead to increased frequency of urinary tract infections. The best thing is to start out very gently and save vigorous thrusts or rasping drags for later, when the woman is highly aroused and the labia and clitoris are highly engorged and

swollen, at which point susceptibility to pain and trauma is likely to be decreased. Decades ago, far from being vaunted, genital kisses were not only taboo but grounds for divorce. Such behaviour was considered kinky and perverse. Nowadays it is more likely that couples might separate on the basis of failure to provide such perversities. The advent of HIV/AIDS and the consequent campaigning for ‘safer sex’ have increased exploration and appreciation of so-called ‘non-penetrative’ sexual activities. No longer is peno-vaginal sex considered the be-all and end-all of ‘real sex’. Cunnilingus is just one of the activities which, with its low risk of pregnancy and STIs, is really coming into its own as not just an entrée but a main course. Jesus said ‘Do unto others as you would have them do unto you’. According to this, most guys should be champing at the bit to go down on their women. Well we women don’t mind, so long as it is not just ‘lip service’ followed by a sharp directive:‘Okay now, change over!’

J. Edgar Hoover, 1895–1972.

W

hat is rimming? Having worked in Oxford Street for seven years, I am quite familiar with the activity, popular mainly amongst men who have sex with men but of course open to all genders, sexualities and ‘tastes’. Rimming involves ‘oro-anal eroticism’. That’s basically, licking around the butt-hole. Now while this may not be everyone’s idea of a delicious experience, it is certainly very popular and sexually gratifying to some. Perhaps one shouldn’t knock it until one has tried it. Although I myself plan to stop short at knocking it. Perhaps rimming is the male equivalent of cunnilingus. Both concepts sound a bit gross when you first hear about them, but a hole’s a hole and oral stimulation of most holes, even the umbilicus, seems to bring untold pleasure to the initiated. But a word of warning before you take that tongue or bum off for a slathering. The anus is home and exit station for Mr Hanky, the Christmas Poo, and all his other seasonal relatives. The risk of Hepatitis A and other infections is very high with this activity. There is no more direct

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‘I regret to say that we of the FBI are powerless to act in cases of oral-genital intimacy, unless it has in some way obstructed interstate commerce.’

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Rimming

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transmission for Hepatitis A than straight from the bum to your mouth. In order to bypass this problem, doctors and health workers recommend using dental dams and gloves for all such ano-centric pursuits. What’s a dental dam? Well it’s a pleasant-tasting (usually vanilla, smells just like a ‘Milky Bar’) square (about the size of a tissue) of latex which you are supposed to interpose between your mouth and the other person’s pink (or brown) bits. When I worked at the Sexual Health Centre at Sydney Hospital, we used to hand them out left, right and centre, with encouraging exhortations to ‘Try it! You’ll love it!’ I used to point out carefully how much the odour resembled ‘Milky Bar . . . you know, the white chocolate? It smells exactly like Milky Bar!’ Somehow I felt that this was the strongest (only?) selling point. That, and the fact that they were free. And we had boxes and boxes of ’em in storage. Funnily enough, we could barely give ’em away. Seemed like smelling like ‘Milky Bar’ just wasn’t enough. That’s right. Whenever in general practice I have advocated using dental dams or asked if a person had ever used a dental dam, people have usually asked me what a dental dam was before simply laughing. I tell myself they were laughing with me, not at me. Although I wasn’t actually laughing. Yes it seems that the concept of ‘safe oral sex’ is largely a delusory spectre in the minds of sexual health physicians and public health officers. Other than the occasional conscientious sex worker, it seems like hardly anyone who

So while the dental dams might initially seem like a kinky idea and you might only associate wearing gloves with doing

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is in it for the fun of it wants to be bothered with ‘Milky Bar’flavoured latex. Is it the latex? Or does everyone just prefer dark chocolate? I think it’s the whole concept actually. People like to abandon themselves during sex. They don’t want to be reminded that there are health risks and infections. They don’t want to be covering skin and mucous membranes when what they specifically crave is skin-to-skin contact. People often believe that even the thinnest sheet or sheath of latex is too much of a barrier. One way of getting around this is to remember that you can’t catch an infection from someone who is completely free of infection. If you and your ‘Rimming’ friend head off to the local doc and get completely checked out from top to ‘tail’ with blood tests, urine tests and swabs from all the appropriate orifices, and await the necessary ‘window period’*, then if you get the ‘all clear’, presumably everything’s ‘all clear’! Unless one of you has another partner who has not been given the ‘all clear’. Even if neither of you has an infectious disease as such, it is worth remembering that faeces is largely made up of bacteria, mainly E. coli. This bacteria is designed to be in your guts and make its grand exit via the anus. Its next port of call is meant to be into a porcelain bowl, next stop Bondi Beach, not your mouth. Sucking down poo, even from the bum of someone you really dig, is none too sanitary and none too healthy. Even thinking about it makes me feel kinda queasy. But hey, that’s me.

dishes, it’s worth at least considering taking a few precautions if you choose to get your rocks off the oro-anal way. Rimming is kind of like loitering with intent. Intent to force entry perhaps. That’s right. It’s an effective way to relax the anal sphincter muscles and as such is a common but not essential prelude to anal sex just as cunnilingus may be a preparation or warm-up for peno-vaginal penetration. But rimming may be practised with or without any follow-up of the anal penetration variety. It may be a meal in itself so to speak. Between consenting, infection-free partners, rimming is yet another variety of sexual congress that some delight in. It is however riddled with risk of infection. There are practical difficulties in terms of preventing the rimmer from getting faecally contaminated. Some people use enemas or douches. There can be risks with these as well since vigorous enemas or douching can create splits or breaks in the delicate anal and rectal mucosa which increase risk of infection. Also, sharing enema equipment is a big risk. Meticulous bathing or showering are better options, really. It’s important to accept the anus as a hard working and essential part of the body, deserving of respect and care. It must also be recognised for its sensual and erotic potential, even though this may be happily ignored by many. The anus is more than just a poo shoot. For a lot of people, especially men who have sex with men, the anus is ‘where it’s at’. It’s up to each couple to decide for themselves as to whether they see an ‘us’ in ‘anus’ or an ‘aah . . . no’ in ‘ano’.

* The ‘window period’ for HIV is considered to be three months, which means it may take three months for the infection to show up on the blood test.

2nd jock: What? Which situations? 1st jock: Prison, when it’s like a substitute, or guys in space. 2nd jock: Guys in space . . . 1st jock: Not on purpose. It just happens because they’re weightless and they float into each other when they’re asleep. 2nd jock: You’re so lame. 1st jock: Well I know it’s wrong! It’s against, like, nature. It’s basic plumbing. 2nd jock: What? 1st jock: It’s the human body. It’s divided up into ‘in holes’ and ‘out holes’ and stuff is supposed to go in the ‘in holes’ and come out the ‘out holes’, but gay guys, they like put stuff in the ‘out holes’. 2nd jock: So is a mouth like an ‘in hole’? 1st jock: Right. You put burgers in it, brew. Unless you’re sick and you puke and then it’s an ‘out hole’ so it’s wrong. From the movie In and Out.

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1st jock: There’s only two times where it’s okay to do, like, gay stuff. Two, like, emergency situations.

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Am I happy or gay?

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eing ‘gay’ has always been a source of confusion and hypothesis for philosophers of life from teenagers to blue-rinsers. What is it to be ‘gay’ and what’s the secret to being both happy and gay? Why are people with same-sex leanings called ‘gay’ anyway? Well for one thing, sometimes they’re not. For the purpose of accuracy, often people prefer to describe groups of individuals in terms of their actual behaviours. Hence the term ‘men who have sex with men’. It is a common but inaccurate assumption that all men who are attracted to other men engage in regular and compulsive anal sex. Some men with same-sex leanings don’t have sex at all and those who do don’t necessarily enjoy anal sex. Of those who do, some like to be the insertive partner (‘top’) and some like to be the receptive partner (‘bottom’, no pun intended). Some men are ‘versatile’ and may go both ways, and I’m not talking here about bisexuality. Knowing whether you’re gay is a complex conundrum for some; for others it is an in-built sixth sense and a patently obvious fact from day one of consciousness. Sometimes it seems as if everyone else knows or supposes a guy is gay, long before he realises or accepts it himself. There’s no need to rush into self-revelations of this kind. It’s not really for others to decide whether and when you come out. One of the main factors that inhibit people from accepting and embracing their homosexuality is the disapproval and dashed expectations of family and society at large. Some cultures and religious or moral backgrounds may be particularly unaccepting of homosexuality, and

This kind of attitude is rather selfish and narcissistic. It is nonetheless common. After taking some time to adjust,

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flying in the face of this rigid code of moral correctness can be mighty intimidating. Some men prefer not to be fully out until their parents have passed on. Others decide suicide is the best way of avoiding conflict. They choose extinction over the distinction of living ‘La Vida Loca’. The advent of HIV/AIDS forced a number of parents, who had previously turned a blind eye or been genuinely oblivious, to come to terms with their son’s sexuality in a double whammy revelation: ‘Mum, I’ve got AIDS and by the way, I’m gay.’ It is sad that many parents and families find it so difficult or impossible to embrace their sons in their entirety. Some parents have violent objections to the concept of homosexuality, feeling that it is a sin, a weakness or just simply ‘unnatural’. Of course it does seem to come naturally to their sons, who, believe it or not, did not actually choose to be gay. Many men who enjoy and embrace their gayness will nonetheless say that they feel life would be much easier if they were straight and given the choice, they would not necessarily choose to be gay. For some parents, having a gay son is a source of guilt and shame. They wonder what they did wrong to turn their son gay; they wonder if friends and family will look down on them for being tainted with an irregularity; fathers may worry it will reflect negatively on their own masculinity. Parents entrenched in unimaginative and conservative values may bemoan the loss of potential for a big white wedding and grandkids.

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many parents realise that gay, straight or bi, their son is their son: a man who needs love, respect and maybe a little extra understanding. For some parents, to whom the idea of homosexuality is very foreign, the adjustment may be particularly difficult. Seeing a counsellor or joining a group of other parents of gay men may be really helpful. Most men find it very hard to come out to parents and friends. Naturally they fear rejection and castigation, guilttripping (‘How could you do this to me?’) and punishment (being thrown out of home or having all support cut off). The reasons people choose to come out are many and varied but usually centre around the desire to be honest and to share a very important and precious part of their lives with the people they love and care for. It is a pity to reward this kind of openness with cruelty, harshness and insults. Often the parents and family may suspect the guy of being gay long before he actually tells them. A friend of mine for example, ummed and aahed for ages before coming out to his Mum. When he finally did, she was so enormously relieved she cried. ‘Is that all? I thought you were going to tell me you had AIDS!’ she sobbed, smiling through tears of joy. Realising that one is gay, and even coming out, may not be the end of one’s woes as a gay man, just as knowing you are straight does not necessarily mean your love life will be smooth sailing (don’t I know it). Knowing one’s sexuality is just the beginning of one’s sexual journey. Finding a partner involves a lot more than just knowing what sex you are after. But it’s a start.

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Many men may enjoy satisfying sexual or semi-sexual relationships with women before realising they might be bi or gay. Sometimes having a string of relationships with women that don’t work out may make a man start to wonder about his sexuality but not all men who have problems with women are necessarily gay. These same men may find they go from having ‘gal troubles’ to having ‘guy troubles’. Sometimes a man may be married with kids before he fully cottons on to the fact that he is gay. Coming out in this situation can involve a lot of heartbreak all round, but living a lie and repressing one’s true sexual nature, or playing it both ways by having gay sex on the side, is worse, since in doing this everyone is betrayed and no-one is really satisfied (not to mention the physical risk of STDs). Of course, ideally, men who are gay should not marry women under the guise of being straight. Sometimes men know or suspect they are gay and think getting married will fix it or hope that they can simply repress their homosexual urges. Of course there may be pressures from many sides to go along with conventional practices and strong friendships with females may be moulded into sexual relationships that may work temporarily. Sometimes the urge to have children prompts the gay or maybe-gay man to get married, thinking it is his only chance for procreation. Having children with a woman even though you are gay might be a perfectly fine thing to do, but to do so without letting the woman know the facts is less than ideal. Many gay men get asked to donate sperm for artificial insemination and there is nothing to stop a gay man from

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being a sperm donor, so being gay doesn’t automatically mean no kids. Just as being straight is no guarantee of fatherhood either. Not everyone who comes out as being gay has hassles. Some parents and friends are very switched-on and accepting of their children’s choices. They will naturally be concerned about issues of safe sex and possible discrimination from others but they have the wisdom and largesse to actually put the interests of their sons before all else. Some parents’ reasons for having kids in the first place are predominantly selfish and to do with making them look good and feel good about themselves. Their fragile self-image is threatened by any aberration that doesn’t fit into their scheme. Other parents decide to bring kids into the world hoping to bring up some really good people and give them the love and support they need to grow up healthy, happy, strong individuals, not just identikits of the parents. Parents like these are able to accept their children for who and what they are and embrace what their children embrace with all the vigour and enthusiasm they can muster. Coming out to one’s parents can bring greater intimacy, trust and understanding to the relationships. It can also result in rejection and devastating hurt on both sides. If a parent is rejecting and refuses to even try to understand the gay child’s point of view, that parent is not worth maintaining a relationship with. We can choose our friends but we did not and cannot choose our parents. Just as every child has his or her faults, so does each parent, but a parent who rejects a child purely on the basis of the child’s sexuality is a bad parent. They may think they mean well.

If you’re gay, that is.

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They may think that in being gay, the child is doing the wrong thing, wrecking his/her future, ruining his/her life, but a loving parent will continue to grapple with the issue, discussing or even arguing with the child until finally some resolution may be reached. A parent who simply rejects outright and refuses to try to reconcile the differences opts out of the relationship and loses the child. It is a loss to both sides but relationships that depend on one party conforming to another’s rules, irrespective of their own feelings and needs, is not a relationship worth having. Sad to say, some parents might not be worth coming out to. But it is hard to know in advance which ones these will be. Sometimes parents who you thought were narrow-minded or backward in terms of social progressiveness might surprise you. With gay rights, equal opportunities and antidiscrimination policies being capably enforced these days, the lot of the gay person is undoubtedly improving but of course prejudices are far from being completely eradicated. Even within the gay body, there exist numerous prejudices. Effeminate gays may be ridiculed by butch queens; people who are still in the closet may be disdained by those who are ‘out’; bisexuals may be spurned by gays and straights alike; ageism is a factor; overweight or ‘not gym-buffed-beautiful’ types may be sneered at; racism amongst gays is alive and well. Being gay, accepting it and having others accept it is just the beginning of the steady progression towards being happy and gay. It’s the first step and a step well worth the taking.

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How do I know if I’m a gay guy?

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Attracted to boys and men predominantly.

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Sexual fantasies involve men.

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Not sexually attracted to women.

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Aroused by images and concepts relating to other men or boys e.g., penises, male buttocks, male chests.

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Not aroused by images and concepts relating to women or girls e.g., breasts, female legs or genitalia.

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Never desired sex with females.

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Curious or keen regarding sex with males.

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Spend a lot of time wondering about whether you are gay and think you are.

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A lot of people think you are gay.

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Your boyfriend thinks so too.

Circumstantial factors that do not indicate you are gay: 1. Neat. 2. Slim. 3. Well groomed. 4. Interest in fashion and up-to-date hair styling.

7. Work in ballet, theatre or the arts. 8. Dance in a flamboyant fashion. 9. Talk using flapping hand movements and high-pitched voice. 10. Walk with what could be described as a mince. 11. Wear make-up or wish to. 12. Have had plastic surgery or wish to. 13. Read women’s magazines or wish to. 14. Wear women’s clothes or wish to. 15. Played with dolls as a child. 16. Non-violent, gentle soul. 17. Enjoy housework, sewing and cooking. 18. File your nails regularly. 19. Wear fragrance (‘aftershave’). 20. Shave your legs.

Just as not all gay men fit these stereotypes, not all men who fit these stereotypes are gay. Not having a girlfriend doesn’t mean you are gay. Not knowing whether you are straight doesn’t mean you are gay either. Maybe you just aren’t sure yet. Talk to a doctor or counsellor if you feel confused or just want to chat about stuff. Take your time. You’ve got a whole lifetime to figure it out and there’s no rush. Sex is important, but it’s not everything. When it becomes important to you,

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6. Enjoy ballet, theatre and the arts.

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5. Streisand or Sondheim fan.

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you’ll work it out. Don’t be afraid to let someone help you, preferably someone with experience that you can trust, such as a doctor or trained counsellor or psychologist who speaks your language and whom you get on with. No-one should pressure you to explore your sexuality until you’re good and ready and no-one should hassle you to come out just because they have or they want you to or they think it’ll be good for you. You need friendship, understanding and support, not pressure and prejudice. All in good time, matey. P.S. There’s no such thing as ‘in holes’ and ‘out holes’. They’re all just holes: multi-purpose holes. And that’s the hole truth, nothing but the truth.

S’n’M, B’n’D, M’n’Ms: cruel to be kind, in the right measure S and M: Sado-Masochism B and D: Bondage and Discipline D and M: Deep and Meaningful M and Ms: Melt in your Mouth (not in your hand) B and B: Bed and Breakfast (No M and Ms in the Bed: they Melt, but S and M, B and D and D and Ms — A.O.K.)

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hat are these titillating alphabets all about and are they worth getting into? The trusted ‘B and D roll-a-door’ is a proven pleaser. I couldn’t do without my B and D. M and M’s are a must for the chocoholic with hot hands. And where would all the romantics be without their little love nests: the B and B’s? But S and M sounds a bit scary. What’s it all about, eh? Sado-masochism is a sexual variation that centres on dominance and submission. The term is derived from the names of two famous old-time dudes called the Marquis de Sade (ooh, very posh) and Leopold von Sacher-Masoch (we believe he may have had a hand in the ‘Sacher Torte’. Hey, anyone with a sweet tooth couldn’t be all bad.) For de Sade (no relation to ‘Sadie the Cleaning Lady’) and the ‘sadists’ who follow his lead, pain, not pleasure, is where it’s at. ‘There’s a fine line between pleasure and pain’ could easily have been his theme song, if he had lived in the eighties. In fact, living between 1740 and 1814, he did live in the eighties but it was the 1780s and the Divinyls were more of a 1980’s band. As well as being handy with the whip, de Sade was not shy of the ol’ quill and ink, writing numerous raunchy books including 120 Days of Sodom which is chocka with stirring examples of how being beaten, flogged and humiliated might for some constitute a great night out. Perhaps those people who go to bars, spend the whole pay packet getting blind, vomiting in their own cars and then suffering a horrendous hangover are really onto

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something. Come to think of it,I actually know a lot more sado-masochists than I thought. Von Sacher-Masoch (he of the Sacher Torte), as well as being a dab hand with the pastries, was also a noted historian and novelist. Just as that other famous romance novelist, Barbara Cartland, had a theme: pink, Von SacherMasoch had a special little motif too: whippink! In his personal life, he especially liked to be whipped by women wearing luxurious furs. (A very thoughtful bloke, he didn’t wish for the ladies to catch cold, most likely.) After all the fun, he would whip out the famous choc torte (this was way before M and M’s) and they’d get stuck into it, with plenty of whipped cream of course. Just imagine: after all the whipping, they were really beat. Many religious figures have also gotten into the old flagellation scene. ‘The flagellants’ (no, not the ‘flatulence’!) were a twelfth-century clan who believed that you weren’t really serious unless you drew blood. Whereas the 1980s party-hard motto was: ‘Rage ’til you puke’, back then it was ‘Flog ’til you exsanguinate.’ How times have changed. The saints have done their bit too, to propagate the art. Saint Margaret Mary Alacoque was a seventeenth-century nun who took the game way seriously: she carved the name of Jesus (this guy she was really into), on her chest and then burnt it in with a candle. Joan of Arc topped that by burning not just her chest, but the whole dang lot. Saint Mary-Magdalen dei Pazzi (doesn’t ‘pazza’ mean ‘crazy’ in Italian?) was more of a ‘back to nature’ kinda gal. She used to roll her naked body in thornbushes in the convent garden then go back to the convent to whip

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herself. She forced novices to bind her to a post, insult her, whip her and drop hot wax on her. The insults would go something like: ‘What a moron! Who’d be idi-bloody-otic enough to go rolling naked in thorns? Jesus! (Woops!) What a bloody idiot!’ and so forth. Well whatever does it for you. I’ve never understood going into the nunnery. Still don’t really. But evidently you have to be just a little different. So yeah, sado-masochism has been around even longer than the Sacher Torte. These days, with our more permissive society, S and M is more visible and clubs like ‘The Hell Fire Club’, who have got it, flaunt it. Some people might bedeck themselves in heavy leather, chains, gloves and harness-type gear, but practise the most ‘vanilla sex’ imaginable. The guy in the three-piece suit and glasses however, might be a regular Clark Kent, wearing nipple clamps, penis piercings and chains underneath, and sleeping in a metal-spiked leather sling suspended from the ceiling . . . of his dungeon. You just never know. But true to say, typically, S and M practitioners do cultivate a particular look with an emphasis on pastel pink and lace . . . no sorry, getting mixed up with Barbara Cartland . . . I mean tight leather, black rubber, chains, jack boots, thigh boots, long gloves, straps, buckles, studs, whips, dog collars, trusses, piercings, tatt’s — not ‘I love Mum’, more like ‘I love Satan’ (or ‘I love Santa’ for the dyslexic) — anything that suggests power, toughness, dominance and force. Sometimes uniforms are donned: police kit complete with truncheon, army officer with gun, nurse with syringe (I made that last one up).

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Yeah, so it’s a real scene and people who are into it get together in clubs or via personals in the appropriate mags. Novices usually begin as masochists, being subordinated, punished and humiliated. It allows them to explore fantasies of domination and surrender. Ironically some of the keenest masochists are powerful, highly controlling individuals in their everyday lives. After all the responsibility and high-powered decision-making at the office, they like nothing better than a pants-down, sling up, slap around to get them feeling powerless, vulnerable and a bit sore. It can be a nice change to let someone else take control. Through being a sub (submissive or slave), one can learn how to be a dom (dominatrix or master). An experienced dom knows how to give the sub the pain and humiliation he/she craves without going too far or actually harming the sub. Usually a ‘safe word’ will be established so that the sub can let the dom know when he/she has reached his/her physical or emotional pain threshold. It shouldn’t be a word like ‘No’,‘Stop’ or ‘Don’t’ or even ‘Please don’t’. These words will be bandied about all through the process long before the sub genuinely wants it to stop. It ought to be a clear signal that will be immediately recognised. Perhaps ‘Sacher Torte!’ would be appropriate and distinctive enough. Obviously while S and M can allow for exploration of a number of harmless fantasies and emotional wells, there are multiple potential dangers, especially if you get involved with a dom who is inexperienced, irresponsible or genuinely cruel. Paradoxically, most doms are actually extremely gentle and caring folk in real life. They need to be, to be successful doms, capable of delivering both cruelty and caresses,

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contempt and tenderness. They have to be able to deal with people at their lowest point and at their most vulnerable. And they have to make it sexy. A challenge, huh? S and M is not about hurting people. It is about trust and role-playing. It requires lowering of inhibitions and freeing of fantasies. People who do S and M together generally maintain their roles quite strictly during S and M play but in their every-day lives, they treat each other as equals or may even reverse roles, with the dom doing all the housework while the sub files his/her nails. There are many professional doms who charge stupendous fees. High court judges, C.E.O.s and goodness me, even doctors flock in for the pleasure of being strung up by their big toes and teased, tortured and titillated. There is a lot of taboo as well as fascination surrounding S and M. Those who know nothing about it feel sure it is the devil’s work. There are indeed dangers and some subs do get serious cuts, abrasions, bruises and, rarely, fractures and more severe injuries. It is vital to know and trust your dom. Absolutely under no circumstances submit to any activity that involves strangulation or suffocation. There should be no blood loss or broken skin. The practices of piercing, burning and scarification are profoundly hazardous and a major infection risk. Make sure you agree on a safe word (‘Sacher Torte!’) and remember to use it! B and D is related to S and M but it centres more specifically around the practice of ‘Tie me Up, Tie me Down’. It is really quite a commonly practised sexual variant and is designed simply to increase the suspense and pleasure, by minimising one person’s capacity for movement. ‘Any restraint upon muscular and emotional

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activity generally, tends to heighten the state of sexual excitement’, wrote hallowed sexologist Havelock Ellis. People enjoy feeling helpless. They love the sense of being forced to endure sexual arousal and climax with no possibility of actively participating. Cruel to be kind indeed. Some people may use simple silk scarves, others prefer chains, handcuffs, bandages, stockings, leather cuffs, furlined bands, cords or ropes with complex knots and ties. Sometimes a gag or blindfold may be used as well. The recipient may be tied, lying, to the bed or couch, standing, to a chair or post, or may be tied in a slightly contorted position, pretty much anywhere. Ligatures are usually applied to the limbs, torso or chest but should not be tight or uncomfortable. Never place any restrictive bands near the neck. Make sure the subject can breathe easily and can give a signal if there is a problem of any kind (e.g.,‘Need to go to the toilet’ or ‘Feeling faint’ or ‘Something in my eye!’) If using handcuffs, make sure you know where the keys are and can find them in a hurry. If working with knots, make sure you can untie or cut your subject free swiftly and painlessly. Remember that the struggling will tighten the knots and unless you want to cut up your sensational Hermès silk scarf or Armani tie, make the knot a slip knot you can undo easily. Rope burns are painful and can get infected and metal chains can be very uncomfortable as well as being difficult to fasten sufficiently firmly. The idea is to give the person maximal pleasure and minimal pain. Bondage should leave no marks. It should just leave her/him crying for more. There is nothing more passive than allowing oneself to be tied up and tantalised before being mercilessly ravished.

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Feeling vulnerable and out of control and at the same time adored and desired is very hot and understandably can produce slow, deep, full, mind-blowing orgasms and a huge sense of relief. Struggling against firm, well-tied restraints whilst being licked, blowed on, tickled or simply ogled, is about as erotic a form of foreplay as one can get. It’s completely harmless and with practice, very sexy. Being tied up and made to watch one’s partner masturbating is also a popular trick. It builds suspense, lengthens and deepens the arousal, and is ‘bound’ to end in an exciting and memorable climax for all concerned. The idea of being bound and gagged may seem like the stuff of nightmares. Certainly if it was a kidnapper doing it, it would be. But being bound and gagged by someone you know and love and trust is a completely different scene. It’s more like being a precious gift, wrapped tenderly to be admired, thoroughly appreciated, fondled and thoroughly used. And you know you can return the favour. Bondage gives both partners the opportunity to enact roles and play out fantasies in a safe and indulgent environment. You can give your partner the time of his/her life and feel the satisfaction of total control and responsibility for their pleasure. Afterwards they may show their gratitude by tying you up! Obviously after the games, don’t fall asleep with your partner still gagged and restrained. Don’t put them face down. Don’t leave them suspended upside down or in an awkward position for too long. Avoid using alcohol or other drugs before or during bondage since your alertness and judgement will be adversely affected. As long as you are

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sensible and safe, you needn’t be afraid to experiment with new positions, new knots, new characters, new scenarios and new settings. But for this kind of activity, it’s best to stick with the same partner: one you can really trust. You wouldn’t want to be robbed, raped or humiliated and left genuinely helpless by a twisted pervert out to take advantage of you. The whole thrill of B and D is in letting someone take advantage of you, knowing that they won’t.

Fantasy, fetish, fone sex

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haring fantasies, indulging each other’s fetishes and talking dirty (on the phone, the net, the couch) can all enhance intimacy and eroticism. Intimacy without eroticism is good. Eroticism without intimacy is good. But intimacy and eroticism together enhance each other. Through intimacy we expand our capacity for eroticism. Together, intimacy and eroticism have more than just an additive but a multiplicative, perhaps even exponential effect: eroticism to the power of intimacy, intimacy to the power of eroticism. The potential, if you care to explore, is infinite. Not all fantasies need to or are meant to be shared. Sometimes the pleasure is only maintained by the secrecy and forbidden nature of the fantasy. Other fantasies may be

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a major turn on for both you and your partner and each person may add a little something extra that spices it up and invests it with fresh erotic charge. You may decide together to act out a modified version of your mutual fantasy with anything from costumes to props to set decoration, depending on your skills, time, dedication and sense of fun. Spontaneity is great but occasionally a bit of forward planning can have delicious pay-offs. Collusion and cooperation of this kind is very intimate and can obviously be erotically rewarding. The ability to ‘make each other’s dreams come true’ might not be a bad one to foster. Fantasies that exclude the other person or concentrate exclusively on ephemera that are completely unrelated to the living, breathing individual you are with can however obstruct the development of sexual intimacy. It is common and normal to sometimes ‘tune out’ one’s partner and focus on an erotic fantasy, but if one does this all the time and never allows the partner’s individuality, personality and reality to intrude, one almost might as well be masturbating. For the partner, being externalised and virtually ‘used’ in this manner is a lonely and minimally satisfying experience. At least some of the time, treat your partner and yourself to ‘eyes wide open’ sex: really see each other and discover how amazingly erotic this is. There is truly nothing sexier than watching someone turn on as they turn you on. Don’t be shy. Just see what happens. Fetishes are objects or conditions that are invested with erotic appeal for some people, even though they are not usually considered sexual. Common well-known fetishes

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include: rubber, feet, shoes, boots, leather, particular clothing or lingerie or particular hairstyles. If fetishes enhance the sexual experience for the individual, great. Fetishes can, however, become problematic if they start to take precedence over the partner or if arousal and full sexual response depend entirely on the presence of the fetish. Say for example, a man can only be aroused when his partner is wearing red stilettos or indeed, he cares not whether the partner is present or not as long as he can caress and ejaculate into the red stilettos. In general fetishes are thought to be more common in men. It is quite common for men to be turned on by suspenders and hose for example or G-strings, corsets or high heels. This is not a problem if the partner (male or female) is willing and able to comply. The partner may however feel pissed-off, alienated, used or simply superfluous if the fetishist refuses to perform unless the requisite gear is in place or worse still, concentrates his attentions exclusively on the gear and ignores the wearer both before and after removal of said gear. Getting turned on by a number of different objects, attires or situations is normal, healthy and entirely functional but to be rigid or restricted in one’s requirements is problematic. This kind of obsession and preoccupation is unhealthy and threatens the relationship since it is only erotic for one person and it completely annihilates intimacy and even the merest partner recognition and appreciation. Variety, flexibility and balance are vital to keep a sexual relationship vibrant and dynamic. Wearing a fireman’s helmet or a complete set of scuba gear is cool for an occasional lark. If such outfits

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become de rigueur, you may have a problem. Unless of course your partner is a fireman who does regular on-call duty, or indeed your residence is 20 000 leagues under the sea. ‘Trisexuals’ are willing to try anything once. This is a great attitude in general so long as basic safety is respected. To be willing only to do it one way is perseverative and obsessive and finally, dead boring. Relying on fetishes means that the fetish is no longer enhancing your love life but strangling it. Seek help from a professional if you or your partner have such a problem. Phone sex and cybersex are relatively new ways of relating sexually as well as socially, across vast distances, across the street or even across the corridor in an office romance. They may constitute a convenient and easy way of meeting new people or maintaining the erotic power surge in longdistance relationships. They may add variety to our repertoire of sexual communication. They may be a way of building-up the suspense prior to a sizzling flesh-to-flesh encounter. Some people find it easier to express themselves candidly or even lucidly, in writing or over the phone. For some, these forms of communication may be less intimidating or nerveracking for the transmission of very sensitive material. In these ways, phone sex and cybersex may enrich and broaden our sexual experience and opportunity. Phone sex and cybersex also allow for anonymity and blatant deceit regarding identity. People may exhaust their erotic and emotional energies in these vast electronic wastelands, living a ‘virtual’ life that is devoid of honest, frank and tender human contact. In the case of commercial phone sex lines, this can also be extremely expensive.

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It may be fun and informative once in a while, to take on a false persona, try on a different gender, sexuality or age, but a huge gulf separates the realm of fiction from the grittiness and deep-down satisfaction of real-life, real-time intimacy and mutual discovery. Just as pen pals in the olden days could form lasting and rewarding relationships, sometimes ending in successful marriages, these days, the net acts as global matchmaker, with many internet romances resulting in intercontinental nuptials. Just as often however, the cool, elusive-but-irresistible spunk you met on-line, hunted down and pledged undying love to, is revolting, repulsive and alarmingly adherent in the flesh. You take your chances and need to bear in mind that the phantom you have grown to know and love may turn out to be a ‘virtual stranger’. Meeting, chatting and having net nooky is a novel and convenient way to exercise the social muscles and get the juices flowing. Focusing exclusively on these kinds of interactions is limiting and may increase anxiety surrounding real-life social play. Hiding behind a fictional identity is self-defeating unless you only wish to exist as a fictional character whose entire sex life and relationships are delusory. Some people claim to thrive on anonymous sexual encounters and for this purpose, phone and cybersex are the safest possible options in terms of infection, pregnancy or assault risk. But while anonymity may deliver some erotic charge to a select few some of the time, it is impossible to achieve any kind of intimacy or ongoing relationship development for as long as anonymity is maintained. Either

the masks come off somewhere along the way or else eventually the absence of intimacy will lead to stagnation and stultification of eroticism. Sex without soul is like music with no melody: cacophonous, abrasive noise. So are intimacy and eroticism really such essential and basic ingredients for a satisfying sex life? Well given that not all relationships have both these components, either they are not essential, or else perhaps there are many relationships out there that are not genuinely sexually satisfying. As for being basic, well ‘basic’ seems to imply ‘simple’ or ‘easy to achieve’, and I don’t think this is true. Building intimacy and injecting erotic energy do not come automatically and we are not all brought up to even respect, let alone actively cultivate, these skills. Single people can explore their own erotic contours and develop a form of intimacy through self-knowledge and self nurturing. Couples can get more out of their relationships by charting each others erotic contours, and in discovering each other and uncovering themselves in the bright light of each other’s gaze, they can enjoy genuine and profound intimacy which may, if desired, be enhanced by fantasy, fetish and fone sex. What could be more exciting or sexy?

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Food/sex

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ne of my dearest friends once said to me,‘The only things that make life worth living are food and sex.’ It was only after he contracted HIV and was unable to eat because of a severe fungal infection in his mouth and oesophagus, that he lost his lust for life. I often think about him and wonder if he was right. What makes food and sex so special and can life exist without them? Well it depends on how you define it all really. If you think about it one way, we all started out as an orgasm. On the other hand, these days with assisted reproductive technology being what it is, with IVF and so on, life can germinate without so much as a kiss and a fondle. And as for living one’s life as a total celibate, I’m living proof that that’s possible. Oops. As for living without food, that is even possible, theoretically, if you have all your nutrients in liquid form either by mouth or intravenously. Plenty of alcoholics would argue vehemently that a totally liquid diet is not only a perfectly viable way to sustain life but a great way to avoid having to do the dishes. As a doctor, I cannot recommend this approach to nutrition but I must admit that I am constantly amazed at the resilience of some inveterate drunks. I guess alcohol also works as a preservative. Babies, it must be remembered, derive all their nutrients in the early months of life, not from food but from milk, which strictly speaking, is not a food but a beverage.

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So it must be conceded that, looking at it in a particular way, it is possible for life to go on with neither sex nor food. But what kind of life is that? It’s all to do with balance in the end. (Isn’t that boring?) I mean if you eat way too much, you get fat with all of obesity’s attendant risks. If you don’t eat enough, you get anorexia nervosa and a whole lot of people start whispering unflattering references to ‘Ally McBeal’. Same with sex. Get too much and the bitches call you a slag/slut/whore. Too little and you feel all left out when people get chatting about their latest conquests and what does and doesn’t get their juices flowing. You’re the only one raving about the new ‘Ronson Super Juicer’ and how easy it is to clean of pulp and rind! Then your mates think you’re really kinky. It’s one way to earn respect but who’s fooling whom? Seems to me, sex and food are inextricably linked. Think about it. Both activities involve the introduction of objects of desire into body orifices. Both activities are pleasurable, sensual and satisfying. Both may require vast degrees of preparation and expectation but be surprisingly quick in the execution. Too much of one may preclude the other; indeed many women describe weight loss in the early, heady days of a new sexual relationship and conversely, some obese people count their size as one of the factors that makes finding a sexual partner problematic. Mostly however, sex follows food as night follows day. A good meal at a fancy restaurant is considered de rigueur in the whole seduction process. Just as food can inspire the desire for sex (the most famous aphrodisiacs are oysters, chocolate and green M & Ms), sex can pique the appetite for

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food. Surely the commonest post-coital sequela after snoring has got to be ‘Gee that’s made me hungry. Got any ice-cream? How ’bout some CC’s?’ Notice how I’ve carefully steered around the delicate issue of food during sex? Well yes it’s true, some people do eat while having sex but one would hope that this would only occur during truly marathon sessions, in which participants’ strength must be kept up. Diabetics inclined towards hypoglycaemic attacks would obviously be excused for eating during appropriate breaks. Otherwise, there’s no excuse for this kind of crumbs-in-the-bed behaviour. The ‘wet patch’ phenomenon is one thing, but the sticky/crunchy/squelchy patch is another thing altogether. Indigestion, belching, choking and reflux are other hazards to bear in mind. Okay okay, so food can be used in sex for things besides eating. There are some who like to smear each other’s bodies with food substances or even use foodstuffs to penetrate assorted orifices. This may enhance sexual enjoyment although it does nothing for the state of one’s bedclothes/carpet/car upholstery. But for those who are happy to leave such house-pride issues out of it, food as a sexual tool can be fun, and even I must admit that cucumbers are cheaper than dildos. Just don’t insert anything you can’t retrieve. Enough said. Finally it must be mentioned that both sex and food can be used by some to escape from dealing with problems. Some people try to drown their sorrows or stuff away guilt, shame, fear or anxiety by using sex, food or both to numb themselves. Aside from the risks of such excesses in themselves, the greatest danger is that the original problem does not get

addressed and, left to fester, can get worse, perhaps irretrievably so. In balance and moderation, sex and food are probably the greatest pleasures we get to experience in life. When used to excess however, erosion of self-esteem, pride and identity can result. Food and sex — use ’em, don’t abuse ’em.

Top five reasons why food is better than sex: 1. More easily accessible. 2. Provides more nutrition. 3. You can have it in public. 4. You get to have it at least three times a day, even at your office desk, if necessary. 5. Being a food critic would have it all over being a sexual services quality assurance officer.

Top five reasons why sex is better than food: 1. Can make a baby. 2. Helps you to sleep more soundly. 3. It’s a form of exercise. 4. You can brag about it. 5. It’s inspired by love (sometimes).

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Sex work: the oldest profession in the world

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find it hard to believe that prostitution is really the oldest profession on the planet. I mean, where were prehistoric man’s priorities? If our basic needs are food, water, shelter and safety, how is it that sex workers established themselves even before restaurateurs and interior decorators? Evidently the urge to have sex with no strings attached is a dominant one which cannot be ignored, even when the wolf is at the door, literally. It has been said that men pay for call girls not for the sex but so that the girls will leave them alone after sex. This may be one motivation. Other men visit sex workers primarily for companionship and a listening ear. They may have a massage or get fellated too, but the main attraction is the simpatico company and the absence of pressure and expectations. While some women spoil themselves with a pedicure, a new hairdo or a new pair of pumps, men might prefer to indulge themselves with an erotic massage, a lap dance or a bonk with a perfect stranger, unencumbered by feeling obliged to say ‘I’ll call you’. Not all sex workers remain anonymous faces to their clients. Some men build up a rapport with one or perhaps two sex workers and patronise them semiexclusively over many years. Instead of lying on the psychiatrist’s couch to pour out their woes, they stretch

It was then that I realised what a great service the sex industry provided, giving sexual comfort and a human

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out on the brothel four-poster and let a different kind of professional take care of them. ‘Decent’ society would like to pretend that the sex worker industry did not exist. More to the point, they would like to ignore the fact that their ‘decent’ husbands, brothers and sons (and these days, wives, sisters and daughters too!) compose the clientele that keeps the industry alive and thriving. Using the services of a sex worker is viewed by many as desperate and low-life behaviour, sort of like putting an ad in the personals: you’d never do it or if you did, you wouldn’t admit to it. I must admit I once had some preconceived ideas about the sort of men who would frequent a brothel. I envisioned trench coats with lapels turned up, hats tilted low over the eyes and possibly a jagged scar on the cheek and a wooden stump in place of a leg. Perhaps such a gent would have a heavy accent and a suspicious, sneaky manner. Such were my imaginings. Too much TV? I dunno. This all changed when I started general practice. Some of my dearest, sweetest, kindliest old gents who were bachelors or widowers would tell me about their sexual problems and I would flip through the files looking confused before asking ‘But I thought you weren’t married. Do you have a girlfriend?’ ‘I’m not married and no, there’s no girlfriend. Girlfriends — too much trouble at my age! I’m talking about when I’m with a prostitute.’ ‘Oh!’ I would exclaim, feeling very dumb and naïve. ‘Oh, of course. So what’s the problem again?’

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touch to men of all ages and walks of life, who otherwise would have been deprived this gentle and evidently rewarding sensual contact. It is all very well to feel terribly superior and say ‘I would never pay for sex!’ If that is the case, good for you. But that doesn’t mean that those who wish to pay for it and have it on call, no strings, no complications, are to be disdained, criticised or held in contempt. To pay for sex does not inherently demean women or men. It is better than being raped and abused daily by one’s spouse for no pay and without the protection of brothel management. If anything, the sex industry recognises that providing sex is a kind of ‘service’ that should not be taken for granted and that has value. Women who go into the sex industry are often looked down on and made to feel so ashamed of their work that they keep it a secret. Perhaps they are not so much ashamed as simply aware of the practicality of secrecy in a society riddled with hypocritical prejudices. There would be few women who would enter the sex industry as a first choice or dream job but for many it offers the money and flexibility they need to remain independent while they fulfil other responsibilities and life goals such as going to Uni, bringing up a child or paying off debts. Getting hooked on drugs may precede or follow getting into the sex industry. Drug addicts may find sex work their only option to finance their habit. Sex workers who were previously drug virgins may find themselves turning to drugs to assist them with the fatigue and psychological strain of dealing with clients who may be difficult,

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demanding or abusive. Some who are doing sex work against their better judgement may ‘need’ drug assistance to blur the reality and induce an artificial haze. They can pretend it’s not happening, zone out and be present in body but not mind. Sex work in the context of a well-run brothel or agency is theoretically relatively safe. Clients are credit-checked and identified. Girls are taught to examine the men for signs of disease such as penile discharge, herpetic sores, ulcers, florid warts or any other worrisome signs. The girls have the right to refuse service on this basis if they see fit. If they are in trouble they can call for help. Unsavoury sexual acts can be refused at the worker’s discretion and safe sex measures are employed at all times. Workers who hustle on the street are not protected. They may have difficulty enforcing condom use. In situations where failure to pay, violence or rape ensue, they have little recourse. Police will try to protect them but of course what they are doing is illegal in the first place so they may be reluctant to seek police assistance. Having had a lot of patients at various times who worked in the sex industry also allowed me to change my preconceptions of what working girls were like. Uni students from the North Shore came in with their twin sets and pearls. Transsexuals came for their hormone shots. Corporatelooking women wearing Chanel and dripping jewellery would show off their latest baubles given by favourite clients. Drug-addled heroin addicts in torn tights and mini-skirts inside out would stagger in, wig askew, badgering me for Valium to help them sleep after a horrendous night.

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The spectrum was infinitely broad. Some seemed to really have it together and evidently were making a stack more money than I (not difficult admittedly). These women had high self-esteem, were assertive and absolutely scrupulous about personal safety and safe sex. They treated the job as a career and were highly professional about maintaining standards of personal presentation as well as maintaining a healthy distance from any emotional entanglement with clients. One thing that always struck me was that these women wore the most exquisite lingerie I had ever seen, and gold Chanel watches and quilted Chanel bags were part of the ‘uniform’. Others seemed quite conflicted about their work, with a mania for secrecy that bordered on paranoia; they led separate lives that were constantly verging on catastrophic collision. Others still, seemed to be struggling to simply survive. Drug use was a major factor in what I called ‘life disorder’: when the whole life is a mess, from the point of view of health, relationships, finances, career and home (or lack thereof). Some of these women’s lives seemed to involve stumbling from one assault to another, from one drug haze into another, from one illegal activity to another, from one run-in or conflict with the police or some other authority to another. Sometimes they had conflict with me too. What they wanted and what would have been good for their health was more often than not, far from being the same thing. I would not encourage anyone to enter the sex industry. I feel that finally, while the industry provides a service to its clients and an income for its employees, it is not a job that

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encourages a healthy perception of self and one is a potential target for abuse. It is not highly intellectually challenging and there are health hazards. The stigma attached might also be problematic at a later date. Marriage to Prince William, for example, would be out of the question. On the other hand, women who choose to take the pros with the cons and enter the industry for a day, a year or a lifetime, deserve support, protection and respect. Whether you like it or not, they satisfy a need and provide an invaluable service. These brave, pragmatic and sometimes desperate women choose this line of work because they believe it is their best option. They are working for a living in order to be independent and take care of their families or simply to finance their own dreams. They do not set out to do harm and are more likely to be harmed than to cause harm. Some women may feel threatened or angry when they learn that their partner is visiting a sex worker. The threat of STDs is negligible in cases where safe sex practices are employed. Some workers, especially workers who don’t speak English, may not insist on condoms, either because of difficulties with assertiveness or language barriers. This is hazardous for all concerned. Not using precautions is ‘unprofessional’ and dangerous, but considering these women are often illegal immigrants, ignorant of contraception, sexually transmitted diseases and even the most meagre of basic human rights, it is easy to see how this occurs. Sometimes these women are frightened of their pimp or manager, terrified of being discovered and thrown out of the country and unaware of how to access or even their right to access health services. They fear doctors and

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authority figures, unsure as to whether contact with them will lead to their being sent home in disgrace. They may be obligated to work to pay for their transit, board and food. They may need the money to send back home to look after their parents and siblings. The situation is often a grim and pitiful one. It is hard to lay blame on women who seem to be such victims of an unjust and unforgiving predicament. Poor education, poor language skills, poverty and illegal status may mean that sex work is their only way of surviving and keeping family back home alive. Sex work is not a sin. It’s a job. And somebody’s gotta do it. Just don’t think Prince William’s gonna marry you if he finds out.

Myths about sex workers: 1. Sex workers are sluts. Sex workers keep their clients and their own partners completely separate. They maintain fidelity to their partner; clients are not counted as ‘lovers’. There is nothing morally bereft in this. 2. Sex workers spread STDs. Actually, because sex workers generally are quite scrupulous about safe sex measures at work, they are unlikely to catch or transmit infections in this context. Sex workers are more at risk of

catching diseases from their regular partners since often they will not use condoms in their private lives. Their clients however are protected from infection by the fact that conscientious sex workers have regular STD check-ups and use condoms at all times. 3. People who use the services of sex workers are desperadoes. The people who use sex workers are not a homogeneous group. In their number are included politicians, judges, doctors, corporate high-fliers as well as labourers, students, disabled people and retired pensioners. People who are assertive enough to go out and get what they desire are not, to my mind, ‘desperadoes’. 4. Sex workers are drug addicts. Some sex workers are drug-addicted. So are some doctors, lawyers, bankers, models and movie stars.

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Condoms! ‘BE WISE, CONDOMISE!’

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ne of my favourite memories from Uni days is a scene from one of our Med Revues,‘Debbie does Dialysis’, in which three guys dressed as six foot condoms, (the original ‘total body condoms’), jigged around the stage of the Footbridge Theatre singing: ‘Condoms are nice and condoms will stop you From getting a disease that you don’t want to . . .’ to the tune of a Smiths’ song. It certainly had me tapping my toes. Those guys are hallowed surgeons now and I’m sure they still take their personal protection very seriously. But what of the current status of the condom? If you were a condom, where would your self-esteem rating be hovering in the year 2001? High, medium, low . . . or inestimably low? How does Everyman feel about the humble condom? How and why does he use and refuse them? These questions and more will be answered, here, in the seX-files. ‘ME, USE A CONDOM? BUT I DON’T HAVE AIDS!’ (or ‘CONDOMS? BUT I’M NOT GAY!’) A lot of people associate latex and rubber with fetishists and sexual adventure . . . as long as that latex and rubber

GENETIC COPYRIGHT: THE DROIT MORAL OF THE DNA Another good reason to ‘roll one on’ is to maintain control over one’s genetic material. Guys, your precious DNA, ingeniously secreted within those squirming spermatozoa, is your unique and priceless blueprint: the essence of your identity. But once that enthusiastic tadpole wriggles across the vaginal threshold past the pink pearly gates of the cervix, you no longer have any rights in determining its destiny. When your female consort falls preggers, you can beg and wheedle all you like (I’m told items from Tiffany’s can hold some sway) but it’s always she who has the final word on whether to go ahead or abort. If the thought of termination kills you and the idea of paying paternity leaves you feeling drained, just remember that ‘Condoms are nice . . .’

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gear is black or fire-engine red, with a lot of zippers and matching thigh boots. The flesh-coloured, delicately unfurling piece of latex known as a ‘rubber’, ‘frenchie’ or euphemistically as ‘protection’, spells the opposite of fancy-freedom and wild risk-taking. It is a grounding reminder of the all-too-real potential consequences of intercourse: STDs and pregnancy. Some people are under the misapprehension that the only reason to use condoms is to avoid getting HIV/AIDS. Sure this disease can be prevented by condom use but there are lots of other important diseases (chlamydia, gonorrhoea and the still-not-extinct-syphilis to name a few) whose transmission can be halted by the condom too.

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‘IT BROKE!’

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In a world where ‘unsafe sex’ is almost as un-P.C. as wearing fur, a lot of folks feel too ashamed or guilty to admit to having thrown caution and latex to the wind in their last sexual foray. They probably feel they could do without the lecture and heaven forbid that Dr Pan might start warbling ‘Condoms are nice . . .’ in that kinky outfit she keeps in the secret wardrobe. Hence the apocryphal ‘broken condom’ saga gets trotted out again. I’m not saying condoms never break. Sharp nails (not the ‘hammer and . . .’ variety unless you’re really kinky) and vicious jewellery can wreak havoc. Failure to pinch out the air in the nipple-like tip of the condom can cause a ‘pop-goes-theweasel’ effect. But many’s the time when a ‘broken condommeur’, when gently pressed (in the vice I keep by the desk . . .), has admitted that their condom didn’t so much break as take leave of absence. Hehehehe. In rear-entry situations, condoms can be removed or slide off while one’s back is turned so to speak. Using condoms in a way that allows them to form an effective barrier requires trust and trustworthiness as much as dexterity and adeptness. ‘IF I USE A CONDOM, I LOSE MY ERECTION’ Relax, you’re not the only one. Heaps of guys tell me (after some time in that handy little vice, usually) that ‘Okay, the real reason I don’t/didn’t use one is ’cos if I do, I can’t maintain eye contact, I mean, my erection.’ Now is this a physical or a psychological effect? Well possibly a bit of both. I mean I have heard plenty of stories about guys who can’t find one that’ll fit (‘I mean even “Xtra

THE DOGGY BAG Now where is it that guys learn the delicate etiquette of condom disposal? The obsessive attention to detail some guys display when they remove used condoms, inspect for leaks, tie the tops with Gordian knots, diligently wrap in toilet paper and discard, is second only to the meticulous care with which some of them dab at themselves, gently roll back the foreskins, rinse and pat dry, all as if they were handling two-day-old puppies. To other guys however, the idea of washing under the foreskin remains undiscovered until the smegamacious-crud-build-up drives them to the doctor saying ‘My girlfriend won’t go down on me. She reckons me dick stinks.’

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Xtra Xtra Large” cramps my style, if you know what I mean’) and in those cases, rare as they probably are in the real world, perhaps there is a component of physical discomfort (for both partners potentially, I imagine). But largely this is a psychological effect. The foreignness of the condom (and I don’t mean just the ones made overseas) and the unsexy associations (disease, pregnancy and Siimon’s Grim Reaper to name a few) may cause some guys to lose their nerve. For those inclined to ‘premature take-off’, the degree of handling required to clothe the member may be enough to inspire lift-off. This is where practice can make perfect. Try putting a dab of lubricant (always water-based, remember) on the penis before rolling on the condom and practise masturbating to ejaculation with or without company. Pretty soon you’ll be able to handle yourself like a pro. (Pros these days always insist on rubbers.)

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ADVANTAGES TO THE FEMALE OTHER THAN CONTRACEPTION AND STD PROTECTION

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Okay, so you’re monogamous, on the pill and both immaculate on STD screening. Is there any point in continuing with condoms? Well possibly yes. For starters, some women get less thrush and gardnerella when their boyf’s use the ’doms. That’s thought to be because the semen itself is alkaline and by altering the pH of the vagina, its presence promotes the overgrowth of the fungi/bacteria that cause thrush and gardnerella (not STDs in themselves). Using condoms prevents the semen from disturbing the delicate balance within the vagina. The other thing is that some guys take longer to come with a condom on, which gives the ladies time to catch up, so to speak.

Top five things not to do with a condom: 1. Do not attempt to re-use condoms. Stingy types who try to turn them inside out or rinse and re-enter will suffer consequences Scrooge never dreamt of. 2. Don’t ‘short-sheet’ yourself. Make sure you roll the thing all the way up and hold on as you withdraw to avoid leaving the thing behind. One of my favourite pastimes at the surgery is retrieving them . . . usually several days later. Not. 3. Don’t use oil-based lotions or creams like

4. Don’t use out-of-date condoms. Okay, I know it’s been a long time between drinks but that’s all the more reason to lash out and buy something new. If you aren’t a high-volume user just don’t buy a whole crate at once ’cos they don’t last forever. Think like fruit and veg: ‘Fresh is best, naturally.’ 5. Don’t leave it to the last minute to put on the ’dom! It should go on as soon as the penis is erect. The pre-cum that leaks out right from the start of arousal may contain sperm (it only takes one to make a baby!) and possibly, infection.

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vaseline, olive oil or essential oils. They can break down the condom material and make it useless. Only use water-based gels. Ask the chemist for help if necessary. Saliva is okay but somewhat less fragrant and supplies are limited. (Besides, hawking and spitting is not considered sensual by all.)

Top ten non-sexual uses for the condom: 1. Pencil case (people will have new respect for your property). 2. Water bomb (you’ll be amazed at the strength and volume capacity of these babies!) 3. Swimming cap (perfect the bald look). 4. Washing-up glove (you’ll never get asked to do the dishes again!) 5. Paper weight (fill condom with water/rocks/attractive coloured marbles. Be creative!) 6. Keep your lunch/matches/watch/diary/ camera/anything precious, waterproofed. Especially handy if you are considering an intercontinental swim or boat trip in choppy waters. 7. Balloons for kids’ birthday parties (suggest draw faces on for maximal effect). 8. Hair elastic/novelty hair tie (fashion — who can understand it?) 9. Cover jars whose lids have gone missing. 10. Tie around finger as memory-jogger. When you see it, think: ‘Must remember to buy milk!’ or ‘Book appointment with psychotherapist’.

Cocaine, injected, snorted or smoked, has been described as inducing whole body orgasms and spontaneous ejaculation

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phrodisiacs, named after the Greek goddess of love, Aphrodite, are substances that enhance sexual desire and performance. It is accepted that testosterone is the main hormone responsible for libido and giving a testosterone-deficient person testosterone replacement will cause a marked increase in their sex drive and potency. But other than testosterone, nature’s aphrodisiac, there are probably no real aphrodisiacs. Sad ain’t it? Certainly over the ages, various substances, from oysters to ground rhinoceros horn to green M & Ms, have gained the reputation for enhancing sexual motivation. Fortunately the placebo effect is a powerful one and, while these substances may have no scientifically provable efficacy, the power of belief can move mountains, or at least the mons pubis. If the brain is convinced it is being turned-on sexually, the genitals will never be far behind. Both alcohol and pot can have variable effects on increasing sexual arousal. In the case of pot, this effect is thought to be dependent on expectation and belief (placebo) and in fact if anything, testosterone levels may be decreased by long-term marijuana use. Alcohol, by lowering inhibitions, can provoke sexual desire although with increasing intake, the ability to get an erection or vaginal and clitoral engorgement is impaired.

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Aphrodisiacs

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without genital stimulation. In the short term it is believed to enhance sexual enjoyment and potency, but in the long term, studies show it may lead to impotence and frigidity. Several species of beetles, known collectively as ‘Spanish fly’, have long held the reputation for increasing sexual pleasure. However Spanish fly irritates the urethra and causes bladder inflammation. In rare cases, severe bleeding has resulted in fatality. One possible true aphrodisiac has been used by West African witch-doctors for centuries: yohimbine. This substance comes from the bark of an African tree and is used, often successfully, to overcome impotence. The side effects, however, are not insignificant and include sweating, nausea, vomiting and an elevation in blood pressure that may be fatal, especially in those with a history of heart disease. So sadly it seems that there may be no useful true aphrodisiacs around at this stage. Fortunately, with the brain being such a powerful and suggestible sex organ, whether an aphrodisiac has ‘true’, scientifically verifiable effects on sexual chemistry is largely irrelevant. An aphrodisiac will have aphrodisiac properties as long as you (or your partner) believe it does! So go ahead and gorge yourself on oysters, deluxe chocolate truffles and all the powdered rhinoceros horns you can eat. I’m sure that as long as you lick them directly off your partner’s naked body they will have more than the desired effect.

2. Pheromones (each person’s natural odour — a sexual attractant). 3. Anything with smooth, runny, viscous, luscious texture (especially when spilled onto one another accidentally or intentionally). 4. Oxygen (helps keep brain working when all the blood is going elsewhere). 5. Sweat and other juices (preferably fresh and sucked direct from the source).

Anal sex: it ain’t dirty, it’s just another hole

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nal sex is called ‘buggery’ by some people. I think this is because buggery also refers to having sex with animals and mostly when people, say, men, have sex with animals, they are animals smaller than themselves and not necessarily females, so the kind of sex they have with these small animals is probably anal sex.

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1. Saliva (particularly someone else’s).

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Top five popular aphrodisiacs:

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That’s what I imagine anyway. I know some people have described women having sex with male animals too and again I think it is usually smallish animals. But strictly speaking I don’t think in such cases it is referred to as buggery. Because it’s not anal sex. Not that I’m an expert on these things. You’d have to talk to Dr Doolittle to get the facts on this stuff.* When humans have anal sex (with each other) one person is the receptive partner (supplying the anus) and the other is the insertive partner (supplying the penis, dildo or dildo-alternative). For gay men this is the main kind of penetrative sex. For straight couples, it is considered an alternative to vaginal sex. The advantages of anal sex for the heterosexual couple are that anal sex theoretically has a much lower risk (although not a zero risk) of pregnancy and can be practised during menstruation without having to take the tampon out. The anus provides a nice tight sensation for the male and can give the female orgasmic pleasure. The dangers include tearing or damaging the delicate anal tissues and sphincter. Also faecal infection may be introduced into the vagina or urethra (both his and her urethra) if hygiene measures are not carefully followed. Handling the anus and rectum, with the possibility of faeces or farting always on the cards, can cause embarrassment to one or both parties, spoiling the mood. Worse still is when only one party is actually keen on the idea of anal sex and the other one is getting pushed into it unwillingly. Many people presume that all gay men and gay couples have anal sex. This is untrue. Some gay men prefer to have fellatio or other forms of non-penetrative sex. But those

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who do enjoy anal sex say it can be delightful, intimate and orgasmic. Anal penetration requires a high degree of relaxation of the anal sphincter muscles. Some people (not just gay men) use amyl nitrate, sniffed, to enhance this muscular relaxation. Amyl nitrate is a potentially harmful drug that works largely by causing relaxation of involuntary muscles including the muscles around the blood vessels thereby dropping the blood pressure which gives it its psychological ‘spacing out’ effects. This can be very dangerous and even life-threatening especially when combined with other drugs or a heart condition. The combination of Viagra and amyl nitrate is known to be potentially fatal. Anal sex is the highest risk activity for transmission of sexually transmitted infections (STIs) because the anal tissues are not designed to take the trauma and stretching of penetration. The resultant tears and abrasions (not necessarily visible) are very vulnerable to infection. Using condoms is of course pretty much mandatory but even using condoms does not eliminate risk since condoms are designed for intravaginal use and breakage is much more likely under the increased pressure and friction of the anus. Examining and taking a swab from the anal canal is a very important part of STI testing if you practise anal sex. Not all doctors will automatically do this anal examination (though I think we should!) because we may not realise that anal sex is part of your sexual repertoire (we doctors are sometimes a bit weak on imagination!) Often patients will direct us to the area because they have noticed lumps or growths or soreness in the area. Having anal sex gives you increased

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risk of getting anal warts, haemorrhoids and anal fissures, which are all very common. Of course you can get fissures, haemorrhoids and anal warts even without actually having anal sex. (Just by thinking about it! Not really.) Haemorrhoids are kind of like varicose veins of the bum and anything that leads to a build up of pressure can cause them, especially any kind of straining, say when you have a hard poo that doesn’t want to leave the holding bay. If they are mild, they can be treated with suppositories (like solid bullets of cream — they don’t hurt, they help!) or ointments. Alleviating constipation is vital, through increasing fibre and fluid intake and stepping-up your exercise and physical activity. Giving anal sex a break is highly advisable. Sometimes really troublesome or recurrent haemorrhoids need treatment by a surgeon. Don’t worry: just because they are surgeons doesn’t mean they are keen to slice you up into pieces. Often surgeons treat haemorrhoids with a very simple but effective technique known as ‘rubber banding’. Patients of mine who have had this simple procedure rave about it and call their surgeon a genius. Which makes me feel very inadequate. Fissures are painful splits in the skin. They are common in the context of constipation and can occur with anal sex especially if it is forced and vigorous. They need to be allowed to heal without too much trauma from hard poos or penises. Attention to relieving constipation is again vital. Anal warts can be a cause of great embarrassment and shame. For some people, it is fine to have warts on their fingers and toes and even their nose, but anything that mars the pristine condition of their bum has them all teary and a-twitter. Funny, ain’t it?

Anal sex does have undeniable hazards but for many people, it also has its rewards. Through a safe and thoughtful approach, anal sex can work for you, but only if

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Anal warts are really much the same as warts anywhere else although they are likely to be caused by different virus strains. They are treated by destruction, but instead of ‘Crush, kill, destroy!’ we live (and they die) by the mantra: ‘Paint, freeze, cauterise!’ The doctor can give you paint (e.g., Condyline paint) or cream (Aldara) to apply yourself at home if the warts are not too big or inaccessible. You have to be really careful not to get the active substance on the good skin or it may get destroyed along with the warts. You can mask the good skin with petroleum jelly or even tape. Alternatively the warts can be treated with freezing (liquid nitrogen) or burning (cautery), depending on what your doc has at her/his disposal. Occasionally really large, recurrent, troublesome warts need surgical removal. Anal warts are sexually transmitted but even if you have never had anal sex you can still get them. That is thought to be because the vaginal fluids can run back into the anal region and infect that area even though there was not necessarily any direct contact. Even though lots of people practise and enjoy anal sex, there remains a hefty degree of taboo around it. Anuses and poo trigger the ‘Not nice’ antennae in-built since childhood and are championed only by ‘South Park’ enthusiasts. But even most ‘South Park’ fans are probably squeamish about having or admitting to anal sex themselves. Maybe that’s why they love the show: vicarious poo pleasure.

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both you and your partner are keen on the idea. Don’t hassle your partner into doing stuff they don’t want. Otherwise you deserve to be shat on.

*Bestiality of all forms, whether involving anal penetration or not, is illegal and absolutely ill-advised.

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Sex’n’TV ‘Masturbation is the thinking man’s television.’ Christopher Hampton 1946– : The Philanthropist (1970).

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aced with the question ‘Would you rather have sex or watch TV?’, I would have some difficulty. Of course it depends what’s on. And who’s offering the sex. But if I have to answer quickly and honestly and follow through immediately, I’ll take TV, thanks. I find this troubling. What does that say about me? It’s one thing being frank with yourself. It’s another thing accepting your own conclusions. Is TV really that good? Is sex really that bad? Funny thing is if you ask me if I’d rather go to the movies or have sex, I’d choose sex. That’s despite the fact that if you asked me if I’d rather see a movie or watch TV I’d say movie.

TV is undemanding. There’s no judgement involved in how you watch it. No pressure to be a ‘good viewer’ as opposed to ‘good lover’. You don’t have to be considerate.

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Confused? Well, see I think the quality of entertainment and the richness of the experience is usually greater at the movies. So movies beat TV. But sex is better than movies ’cos it’s a fuller experience again and if you’ve already committed to a three-hour engagement (that’s the movie itself, the queuing up in the loos . . . the whole package) you might as well be the star of the show. So then how do I figure that TV is even better than sex? Well hang on, I’m just figuring that out myself. See if I am in the mood to see a film, I’m all ready to sit in a dark room and immerse myself in a sensual experience. If I’m going to do that I might as well have sex. Depends who with of course. But if I’m tossing up between watching TV and having sex, I kind of picture myself in the lounge room holding the remote and that feels kind of comfy and easy and a lot less trouble than trying to transform into something alluring and rustle up a date. So I suppose it’s situational but there’s no question that TV has a lot of advantages. For one thing there’s the surprise element. Unless you study the program like a form guide, you never know when you hit ‘ON’ what’s going to appear on the screen. You don’t even know what channel it’s going to come on with. It’s exciting. With sex, unless you’re hanging out at the Wall or in a booth at the sauna, there’s none of that mystery. Your sex partner today is likely to be the same one as yesterday, if you’re lucky. And you always know who it is before you turn him or her on.

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You can talk over the TV, take calls during ad breaks or even in the middle of a show. No-one cares. I like the passivity of TV viewing. There is also the option to take part, say in ‘Aerobics Oz style’. Before the bad knee hobbled her, my mother used to faithfully record that show and do it along with them in the kitchen, or so she told me. I was very impressed until I saw her in action. No resemblance whatsoever between what they were doing and the gyrations my mum was making in her flip-flop slippers and Stubbies shorts. Let’s just say there was movement taking place in my mother’s body but there wasn’t a lot of it. Her heels occasionally left the ground but her slippers — never. But it’s TV so the instructor never once chastised her. In addition she didn’t have to wear a leotard and could fast forward or eject at a whim if she didn’t like the music. ‘I mainly like it ’cos they play nice music’, she tells me. Well I gathered it wasn’t for the work-out. What I love about TV is that there is NO commitment required. I don’t have to concentrate. I don’t even have to watch. I can be in the other room or be chopping vegies. And occasionally there’s something really good on. That’s the best because it usually takes you by surprise. You flick around and say, something on SBS catches your eye. For me it’s usually those moist-lipped Spaniards lisping and looking gorgeous while they do it. Who cares what they’re saying or why they’re acting so uptight? You know you won’t have long to wait before they’re ripping their clothes off and . . . well it’s the thrill of suspense: you know there’s gonna be sex but you don’t know exactly when. There’s no preparation required

a. having read the VCR manual; b. having blank tapes, rewinding them and knowing which ones you can record over; and c. the hardest part: making a mental commitment to go back and watch the stuff one day. It’s a big ask. If you couldn’t be bothered staying home or sitting down to watch it when it’s on, how badly do you really want to watch it? Besides how do you know that when you’re watching it there won’t be something else even better on at the same time. That you’re missing. Should you record that too? Then you need two videos. And you’ve only just worked out how to use the first one. TV’s useful. Say you’re watching TV and your partner starts nuzzling you or just squirming around generally. If you feel like having sex you can. The TV won’t mind. But if you don’t feel like it you’ve got the excuse that you’re watching TV. And it’s really good. If your partner is at all suggestible, he or she will start watching too and hey presto: it’s a shared moment. You’re both there

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and participation is strictly optional. You get a fix of sensual sustenance, then can just switch off and get on with doing your tax. It’s great. You don’t even have to commit to a whole movie. Even watching a half-hour episode of say, ‘Friends’, can sometimes be just too much commitment. Unless you record it, you still have to sit through the ads. Admittedly, sometimes the ads are the best part. Recording stuff really takes commitment ’cos recording stuff means:

doing something you enjoy. (Now how often does that happen?) If you’re having sex, how comfortable do you feel about interrupting proceedings to say ‘Hey I just wanna see if there’s anything on TV?’ That’s right. Even the most suggestible partner is going to feel unenthusiastic and affronted. That’s ’cos sex has a preciousness about it. It’s like ‘What could possibly be more important than me? I’m sex!’ It’s like you have to feel guilty if you stand ‘Sex’ up for a night with anything of lesser status than ‘Near-deathexperience’. Forget that. If you reject sex, it’s like you’re rejecting the person and they get offended. The TV never gets offended. Am I expressing a preference for inanimate objects that give a semblance of human feeling without any requirement to get involved, make commitments or live up to expectation? No, it’s more like an expression of laziness. Besides I’m never going to choose between sex and TV. I’d like to keep the option of both, thanks. Sex is wonderful, in the right place at the right time with the right person. But watching TV is a hell of a lot easier.

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henever I’m in a quandary about something, I do what every sensible girl does. I call my Mum. Musing on this bisexuality thing, I say to my Mum,‘Hey, what do you think about bisexuals?’ ‘Oooh, they’re all scumbags!’ she spouts without delay. None of that political correctness for her. If my Mum is going to have a bigoted, narrow or unenlightened view, at least you can count on her to be unabashed about it. ‘So refreshingly honest, however uninformed,’ I concede mentally, giggling. ‘Ow Mum, that’s stupid! Why? Why do you think that?’ ‘I just don’t like them. They’re just out for all they can get!’ ‘But what’s the difference? Straight or gay people can be out for all they can get too. Being bi doesn’t mean you’re promiscuous. You could be mentally bi but be practically celibate!’ ‘I suppose so . . . but still it’s weird. It’s kinky. You should just be one or the other. You can’t be both. I don’t think it’s normal.’ OK, so I didn’t say calling your Mum was helpful, I just said I do it. The fact is, there are lots of misconceptions and prejudices against bisexuals. As a result, hardly anyone wants to admit to being one. Plenty of gay guys and girls may have had ‘opposite

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Bisexuality: it’s not kinky, really

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sex’ attractions or experiences but few readily adopt the label ‘bisexual’. The predominantly straight who have had ‘same sex’ leanings, actual or imagined, may consider themselves adventurous trisexuals (who’ll ‘try’ anything, at least thrice), but bisexual? No way. Bisexuals are shunned by gays and straights alike. Gays think they’ve chickened out of being gay and straights think they’re just kinky. The exception here is the straight guy who thinks bisexual chicks are cool. What we’re talking about here is usually not so much an issue of tolerance and sensitivity to the bi-girl’s needs. It’s more like ‘Phwoar, I’d love to have two, three, hey maybe more girls at once. I wonder if she could bring all her lezzo friends round for a party!’ Unfortunately, dude, if you do happen to link up with a girl who also fancies girls, chances are that when she’s having intimate times with her lesbian partner (note the singular) you’re going to be about as welcome as a starving cannibal at a nudist colony. Being lesbian does not automatically mean you are into threesomes (particularly if that third person is a guy). Bisexual means attraction to both sexes but not necessarily simultaneously. Being bisexual ought not to imply a predilection for orgiastic group sex, although, hey guys/gals, you never know your luck. Intuitively one would think that there would be a lot more people who would be attracted to both sexes than who actually have experiences with both sexes. The actual studies show that while more people admit to feeling attracted to both sexes (only about 5–10 per cent, depending on the study) than admit to experiences with both sexes (only about 4–9 per cent, again depending on the study), the difference is

‘Oh, I suppose you’re right darling. Oh Liang-Liang, why do you ask me, I’m just a silly old woman!’ ‘No you’re not, Mum. I like to know what you think.’ ‘So you can change my mind?’ ‘Yeah, maybe.’

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actually not that great. Again the issue here is what is admitted to. Despite our so-called enlightened times, according to the surveys anyway, people don’t admit to much. This is understandable; after all no-one wants to be labelled something that sounds pathological. We all want to be considered ‘normal’. So what is normal? I think the most realistic picture is that sexuality is not something that can be polarised, pigeon-holed and categorised. It is more likely a spectrum that extends from very or exclusively gay through various degrees of bisexuality to exclusively straight. Just as we all have both typically male and typically female characteristics, physical and behavioural, we all potentially have both straight and gay tendencies. Of course not everyone is happy to embrace all components of their sexuality and many a ‘closet gay’ (or conceivably,‘closet straight’!) will prefer to express instead, a vehement dislike for those who do. Discovering who we are is really a matter of discovering who we can be, whether or not we choose to act on those possibilities. Discovering someone else, is also about helping them discover themselves and letting them be all they want to be. Let’s do that. By the way, Mum finally conceded that she probably would like bisexuals if she knew any, but she was sure she didn’t know any. ‘But Mum, how do you know you don’t know any? Just ’cos the word “bisexual” isn’t tattooed on their foreheads doesn’t mean . . .’

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Bisexuality — some popular but poor definitions:

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1. The straight male’s enduring fantasy version: himself and several Bond-type ‘bisexual’ girls playing Muses to his Apollo. Idea fostered by those late night ‘Call me. Call me now!’ ads featuring busty wenches in and out of hot tubs, caressing themselves. See also ‘polygamy’ and ‘harem’. 2. ‘Scumbags who are out for all they can get!’ — the non-progressive definition that bisexual means desperate and promiscuous. 3. The married man from the North Shore who rarely has sex with the wife since the last of the kids was delivered but now visits ‘The Wall’ in happening Darlinghurst on a regular basis because, as Kate Ceberano used to warble, ‘Young boys, are my weakness’. Strenuously denies being gay. These furtive forays are fortunately under cover of darkness. No names are exchanged but cash, maybe. 4. The married female whose husband no longer or perhaps never satisfied her. He may be happy for her, turn a blind eye or perhaps feel relieved that the pressure is

be cuckolded by another woman? 5. Total nightmare — if your partner is one, you constantly feel your relationship is

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off him. Is it somehow less threatening to

threatened by all members of not just one ‘pathologically jealous’. 6. Total dream — you instantly double your chances. Everyone becomes fair game. You are attracted to all therefore all are attracted to you. See also ‘eternal optimist’ and ‘naïve’. 7. You find both males and females sexually attractive but have not had actual experiences with either sex. In real estate terms, ‘heaps of potential’. See also ‘neophyte’ and ‘eternal window-shopper’. 8. You are female and have only had sexual experiences with males. You are addicted to looking at pictures of fashion models and beautiful actresses, be they lavishly or scantily dressed. See also ‘narcissist’, ‘perplexed window-shopper’ and ‘fashion junkie’. 9. You are male and are constantly surrounded by gay males but only feel sexually attracted to females. Unlikely to be true bisexual but let me guess . . . your

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but both sexes. See also ‘paranoid’ and

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postcode is 2010 and/or you work in theatre or the fashion industry?

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10. You are female/male and all your ex-boy/ girlfriends seem to have turned gay. You wonder if this is your doing and if this means you should turn gay too. Again not so much bisexual as ‘sexually confused’ or possibly ‘sexually repellent’.

How do I know if I’m a bisexual? A misguided guide: 1. Gays shun you. Yellow, lily-livered bastard — you’re obviously just trying to weasel out of being gay. 2. Straights shun you. You’re bound to cheat on your hetero’ partner not only with other women (men) but other men (women) too! 3. Your doctor keeps offering to test you and your partner for HIV and the blood bank won’t accept your offerings despite the negative test results. 4. You have come to accept the fact that people categorise you amongst intravenous drug users, transvestites and transsexuals even though you never do drugs, never cross-dress and don’t have

any gender issues. 5. Guys, when you tell your female partner you’re going out to play ‘touch footy’, she gets nervous and mumbles about never having liked you playing contact sports. 6. Girls, your boyfriend has taken to spying on your Tupperware parties. Even when you produce the neat, colourful plastic ware he snorts sceptically. 7. Everyone presumes you are hot for them, even the most dried-up, wizened old biddies and buddies. 8. When shopping for a new bed, people keep saying ‘Well of course you’ll need King-size, at the very least!’ 9. There is inordinate interest not just in who but what you’ll be taking to the Annual Ball. 10. Over dinner, people keep asking you with repeated upward jerks of the eyebrows, ‘So . . . what’s it like?’. When you smack your lips and say ‘The Puttanesca? It’s delish! How’s your Boscaiola?’ they look pissed-off as if you are somehow holding out on them.

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Lesbian delight

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First kiss at night, Lesbian delight, Caresses at dawning, Fondling and fawning, Last kiss at morning, Lesbian in mourning.

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he love lives of lesbians are a constant source of wonder and fantasy to the majority of straight men. ‘What do they do?’ they ask themselves, bewildered and inquisitive. ‘How do they survive without a penis in tow?’ is a baffling mystery to the male. Well it would seem that lesbian delights exist quite independently of the penis and that’s the way they like it. If someone asked you to sign your name or wrap a present, would you use your fingers or your penis? Well for the same reasons, lesbians prefer the prestidigitators over the penis-pokers. More dexterity, accuracy, nimbleness, sensitivity and less susceptibility to stage fright, first-night jitters and late-night droop. So what do lesbians do? Well, same as everyone else: they go to work, they chat to their friends, go shopping, see movies . . . Oh! You mean in bed? Well, sleep, rest their eyes, read, sometimes have a bit of rough and tumble, sometimes share a little tenderness. Same as everyone else.

In fact, whereas few women would actively push their boyfriends to experiment with gay sex, it is not that rare for

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The tongue and the hands are the most sensitive of all nongenital sites and can be used with great skill and finesse to maximise sensual and sexual pleasure for all concerned. Being a female herself, the lesbian lover may be more finely attuned to the contours of her partner’s sexual desires and responses. Lesbians are not reliant on the latency periods and sensitive egos associated with sagging penises. Fingers do not tire easily and if they do, the tongue can take over. Failing that, vibrators, dildos and all manner of sex toys are just an arm’s length away, if they take your fancy. No egos involved. Lesbians can take full advantage of the female propensity to be multi-orgasmic. For most women, the most volcanic and earth-shatteringly intense orgasms are created by masturbation . . . do-it-yourself style, or made to measure by a lover who knows. So if lesbian sex is so potentially fabbo, then why aren’t all women into it? Well, for one thing, not all women are sexually turned on by other women. A gal may enjoy looking at Christy Turlington in her Calvin Klein’s in Vogue or whatever, but the joy is often chiefly aspirational. She doesn’t want to sleep with Christy, she wants to be Christy. Why? ’Cos Christy can possibly pull some great looking guys. The other reason why women may decide the lesbian arena is a no-go zone may be to do with taboos, negative stereotypes, lack of imagination, fears, or simply, overwhelming desire for marriage and children, the traditional way. Maybe her boyfriend is not keen on the idea of sharing her.

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a guy to condone, suggest or even encourage his gal into giving lesbian sex a go. I suspect the motivation here is that this is his best bet for getting two girls in his bed at the one time. Call me cynical. Maybe he really does simply want for her to expand her horizons . . . and his. Some women may decide after multiple satisfying male experiences, that it is time to redress the balance and give the girls a whirl. They may never turn back, or, after a few flirts with the skirts, they may decide that they prefer the ‘stubble and Stubbies’ over the ‘lipstick, lace and labia’. Some women never bother studying the studs at all. They move straight into an in-depth examination of the female anatomy and once on a good thing, they stick to it. Women who are predominantly attracted to women, are commonly called lesbians, or ‘women who have sex with women’. They prefer to form deep emotional attachments with women, prefer to interact sexually with women, prefer to marry and live with women. Sometimes they have children together: sharing the kids they already have or organising to have some new ones of their own. Obviously they may have multitudes of male friends and buddies, but their tender, mushy feelings are reserved for the femmes. Are women who fall into this category all ball-biting, foul-mouthed, swaggering, shaven-headed butches? No! Stereotypes of overall wearing, make-up abstaining, bulgingbicepped, grease monkeys who are ‘too ugly to get a real date’ are absolutely false. Certainly some lesbians reject the ‘sugar and spice and all things nice, that’s what little girls are made of’ concept of femininity, but then so do many straight women. Lesbians come in all kinds of packages,

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from all walks of life. Some are rough, tough, butch bitches; others are fairy floss fluffy femmes fatales. Not everyone thinks lesbians are cool. Some people think it is unnatural, kinky and molto sicko. Parents hope their daughters will grow out of it. Children wish their Mums would knock it off and act their age. Some lesbians feel the need to hide their sexuality for fear of discrimination in the workplace. They may worry about their children being teased in the schoolyard about their dyke Mum. Lesbian relationships are not recognised legally and commitment ceremonies are not blessed by the church. Lesbians who try to have babies via artificial insemination or assisted reproductive technology (IVF and the like) are targeted by the self-appointed ethics police: ‘How can a woman like that be a fit mother?’‘The child needs a father! Not a couple of butch dykes!’ Comments like these need to be deflected as if they don’t hurt. But of course they do. Especially when attempts are made to enforce such prejudices by law. Deciding who is and isn’t a fit parent has nothing to do with the person’s sexuality and more to do with maturity, personality, motivation, intention and commitment. Some straight people are unfit parents too but there’s no law against procreation for the most abusive, alcoholic, addict, almost-adolescent with no desire or aptitude for parenthood, who accidentally begets a child. Interestingly, some lesbian women may have sexual fantasies involving men. This doesn’t mean they are not real lesbians. Some straight women have sexual fantasies involving women too. Fantasies frequently involve forbidden behaviours and for lesbians, being overpowered

or ravished by a male may hold a certain je ne sais quoi. It doesn’t mean she wishes for it to happen in real life and her lesbian lover, if she learns of this fantasy, need not feel threatened. Fantasies could involve a whole farmyard of animals or a bar full of the aliens from Star Wars. They’re just fantasies and should be enjoyed, not analysed and dredged for sources of guilt, shame or insecurity. We’ve generally got enough of that stuff in stock already. From massage to kissing, licking, sucking and fingering; from the breasts to the clitoris, vagina to anus; from the ‘upper lips’ to the ‘lower lips’; and from tribadism (rubbing genitals) to total body frottage, the spectrum of lesbian delights can be vastly exciting and rewarding. Just because you are lesbian doesn’t automatically make you an expert on orgasms or sensual pleasure, nor does it make you a dab hand at forming or maintaining rock-solid relationships. All being lesbian means is that you know which side you’re batting for. Being lesbian can also mean surviving considerable prejudice and discrimination and possible rejection from family, friends or work mates. For as long as homophobia continues to thrive, and it does, following the yellow-brick road of ‘Lesbian Pride’ will be fraught with wicked witches, warlocks and flying monkeys. There may be no land where troubles melt like lemon drops, but if you wish to, you are sure to find many like-minded lesbians living somewhere over the rainbow near you.

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re you ever too old for sex? Well this question is as searching as the question ‘Are you ever too old?’ My answer is:‘Well . . . it depends.’ One of my dearest friends is 90 years old and sharp as a knife. Sure she’s old and has more wrinkles than Luke Perry’s forehead and I grant you she’s not too quick on the old sticks, but she is vital, vibrant, warm, glowing and a real pleasure and treasure to know. Without being too presumptuous, I would hazard a guess that she is not sexually active currently but it’s not because she is too old. If she wanted to have sex, she could. She is socially very active and is an extremely attractive person. While I admit she is not currently swinging in the singles scene, as her doctor and friend I would firmly attest without hesitation that despite bilateral hip replacements and several brushes with Old Man Time, that grim harvester, she is not too old for sex. Being able to have sex requires a certain degree of flexibility and movement, reasonable blood supply and sensation. Unfortunately many health conditions and tragic consequences of accident or disease may render an individual unable to enjoy sex in the usual way. From quadriplegia to neuromuscular disease, advanced multiple sclerosis to severe stroke, there are myriad sad but fortunately relatively uncommon blows which can knock us out of the saddle. But these conditions may strike both young and old. The issue then is not one of age but simply of disability.

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‘2 old 4 sex’

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Needless to say, an older person is likely to have more serious health problems and therefore risk of disability than a young dude or dudette but that doesn’t mean elderly people in general are too decrepit to cut it in the sack. Perhaps it is unfair too, to focus purely on the physical requirements for sexual activity. Surely a capacity for compassion, understanding, caring and relating is also essential. Well the elderly are definitely in the running there. After a lifetime of experiences and lessons learned, they are perhaps in the best position to relate sympathetically to their fellow man and woman. Friendships, social circles and relationships would have had time to grow and mature. Career, family and financial worries would have perhaps diminished to allow a greater priority to be placed on matters sexy. So then why aren’t our elderly out there playing the field like Barbara Cartland on acid? Well some of them are, believe it or not. Especially with the arrival of Viagra and other erection aids, many older males are getting a new lease on their sex lives. Women too, able to cast off worries of pregnancy and with the springy new, plush and elastic vaginal mucosa courtesy of hormone replacement therapy, are now more than ever physically equipped to carry on their sexual careers. But it is true, that many do not. The reasons for this are manifold. Some are no longer interested and have different priorities. It is not so much that they are too old for it as they have just outgrown it. They’ve moved on to greener pastures . . . like bowling and golfing greens perhaps. Others avoid it because of past traumatic or adverse experiences. This is not an age-dependent thing.

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Others still would like to be having sex but have difficulty finding appropriate or sympathetic partners. The opportunity to have sex may be lacking, especially for a person confined to a hospital, hostel or nursing home. This presents a social problem which is rarely considered let alone prioritised. But physical boundaries aside, society today also creates other far more subtle barriers for the would-be sexually active elderly person. Elderly people are repeatedly stereotypically represented in our youth-worshipping media as asexual beings obsessed with bran, bowels and bowls. Sure such oldies exist but ‘the elderly’ are no more a homogeneous, boring bunch of identikits than are ‘our youth’. Such desexualising images of our elderly are disempowering and do our vibrant, sexy and still swinging grans and gramps a gross disservice. Let’s not make presumptions about elderly people. Let’s give them some respect so that they can have the confidence in their own sex appeal to stand up and be counted without the pimply teenagers snickering and rolling their eyes. Sure some elderly people may have to manage with physical limitations as a result of disease and age. Sure elderly people who are single or who have ailing partners may encounter difficulties getting in touch with themselves sexually. Doubtless those confined to institutions will have enormous hurdles to overcome in order to fully express themselves sexually. But let’s never forget that while being elderly may bring various problems that may make getting sex harder, old age does

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not automatically spell ‘stone cold age’ as far as feeling and being sexual are concerned. The brain is the most responsive and insatiable sexual organ we possess. As long as we still live, it can remain sexually active and continue to evolve and grow. We can be sexual for the whole of our lives, right up to our first centenary, as long as we allow ourselves to be and for as long as we want to be. Let’s respect our elders for their sexual potential and sexual needs just as we respect their requirements for dentures, joint replacements and talkback radio! After all, if good luck and good health smile upon us, one day we’ll be joining the ranks of the elderly ourselves, eh? Oh God!

Top ten potential pick-up spots and pick-up lines for oldies: 1. McDonald’s. I know because I’ve seen the ad. Try: ‘The ice-cream here is fingerlickin’ fabulous!’ 2. At the pharmacy, browsing in the laxatives section. Try: ‘Are you a Coloxyl-girl too?’ 3. In the doctor’s waiting room, at the magazine rack. Try: ‘No you take the February 2001 New Idea. The May ’98 issue’s good enough for me.’ Chivalry — it’ll get ’em every time.

4. At the Chippendales’ stage door. Try: ‘Wanna see me shake a tail feather? My doona or yours?’ 5. Skydiving. Try: ‘Wanna watch me go down?’ 6. Observing parliament. Try: ‘The “Ayes” have it, but your eyes have got me, sweetpea.’ 7. At bridge. Try: ‘I know a thing or two about rubbers . . .’ or ‘I’d like to play bridge-thegap-between-you-and-me.’ 8. At the shopping centre. Try: ‘You’ve got a cane? Well, I’ve got a whip!’ 9. At the movies. Try: ‘You’re prettier than any picture I’ve ever seen!’ 10. In a bar, restaurant, park, petrol station; at a party, club, meeting or dinner party. Try: ‘Hi! My name’s . . . What’s yours?’

Pandora’s BOX

‘Virgin’ — it’s not a dirty word

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n my very early days as a GP, I used to routinely ask my female patients about their most recent Pap smear and if they had never had one, I would enquire ‘Well, are you a virgin?’ On one such occasion, a lady in her late thirties — who I remember well as being a jigsaw-puzzle enthusiast, a fact which stuck in my mind — replied disdainfully ‘No! Certainly not!’ I explained the importance of the Pap smear and how, if she hadn’t had one, she really ought to. She had never heard of a Pap smear but once I mentioned the word ‘cancer’, she was keen to get the procedure underway ASAP. She lay on the bed and as I approached tentatively with the speculum, she leapt up and looked a little aghast. I explained again the procedure and exhorted her to ‘Relax! It won’t hurt a bit.’

She smiled sheepishly and settled back. As soon as plastic met mons pubis she leapt again. ‘You did say you weren’t a virgin, didn’t you?’ ‘Oh yes, absolutely!’ One more try. ‘Are you sure you’re not a virgin?’ ‘Certainly not!’ ‘But have you ever had sex?’ ‘Certainly not!’

Now why is that? Well, hymens aside, ‘virgin’ somehow suggests a character that is puritanical, straitlaced, priggish, prudish, unimaginative and uptight. Anyone who remains a

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It’s not logical, but somehow the jigsaw-puzzle thing suddenly made sense to me. You could say ‘all the pieces came together’. (Since then I always feel a tad concerned if I see my mother doing a jigsaw. I think: ‘Is this just the beginning of a slippery slide into being completely out of touch with the modern world?’) I had to do a lot of pretend coughing and spluttering to hide my chortles. Subsequently I asked her ‘When I kept asking you about being a virgin, what did you think I meant?’ to which she responded ‘Well I didn’t know what a virgin was, but it sounded so dreadful, I was sure I would never be one!’ More coughing. So how many people these days wear the label ‘VIRGIN’ with pride (Richard Branson employees aside)? Is it now way too uncool to be called ‘frigid’ à la Grace Kelly’s ‘fair Miss Frigidaire’? Now that the allure of the Ice Queen has finally defrosted, has the virgin backlash reached full swing? When Fernanda Montenegro of Central Station was pipped at the Oscars post by fair Gwyneth, she growled ‘She only won because she looks pale and thin and virginal’. There was no questioning the pejorative tone in Montenegro’s Paltrow-payout. Describing someone as ‘virginal’ these days is far more likely to be construed as disparagement than compliment. ‘Virgin’ has become a dirty word.

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virgin past a certain age ‘hasn’t lived’ or must have failed at being sexually attractive. ‘It’s unnatural not to be at least curious!’ is an argument I’ve heard frequently espoused. In the past half-century, there has been a striking decrease in the age at which men and women first have intercourse. A recent study by Johnson et al showed that amongst women now aged 55–59, the median age at first intercourse was 21 years. By contrast, amongst women now aged 16–24, the median age at first intercourse is 17 years. The same trend is seen amongst men: the median age at first intercourse for men aged 16–19 is 17, three years earlier than for those aged 55–59. While the age of consent remains 16 (but 18 if you’re gay . . . go figure), the same study shows that of women aged 16–19, 18.7 per cent had experienced intercourse before the age of 16 compared with less than 1 per cent of 55–59 year olds. For men, 27.6 per cent of 16–19 year olds had had sex compared with 5.8 per cent of 55–59 year olds. Progressive relaxation in social mores governing sex as well as a trend towards earlier physical maturation, (for example, the average age at which women get their first period has declined in most developed countries over the last century), possibly account for these figures. But figuresschmiggers! Ballistic statistics! How do we determine an individual’s ripeness to be plucked? When should the pretty petal be deflowered? Just as there must be an age below which the bud is unready, is there an age after which the bloom is spent? In short — does virginity have a use-by date? Well of course not! The age at which a person should

On the other hand there is no upper age limit! It’s never too late to lose one’s virginity, or conversely, you’re

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become sexually active is undefined. It depends on individual readiness, which incorporates emotional and physical maturity, but also personal desire and inclination. While those who stick to the ‘not before marriage’ mantra are becoming more and more outnumbered, not to mention unfashionable, they still exist. Gradually taking their place perhaps is the chorus singing ‘only after establishing a serious (usually monogamous) relationship’. But let us not forget the ‘relatively sexually developmentally delayed’ who choose not to lose their virginity until long after their peers have given up on them. Statistics show that virgins over the age of 30, either sex, are indeed a rare breed (perhaps at risk of being ‘bred out’!) and current trends and attitudes are such that this breed may be inclined to feel like freaks, rejects or at best, second-class citizens. While there’s certainly nothing wrong with expressing and relishing one’s sexual liberty with frequent, adventurous, unashamed, (dare I say) gay abandon, the decision to remain a virgin even into one’s third, fifth or seventh decade is just as valid an expression of sexual autonomy and freedom. There is undoubtedly an age below which one is too young to lose one’s virginity. Just what that age is does depend on the individual but there is still a bottom line below which it is truly hazardous to stray, no matter how seemingly mature, experienced or precocious the sprite. The spectre of abused and thoroughly mixed-up kids, not to mention multiple teenage abortions should be convincing enough.

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never too old to stay a virgin. In fact, at the risk of seeming conservative and even anachronistic, I would thoroughly encourage men and women, hetero, homo and bi alike, to err on the side of reflective deferment when the question of shall I or shan’t I arises. Why not wait until you’re sure? What’s to be lost? Wait until the meaning and consequences of sexual activity reach such clarity in your mind that you are no longer asking, you know. Ability to reflect, consider and defer one’s gratification is a sign of maturity, healthy self-control and an admirable capacity to appreciate long- and short-term outcomes. The rewards of these attributes are manifold and far reaching in all spheres of life, not the least of which is the sexual. Now for goodness sake, let me get back to my jigsaw-puzzle!

Least recommended circumstances in which to lose your virginity: 1. In a tandem hang-glider . . . with a partner who is acrophobic. 2. In a public toilet . . . next to an undercover policeman. 3. Under the jacaranda tree in Sydney Uni’s main quad . . . with O-week (Orientation Week) in full swing. 4. On the Net . . . as part of a live, worldwide, Valentine’s Day telecast.

5. In the back of a limo . . . on the way to a wedding where you are head bridesmaid. 6. Straight after your own wedding . . . with the rello’s and wedding party cheering you on. 7. On white silk sheets . . . on the heaviest day of your period. 8. In a hospital bed . . . after your hernia repair . . . during the doctors’ ward rounds. 9. After taking your final vows . . . of chastity. 10. In high security prison . . . courtesy of Big Jim. 11. As a result of losing a bet. 12. In order to win a bet. 13. In order to maintain a relationship. 14. In order to start a relationship. 15. Out of curiosity. 16. To get it over with. 17. By accident. 18. Drugged, drunk or too depressed to care. 19. Under age. 20. Under duress.

Pandora’s BOX

Twenty-first Century Concubine

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oncubines were part of the establishment in oldenday China. Their status was less than that of a wife but far higher than that of a sing-song girl or sex worker. A gentleman’s first wife usually belonged to the same class as he and so did the secondary wives (usually sisters and companions) that came with her. If a man was rich and powerful enough to take on yet more female consorts, he was no longer restricted by pedigree and could choose on the basis of sexual attraction. In the lower classes, the most alluring females were taken up by brothels or ‘sing-song houses’ at an early age and from this pool of ladies of superior charms, the most delectable would be chosen to rise to the ranks of middle- or upper-class concubinage.

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So if you made it as a concubine, you should probably have counted yourself lucky. The equivalent today might be the Coles check-out chick getting spotted in Penrith Plaza by a talent scout to be the latest model fodder. But what would you be getting yourself into? Pragmatic to the last, Chinese men were careful to avoid inciting jealousy in the ranks when introducing new talent. A prosperous gent in the 1550s instructed his sons that the best way was for a man ‘to control his desire, and for the time being not to approach the newcomer, but to

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concentrate his attention on the others. Every time he has sexual intercourse with his other women, he should make the newcomer stand at attention by the side of the ivory couch. Then after four or five nights of this, he may have intercourse with the newcomer, but only with his principal wife and the other concubines present.’ Kinky. As a concubine you had rights. The master was honour bound to provide not only financially but also emotionally and sexually. Each woman had to be serviced regularly for as long as the master wished to have serenity in the household. Inability to maintain domestic harmony reflected ruinously on a man’s character, which could have serious consequences for his career and business. ‘Sex secretaries’ were sometimes employed by really grand households to ensure that the master had intercourse with the correct consort on the correct day. Red writing brushes were used to keep the special ‘diary of the bedchamber’ and girls were given a silver ring to wear on the right hand before having sex which was transferred to the other hand immediately afterwards. Men in high office were expected to display control and mastery in their private lives. Maintaining a seraglio of enchanting women was a source of pride and status, similar to the modern man with his garage full of Mercs and Beemers. There was certainly no attempt to hide. While doubtless rivalry and competition between the various wives and concubines seethed behind silken screens, a façade of contentment and camaraderie was expected, and loyalty to the master was unquestioning. Aaah. Those were the days!

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So what’s the score now as we enter the twenty-first century? Are there still concubines and what are the rules of conduct today? These days men still have concubines but they call them ‘mistresses’. (Now why is it that ‘mistress’ implies ‘kept woman’ whereas ‘master’ implies ‘he who is served’?) If the man can help it, the wife and mistress never even know of each other, much less meet or cooperate on a rota. The mistress still has some rights, but has a hard time enforcing them. She doesn’t get to share the principal household. If he puts her up at all it’s in a clandestine bower and she is sworn to secrecy. The agreement is usually pretty one-sided. She must not encroach on his wife and family and while she can hope and angle for him to divorce and let her take the top spot, she rarely gets such a guarantee and pillow-side promises are frequently broken. This scenario often drags on for over a decade. Over all, the twenty-first century concubine gets a pretty raw deal if you ask me. So what’s in it for such women? Well if you believe the theory that ‘All the best men are married’ then there’s that. Personally I’d be going for the best man ahead of the groom any day. Then there’s the fact that forbidden fruit often seems more luscious. Then there’s the concept that if a man already has a wife to look after him, it means you get to play with him without having to wash, iron and mend his play clothes. It’s all care but no responsibility. Sure you only get the wife’s leftovers, but those illicit crumbs are the most delicious when partaken in the exhilaration of

mischievous collusion. The wife gets the main meal, sure, but you get dessert! The other thing is that being a mistress does not mean you can only have one master. Presumably, once you’ve decided to play outside the conservatives’ playground, no holds are barred. The clever concubine can play one master off another and pick and choose amongst lovers like a latter-day Scarlett O’Hara. Depending on the nature of her relationships with the men in her life, she may be able to maintain a degree of freedom. However some modern-day concubines are so smitten, financially beholden or fearful of losing their place to the younger faster model, that they must be on call at all times to provide companionship, sex or ego-boosting as required. There is no reason to suggest that there is anything deficient or second-rate about the human side of such relationships. Just because they are covert does not in itself make these alliances inferior to those sanctioned by marriage or otherwise approved by society. Affairs lasting four hours, four days or four decades have taken place for centuries under different guises and with varying outcomes. One thing remains constant. It is almost exclusively the male who feels justified in taking on that extra one or two female consorts. History documents no established system of women keeping harems of gigolos. There is not even a word for such a ‘collection of toyboys’. Perhaps the twenty-first century will see this balance redressed as the Madonnas and Chers of the world cut a swathe through the toyboy box and give Mick Jagger and Hugh Hefner a run for their money. But I seriously doubt it.

Pandora’s BOX

Impotence

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en put great pressure on themselves to perform sexually. They have more of a tendency than women to pride themselves on their sexual prowess and any shortcomings are taken more to heart. The inability to have frequent long, strong erections can deeply undermine a man’s sense of self. It challenges not just his masculinity but also the way he defines himself as a sexual being. For some, ceasing to be potent is tantamount to ceasing to exist. A woman can always fake orgasm but a man cannot fake an erection. Not only are men’s difficulties more obvious and more likely to make intercourse impossible, but there also seems to be a greater social expectation of male sexual competence. Even a woman’s failure to orgasm may frequently be perceived as a failure on the part of the male. The medical term for impotence is ‘erectile dysfunction’, which means an inability to achieve an erection adequate for sexual intercourse. This may be a temporary problem or a long-term one. Temporary erectile difficulty may be caused by excess alcohol intake or being overly tired, sad, angry or mentally stressed-out. As a short-term problem, impotence is likely to affect 99 per cent of men at some point in their sexual careers. But about 10 per cent of men suffer from continuing or chronic erectile dysfunction. Erections are the result of a complex interplay between penile blood vessels, hormone levels, muscle reactions,

Pandora’s BOX SEX

nerve impulses and brain messages. Messages from the brain open valves in the penis that allow blood to fill the two spongy tissue chambers in the penile shaft. As these chambers fill and swell they become firm and then rigid as the outer casing is stretched and drawn tight. A problem at any level or any stage of this process results in impotence. As recently as the late seventies, psychological problems were believed to be the cause of nearly 90 per cent of erectile problems. With improved diagnostic techniques, it is now believed that about 70 per cent of chronic erectile dysfunction is caused by physical reasons such as diabetes, hormonal imbalance, surgery or an accident damaging the blood vessels or nerves supplying the penis. Impotence can also occur as a side effect of certain medication and ageing can also be a factor. At eighty years of age, 80 per cent of men may suffer erectile problems. It is important to be aware that some age-related sexual changes happen to everyone eventually. Erections may take longer and orgasmic contractions are less forceful with age. There is a greater ‘droop’, as in the angle between the lower abdomen and the erect penis increases. With age, erectile function is more dependent on adequate rest, such that a man may feel like sex after a nap but not after a busy day. Latency time (that is time between ejaculation and return of erection) is increased and it may no longer be possible to have sex many times in one day. If these normal age-related changes are seen as evidence of disease the man may become anxious, which in itself is counterproductive and impedes healthy compensatory adjustment to such normal changes.

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Anxiety and tension are probably the commonest causes of erectile failure and while they are usually short-term problems that resolve spontaneously, they can become chronic when the impotence itself causes further anxiety and tension, creating a vicious circle. Derisive comments from a mocking, unsympathetic partner can be destructive and demoralising and may lead to the problem becoming increasingly entrenched. A partner who is unattractive, moody, preoccupied, passive, unenthusiastic or unwilling may trigger impotence. A situation in which there is lack of privacy, frequent interruptions, or concern for crying children or the like, may also induce impotence. A poor relationship, guilt about infidelity or desire to impress a new partner may also be triggers for impotence. Patience and cooperation with the advice of a sex therapist, counsellor or GP is invaluable in overcoming impotence. A doctor will assess whether the problem is physical, psychological or a mixture of both. Tests can determine if the blood flow to the penis is impaired or if hormonal imbalances are present. Conversely, if a man is capable of erections at any time, such as at night, on waking from sleep, with masturbation or with erotic magazines or videos, then there is doubtless no physical problem. If the problem is purely psychological, working with a sex therapist or psychologist may be appropriate and is particularly successful when both partners participate. If the problem is caused by hormonal imbalances, these can sometimes be rectified with medication. If the erectile problem is a side effect of medication, the doctor may lower

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the dose or change to an alternative drug. If the underlying problem is a chronic illness such as diabetes, improved blood sugar control may help. The patient needs to work closely with his doctor to achieve this. However, if the problem is not reversible by any of these means, good results may be obtained through drugs like Viagra or self-administered penile injections before intercourse. Viagra works by enhancing relaxation of the muscle in the penis spongy tissue. Side effects include facial flushing, headache and occasionally, visual disturbance, but most people tolerate it quite well. The Viagra needs to be taken at least half an hour before sex, and manual stimulation is required to get the desired effect. With the penile injection, the erection is more immediate and occurs regardless of stimulation. It is injected into the side of the penile shaft into the spongy tissue called the ‘corpora cavernosa’. The advantage is that only tiny amounts need to be injected so it will not aggravate heart or kidney problems. It is a relatively painless procedure and the injections can be used up to three times per week. They are highly effective and the erection lasts for about half an hour. Drugs like Viagra and penile injections are mainly used to treat physical impotence but can also be used temporarily to increase confidence when psychological issues are at the root of the problem. Surgically implanted penile prostheses are reserved for people with severe impotence and for whom the drugs don’t work. There are many different types, from malleable ones (you ‘pose’ it yourself) to multi-component inflatable devices. They are implanted by urological surgeons with a special interest in this area of treatment and are considered

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a last resort. The ability to ejaculate is not affected by the prosthesis. A potential complication is infection, which may necessitate removal. If a specific vascular problem is causing the impotence then microvascular surgery is an option, but this is seldom successful and not commonly undertaken. Vacuum devices are a good non-surgical alternative. The penis is inserted into a vacuum cylinder, then a vacuum pump creates a negative pressure within the chamber. A tension band is applied at the base of the penis to maintain the erection. Problems can include difficulty with ejaculation, pain or bruising, but for some men the pump is still more acceptable than an injection. Whatever means you end up employing to help with the physical problem, you will also need to have some counselling, preferably with your partner in tow. You may need some advice regarding non-penetrative sexual activities as well as on how to incorporate your new toys and devices into your sexual routine. Occasionally the partner of the impotent man may be secretly or subconsciously quite pleased that the pressure to have sex is off and when he comes home with his new kit box to surprise her/him, he may get quite a surprise himself. The partner’s negative reaction to his new-found potency and the consequent relationship discord can have damaging effects even leading to break-up. In general, it can be helpful to approach management of erectile difficulties in the context of the relationship, exploring not only what the impotent partner wants but also how this affects his partner.

Extraordinary sex Essential pre-requisites 1. Partner of desired sex. Although most women achieve their most powerful orgasms through masturbation, there is still something to be said for company. 2. Privacy. The exhibitionist in you may protest here but remember, sex in a public place is still considered an offence. Think George Michael. 3. Working knowledge of the anatomy. Finesse will always triumph over the blind fumble. 4. Consciousness. It is in all our interests to be accepting and forgiving, but a partner who is drunk, groggy or stuporous is unlikely to please. Similarly, fans of the

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These days, with medications readily available on prescription and therapists skilled and experienced in managing erectile problems, men have much less to fear. Whatever is causing the problem is likely to be able to be remedied; all you need is the confidence to ask for help. Getting your partner involved or at least keeping her/him up to date with your progress is likely to lead to greater satisfaction all round in the long run. Jump to it and gentlemen, start your engines . . .

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early-morning bonk should heed the immortal words of Wham!:‘Wake me up before you go-go.’ 5. Lack of self-consciousness. Twisting oneself into a pretzel to minimise/maximise the size of various body parts is bound to detract from the enjoyment of both parties. The sights, sounds, smells, tastes and feelings that make up the sexual panorama should be appreciated for their uniqueness. Harsh judgements are as out of place as harsh lighting.

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o what’s extraordinary sex anyway? Does ‘out of the ordinary’ mean supernormal, subnormal or paranormal? seX-files perhaps? Intercourse with ET? An indictable offence involving a minor/relative/pet? No! Today we’re talking about sex that is way above the humdrum, that takes us to another plane, that transports us from the banal. Super-sex. But is there really such a thing as ‘super-sex’? Yes,Virginia . . . sex with Superman or indeed any superhero should qualify. In the absence of a man in tights, Barbarella made do with the Pleasure-machine which had the bonus function of gravitydefying effects on hair (sort of like Warren Beatty in Shampoo). Then there was the fingerlickin’ good scene in 91⁄2 Weeks where voluptuaries Kim and Mickey frolicked in

the fridge. That food-flesh-fondling folly was hot enough to defrost at least nine and a half out of ten Kelvinators. So if we agree that super-sex exists in fiction, how do we transport this ‘sextraordinariness’ into our everyday lives? In fact, the approach has much in common with the preparation

Don’t get competitive. There’s enough in life to stress over without making sex a question of personal bests. Extraordinary sex isn’t something that takes place over an

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of a sumptuous meal. Care and attention to detail are key. Knowing the particular tastes and predilections of one’s partner, including any specific allergies and phobias, is useful. Choosing a time where one may be at leisure and undisturbed is vital. Creating the desired ambience with appropriate lighting and soundscape will heighten enjoyment. Young children vocalising is rarely a mood-enhancer. Communication of individual needs and desires will increase the chances of these being met. It is important that you and your partner are able to find some common ground here. Negotiation and occasionally compromise may be necessary. Harmonious sexual relations are unlikely to result if one partner is thinking dressage while the other is thinking rodeo. While it is indispensable to maintain a sense of relaxation it is equally imperative that one does not lapse into an overly passive and floppy state. In fact not only must one retain both alertness and muscle tone, a degree of creative spark and imagination is the sine qua non of the sexual adventure with edge. Let the minds and bodies roam free. Don’t be in any rush to get any place at any time. Foreplay is not a golfing term but it should be approached with the same leisurely pace. Allow yourselves to roam the undulating greens with absolutely no pressure to sink any balls. Make an afternoon of it. Rise early for a morning constitutional round. And guys, there are no prizes here for finishing first.

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evening or even a weekend. It’s the collection of sexual experiences that you build up over years of getting to know your partner or partners and most importantly, yourself. What you need and want from one sexual encounter to another will change and develop as you do and extraordinary sex is achieved through recognising and responding to those nuances and increments. Extraordinary sex isn’t about flashy moves and grand athletic feats. It’s about subtlety and thoughtfulness, caring and sensitivity, versatility and adaptability. It’s not your body or your stamina, your knowledge of the Kama Sutra or your access to Viagra that makes for extraordinary sex. It’s simply your desire to make your sexual experiences and sexual development a priority. And that’s completely up to you and your libido. Building a successful sexual career takes time, effort and a generous smattering of confidence. Partners can be a source of useful instruction as well as good references. With a healthy degree of respect for your lovers, as well as yourself, you are bound to go far. In fact the only way is up and the only glass ceiling you need to worry about is that mirror you installed above the waterbed. Now that’s a worry. So whether you change the sheets and shake out the doona or flick a damp teatowel over the laminex and restock the fridge, make sure you powwow with your partner before you zip into your superhero suits and take on sextraordinary powers. The time for super sex starts now and the only limits are in your combined imaginations. The rules are: there are no rules.

First sex, first love: not the same thing?

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he ‘first time’, for me, well it took my breath away. I’d been looking forward to it for so long, you see. I’d heard so much about it. It seemed like everyone was talking about it. I wasn’t disappointed. No way. It was absolutely stupendous. Mind blowing. Now I finally knew what everyone was talking about! I immediately wanted to discuss it, in depth, with all my friends. (Maybe even write an article in the paper about it . . . ?) I’m talking about the first time I saw American Beauty of course. Isn’t it always somewhat stunning when a film lives up to its hype?

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American Beauty arguably has a number of highlights but certainly one climactic moment . . . gee, I guess it would be unfriendly or even churlish to give it away . . . although the box office figures suggest almost everybody’s seen it . . . Well anyway, there is a point in the movie when one of the characters has cause to say ‘It’s my first time’. Who doesn’t remember their ‘first time’? No I’m not talking about ‘first Tim Tam’ experiences or ‘first Monaco Bar’ or anything oral of that nature. I’m talking about ‘first sex’. I must admit to a romantic fascination with the concept and memory of ‘first love’. For each of us surely, this indelible memory is seared, painstakingly if not painfully into the

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tenderest flesh of the heart. I doubt not that it remains achingly ‘heart-felt’ from the first palpitation of infatuation to the last barely beating flutter of our terminal moments. But what’s the relationship between first love and first sex? Well you may ask. Statistics show that these days, the most common age (median age) for first sex, is seventeen, for both males and females. This represents a significant drop from four decades ago, when the median age at first sex was twenty-one for ladies and twenty for gents. Reasons for this drop are numerous. Significant influences must include the advent of effective contraception (particularly the pill), the changing employment status of women, the extension of family planning services and importantly, a series of legal reforms in the 1960s liberalising sexual behaviour (the Abortion Law Reform Act in 1967 for example). While certainly the age at first sex has fallen precipitously and perhaps predictably, changes in motivating factors at the time of first sex have shown less dramatic but nonetheless distinguishable trends. In a recent study on circumstances relating to first sexual intercourse*, respondents were asked to select from the following statements: 1. 2. 3. 4. 5.

I was curious about what it would be like. I got carried away by my feelings. Most people in my age group seemed to be doing it. It seemed like a natural ‘follow on’ in the relationship. I was a bit drunk at the time.

Movies like American Beauty, which raise issues about first sex, under-age sex and particularly sex between two

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Curiosity (option 1 — cited by 55 per cent of men and 42 per cent of women) and relationship progression (option 4 — 45 per cent of men and 50 per cent of women) were the commonest responses. Curiosity was the factor most commonly selected by men while for women it was ‘being in love’. 58 per cent of women chose the ‘love’ option compared with only 30 per cent of men. A comparison of responses from people of different generations reveals a trend away from romanticism in both women and men. Women and men aged 45–59 were far more likely than their 16–24 year old counterparts to choose ‘love’ as having been the main precipitating factor for first sex. Conversely, women and men aged 45–59 were far less likely than their younger counterparts to cite ‘curiosity’ as the motivation for first sex. So what does this mean? Are we falling in love later but ‘doing it’ younger? Or is sex becoming increasingly dissociated from love? Are we having sex increasingly out of ‘mere’ curiosity? Is there anything wrong with that? And why with an increasingly permissive and supposedly well-informed society, are young people even more curious than their ‘Sexual Dark Ages’ predecessors about sex? Paradoxical or predictable? It certainly arouses my curiosity!

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6. I wanted to lose my virginity. 7. I was in love. 8. Other particular factor (specify).

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people of wildly disparate ages (sorry . . . have I given too much away? Come on, you’ve at least seen the trailer haven’t you?) provoke thought and discussion about both the written and unwritten rules we as a society have to make. As our teenagers become increasingly sexually aware, perhaps even sexually provocative and seemingly sexually confident, it is up to adults to distinguish this partly learnt façade from genuine sexual readiness. The media constantly bombards our youth with images of themselves as sexual beings, sometimes to titillate adults, other times to flog them products by taking advantage of the very youthful vulnerability which is part of their appeal! With all the focus on sex, age of first sex and motivation for first sex, I’m feeling a burning desire to do a study on age of first love. Are people falling in love at a younger and younger age? Are the reasons for falling in love also changing? Somehow, I think not. Golly I hope not.

*Johnson et al, ‘Sexual Attitudes and Lifestyles’.

‘FIRST LOVE’ STUDY RESULTS Top five reasons for falling in love in the twenty-first century: 1. Kinda liked the look of him. 2. He made me feel like singing (I’m tone deaf), dancing (I’ve got two left feet), walking on air (I do not possess levitational capabilities). 3. He made me laugh. 4. The tingle factor. 5. He was wearing Brut. (For readers under twenty, that’s an aftershave, okay? Okay, it’s a really old-fashioned aftershave.)

Five worst reasons for falling in love in the twenty-first century: 1. His bank balance. 2. His surname. (Packer, Murdoch, Rivkin, Gates . . .) 3. His contacts. (No, I don’t mean lenses!) 4. His penis size or expertise. 5. His Brut.

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Porn

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‘But I warn you, with yet more solemn emphasis, against EVIL BOOKS and EVIL PICTURES. There is in every town an undercurrent which glides beneath our feet, unsuspected by the pure; out of which, notwithstanding, our sons scoop many a goblet. Books are hidden in trunks, concealed in dark holes; pictures are stored in sly portfolios, or trafficked from hand to hand; and the handiwork of depraved art is seen in other forms which ought to make a harlot blush . . .’ Henry Ward Beecher.

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ornography’ is a word derived from the Greek for ‘harlot writing’, so well might it make a harlot blush. Porn is indistinctly divided into soft-core and hard-core. Soft porn consists of people scantily clad, in underwear or naked but without explicit display of genitalia or erections or sexual activity. Hard porn may include anything from masturbation to sexual congress between any number, permutation or combination of adults, children, animals or objects. Mostly porn is a visual medium, relying on actual erotic images in paintings, sculptures, drawings, photos or videos, but sometimes the action may simply be described in a story: no pictures, just words so you can conjure up your own made-to-measure images in your imagination.

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What’s it for? Well, to turn you on. (Der!) People use porn to get themselves revved up for sex with a partner, a group or just themselves, solo style. Some people may get turned on by certain scenes in general release films or even ads for soft drink, cars or ice-cream. Swimwear or lingerie poster ads or catalogues may serve as soft porn. A lot of music videos these days could possibly be classified as soft porn and a huge number of magazines (other than Playboy or Hustler which are well known porn mags) marketed to teenagers and young girls have a soft-porn component with their mega pull-out posters of Britney, Jessica or Mandy leering out from the frame, bosoms thrust out and legs akimbo. Hard-core porn videos are illegal in some states. In addition, movies on television are censored, with anything considered ‘too hot’ for the general public to handle, cut out. Even swear words are deleted from the soundtrack sometimes. I think the reason why they do this is so that youngsters watching TV late at night don’t get a surprise. People worry that kids might be disturbed by seeing sex scenes that leave nothing to the imagination. It is vital to preserve the young people’s imaginations at all costs. Pornography is very popular but people often deny that they take any interest in it. They claim it is ‘boring’, ‘so predictable’, ‘corny’, ‘unrealistic’ . . . Come on, guys! It’s fantasy: it’s not meant to be realistic. As for ‘boring’, well I suppose it’s all a question of taste . . . or lack of. If everyone thought it was so boring, why would the porn business be doing such a roaring trade? People like getting turned on by erotica. Whether you prefer Anaïs Nin or Larry Flynt is your call, but it’s all still porn, whether it’s

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a cartoon, a grainy video or classic literature. Taste is a hard thing to arbitrate. Especially in a democracy. For some reason, people think ‘indulging’ in porn is some kind of sinful, shameful activity to be kept under heavy wraps. God knows why. We all know that we wouldn’t be here if someone, sometime, hadn’t been turning on and getting jiggy so why pretend that we’re not interested in sex and descriptions and depictions thereof? Experiments on babies show that they will focus intently and preferentially on any image that even remotely resembles a human face: even vegies on a plate arranged in the form of eyes, nose and mouth. I think if you did the same experiment on adults, you’d find them focusing intently and preferentially on any object or image that remotely resembled anything even tangentially sexual: breasts, penises, labia, female or male silhouettes, two bodies in any proximity, especially embracing or kissing. Any suggestion of underwear or even a frankfurt and a doughnut together will cause some people to take a second look. It’s a free country and porn doesn’t do any harm that I can see, so why people should have to go undercover to get hold of some porn is a mystery to me. People only use it to get inspired for sex or feeling sexy but it doesn’t mean they will be inspired to do bad stuff. If that were the case then movies like Reservoir Dogs and Pulp Fiction should have instigated senseless massacres left, right and centre. Anyone who is so suggestible that anything they see or conceive, they feel compelled to act out, would need to be lobotomised to prevent any thought or imagination at all. Dreaming and having nightmares would have to be prohibited too since all

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kinds of violent, criminal and pornographic occurrences might take place in the sleeping subconscious. By preventing people from seeing stuff that ‘leaves nothing to the imagination’, people are still left with their crazy and completely disinhibited imaginations which can surely conjure scenarios just as obscene, kinky, putrid, tender, sweet, sexy and ‘full-on’ as any porn director. You can’t take away sexual thoughts and I don’t see why you’d want to. As long as people are allowed to think whatever they like, why not let some of them record their thoughts on film, paper or the net so others who appreciate the same things can share them? Why censor something as natural (at least to some) as erotic imaginings? What harm does it do compared to the pleasure and erotic charge it can bestow? For those who think that porn inspires sexual abuse or assault, I feel this is false. Fantasy and real life are separate. A lot of women may fantasise about being overpowered, ravished and raped but that does not mean they actually wish to be attacked or sexually assaulted in real life. Similarly a man might fantasise about overpowering and having his way with a helpless, tied-up woman, but that doesn’t mean he conducts all his social interactions in this manner. That is ridiculous and underestimates the flexibility and scope of the minds of men and women. People who have a screw loose and actually try to assault people have got a lot more problems than watching too many videos. Anyone who cannot separate fantasy from real life or who has the desire to take advantage of people in vulnerable positions needs help but banning porn from the rest of us isn’t the kind of help that’s likely to be effective.

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It’s really a question of personal style and taste but face it, we all seek eroticism and sexual stimulation from one source or another. Whether it’s reading raunchy ‘love’ stories, contemplating phallic symbols, having phone sex (‘aural sex’), watching videos or simply looking at the topless people in National Geographic, it can all contribute to and enhance our erotic life. It’s churlish to say that this form of porn is acceptable but that form is not. A few people shouldn’t decide for everyone else what constitutes good or interesting titillation. It’s horses for courses and even if you’re into horses, that’s really okay as long as it remains part of fantasy, not real life. By letting people fully explore and visualise their fantasies, they have less reason to become obsessed or fixated by them. What’s more, they can gain satisfaction from simple visual stimulation without ever having to endure any of the risks or downsides of the actual scene. Pornographic material may help couples explore and compare erotic fantasies. The sharing of fantasies may enrich their sex life and enhance intimacy and trust. There are few more revealing and deeply personal exchanges than swapping of erotic imaginings and desires, especially wild or unusual ones. The only potential problem I see with porn is that some people may develop unrealistic expectations of themselves, their partners and their sexual experiences in general if they rely too heavily on the highly doctored scenes in porn as their reference point. Porn stars are chosen for their ‘extreme’ personal attributes just as a cartoon character’s features are exaggerated to characterise and create a

striking image. Real-life people’s organs and body proportions may look quite different and perform dynamically in a less dramatic fashion. But again, as long as people realise this is fantasy and everything is ‘extended’ and exaggerated, that’s okay. Porn is for fun and erotic stimulation. It’s mental masturbation. It’s art for the genitals. It’s sharing erotic fantasies en masse. Why deny that we all have such fantasies and many of them are shared by the universal consciousness? Why should art only be about aesthetics or emotions or spirituality or politics? What’s wrong with some art just being blatantly and unashamedly about sex? Leave nothing to my imagination just for a spell, okay? I’d like to see what’s in your imagination. I’ll show you mine if you show me yours. P.S. If you don’t like it, don’t watch it.

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Sex and Power

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issinger once said ‘Power is the greatest aphrodisiac.’ Never having had much power myself, I can’t give a first-hand account of the effects of personal ascendancy on the libido. I can however vouch for the fact that the ‘suit’ factor can do a man a power of good in the sexual attractiveness stakes. Yes, it’s true. We women are attracted to powerful men. Power attracts sex, be it Monica or Monroe, and you don’t have to be an American President to know it. The power of the casting couch in bringing producers/directors and starlets together and the eternal, inevitable attraction between the secretary and her boss: these are phenomena which are now accepted as evolutionary adaptations. Give a man a fancy title, a broad-shouldered Armani suit and a bank balance to match and he’s immediately got it all over his hapless twin brother slouching over the Centrelink counter in Stubbies and singlet. It’s the power of power. It goes straight to a girl’s head. But being a child of the Professor Julius Sumner Miller era, I am compelled to query:‘Why is it so?’ Is it because the female is biologically programmed to seek out a mate who is likely to be able to care for and protect her and her future brood of varmints? Or is it because the emblems of power and success are an indication of personal attributes (intelligence, strength, leadership quality, talent, integrity and determination for

up for all ages and both sexes, especially after her appearance atop a float in the Gay and Lesbian Mardi Gras, grooving to the beat, complete with feather boa. But given that I’m into gross generalisations and sweeping statements,

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example) that are in themselves admirable and desirable? One way or the other, be it Richard Gere cruising in his Lotus in Pretty Woman or Michael Douglas strutting down Wall Street, the glow of power gives a man an aura of sexual allure that is unmistakable and irresistible to generations of women. But does it work in reverse? Are men attracted or intimidated by powerful, successful women? We are completely habituated to the image of the older, successful male with his upwardly nubile, trophy blonde bimbette. But what of his shoulder-padded corporate female counterpart? Does she also leave swooning young himbos in her wake as she strides down the corridors of power? Or, on the contrary, is she likely to be stereotyped and desexualised as a hard-nosed bitch and battleaxe? Thinking of our high-profile female politicians, Amanda Vanstone and Bronwyn Bishop, the words ‘trustworthy’, ‘capable’ and possibly ‘maternal’ spring to mind. But ‘sexy’? Well . . . not really. On the other hand, when I think of Keating, Peacock (the name says it all) and Hawke, ‘trustworthy’ is hardly the first word that pops into my head. But ‘sexy’ . . . well I hate to admit it, but yes. Okay, there are exceptions. I’m not sure that any amount of power could transform our PM into a figure for sexual fantasy, whereas Natasha the Destroyer could well be a pin-

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can’t I just say that powerful men are considered sexy whereas powerful women are perceived as sexless, emasculating ball-breakers? Well anyway, I’ve said it. But moving on in our examination of the relationship between sex and power, what about the use and abuse of power within a sexual relationship? The ability to grant or withhold sex can give a person extortionate powers over his/her partner. In less polite circumstances, a dominant individual can force his/her partner to submit to sex against his/her will. Rape within marriage or within established relationships is not uncommon and often the abuse is just as much about power as it is about sex. Sex offences are often more about overpowering and controlling another individual than sexual gratification. Sex offenders, be they child abusers or garden variety rapists, choose victims who are in a weak or vulnerable situation and part of the sexual rush is related to the sense of power and control they feel in being able to force themselves on their prey. Sometimes the offender will use his/her position of power or authority to blackmail or manipulate the victim into not telling, so as to be able to perpetuate the crime and claim consensuality. The victim’s sense of powerlessness is at the heart of the violation. In the situation of courting, the one who is being courted is often in a position of power, which may sometimes end once she/he capitulates or ‘submits’ to the wooing of the other. This relinquishment of power might be in the context of a female finally consenting to sex with the pursuing male (think of Madame de la Tourvelle in Les Liaisons Dangereuses). Once she has ‘given in’ or ‘given it up’ she

has ‘lost her mystery’ and quality of unattainability. Once she loses this power many a conquistador/Don Juan/Valmont may rapidly lose interest and move on to the next challenge. Ideally sex and relationships should not be about power and should be consensual, not coercive, between two people who consider each other as equals. But where’s the fun in that? There will always be power play between the sexes and in relationships. We can’t help but be alternately attracted and intimidated by power and, equally, drawn to and repulsed by vulnerability. Sexual attractiveness is a complex mixture of physical attributes and personal qualities of which power and weakness are key elements. How that power was derived and how it is used or abused should determine whether or not it becomes an attractor or detractor. Sexual power can be used for good or evil and just as power can attract sex (e.g., Clinton, JFK, Hugh Hefner et al) so sex can be used to attain power and position. Cleopatra started it and La Cicciolina refined the art. (Alexander Downer in fishnets was a good try which possibly backfired.) Perhaps men have it all over women when it comes to using power to get sex, but when it comes to using sex to get power, the female wins, pants down. God knows, my initials are CP, not ‘PC’.

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Rape

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ape is a very emotive term that conjures, for me, images of violent, forceful sexual assault in a dark alley by a swarthy man in a balaclava. Certainly women are sexually assaulted by strangers in parks and on the street, but often the assailant is someone the woman knows — a work colleague, an ex- or current boyfriend, a relative or acquaintance — and the assault can take place at a party at your best friend’s place, in your own home, even in your own bed. The law defines rape, nowadays referred to as ‘sexual assault’, as ‘sexual intercourse without consent’. Intercourse can include any penetration of the victim’s body (e.g., her mouth, vagina, anus) by the attacker’s body (e.g., his hand, penis, tongue) or an object wielded by the attacker (bottle, stick, knife). Obviously any such assault is a serious crime but so are threats or attempts of assault, or sexual coercion through threats. Sexual harassment is a subtler form of sexual abuse and may include comments about your body, your clothing or your sexual nature, ‘accidentally’ touching, bumping into or rubbing up against you, staring unnecessarily at your body or particular body parts, or simply making personal comments that make you feel uncomfortable. Being unwillingly exposed to hard-core porn is a form of harassment. Excessively sexually suggestive or innuendoladen conversation can be a form of harassment. In fact any

Sexual assault is a violation of personal freedom, safety and wellbeing in which the offender overpowers his victim

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unwelcome sexual attention that is thrust on you making you feel embarrassed, infuriated, frightened or demeaned, is sexual harassment. It can happen at work, on the street, on the bus, at school, even at home. Some forms of sexual harassment are against the law. You can get more info and, if you wish, lodge a complaint by contacting the AntiDiscrimination Board in your state. Indecent assault or indecent exposure includes getting ‘flashed’ — someone exposes their genitals to you — or being touched against your wishes. Any body contact that is forced on you is indecent assault. In the past, and even these days, unenlightened souls have claimed that women encouraged sexual harassment and assault by dressing or behaving seductively. Amazingly some people are willing to believe that a short skirt or diaphanous dress are a clear invitation to ‘rape me, I’m up for it’. This kind of thinking is backward, illogical and cruel. Everybody, women and men, should be allowed to express themselves through their manner of dress and presentation without being punished for looking remotely attractive. It is not the woman’s responsibility to monitor and control the man’s sexual response and behaviour. If a man is attracted to a woman, even if he feels ‘wildly’ attracted to her, it is his responsibility to keep his sexual behaviour in check until he has ascertained whether the feeling is mutual. If it is not, he must take ‘no’ for an answer. ‘No’ does not mean ‘yes’, not in any language. A woman should be able to turn down a sexual overture without being punished for it.

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through force or threats. The violation lasts not only for the duration of the actual physical assault but afterwards as well. For months and sometimes years afterwards, the victim may feel afraid, restricted in her behaviour and mode of dress, ashamed, isolated and humiliated. Common initial reactions to sexual assault include shock, anger, numbness, feeling dirty, terror, guilt, embarrassment as well as relief that at least you survived. Long-term problems can include depression, nightmares, sleep difficulties, eating disorders, problems with trust and relationship difficulties. It is important to talk to someone about what has happened. You deserve support, understanding and care. You deserve respect for your wishes regarding whether you wish to make a statement or lay a charge and regarding issues of confidentiality. You decide which services you want involved in your case: your GP, sexual assault healthcare workers, counsellor, hospital staff, police or lawyers. You decide which family members or friends need or don’t need to know. Many women are reluctant to tell anyone about what has happened to them for a variety of reasons: perhaps they feel too ashamed or embarrassed. Perhaps they feel too confused and wonder if it was their own fault, especially if they were drunk or drugged at the time, have only a sketchy memory of events or if the offender is a ‘friend’. In small communities, women may fear being gossiped about. They may not feel confident of support and feel their behaviour, character and sexual history will be up for grabs. No-one wants their reputation to be the football kicked around by popular opinion.

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Sometimes women don’t report the assault because the offender is her husband or relative and she would feel guilty for ‘blackening the family name’ or ‘breaking up the family’. Maintaining the veneer of social respectability is often overvalued. Perhaps the woman fears further reprisals and retaliation from the offender if she tells on him. Some women fear, or are intimidated by, authority figures such as police or health workers. Language may be a barrier. Perhaps in some cultures, sexual abuse of women is not seen as a crime, particularly if the woman is married to the offender. Perhaps she sees sexual dominance from the husband and unwilling capitulation from the wife as part of the marriage agreement. Aboriginal women may not wish to bring shame onto their community or reinforce racist stereotypes by reporting an offender from the Aboriginal community. This kind of loyalty is probably counterproductive since it does nothing to protect the other women who may be at risk and endorses the kind of behaviour that threatens more than reputation: it destroys community trust and lowers the bar for acceptable social behaviour. Lesbians may fear lack of support, disapproval or hostility on the basis of their sexuality and as a result they may be reluctant to seek help. Such discrimination is abhorrent but does still occasionally occur. Similarly, men assaulted by men and men assaulted by women, may fear ridicule, disbelief or lack of support if they report their assaults. It is true that because assaults on men are less common, in the past, services were not as familiar with dealing with them. But every person who is assaulted

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deserves every possible assistance, support and care. Assault is devastating enough without the further humiliation and trauma of being questioned, doubted and brushed off. Each case of assault is different and each person needs an individual approach according to her/his specific needs and wishes. You need to be informed of the possible advantages and disadvantages of making a statement and laying charges and you need time to make up your mind. You need to be aware of the services available for counselling both immediately and in the weeks and months ahead. Your immediate safety concerns have to be addressed. You may wish to consider applying for Victim’s Compensation. You may wish to join a support group. Medical examination and treatment are available to you and testing and follow-up treatment for sexually transmitted diseases are also offered. If the assault occurred within the last three days you can be given treatment to minimise the chance of pregnancy if you decide to take it. A forensic examination and tests can be done, with your consent, if there is a possibility you may wish to involve the police. The purpose of this is to document any injuries and collect evidence for police investigation or a subsequent court case. Usually the forensic examination is advised if the assault was recent and police investigation is desired by you. The doctor will document soreness, bruises, cuts or grazes. Swabs are taken from the relevant sites (e.g., mouth, vagina, anus). Blood samples, hair and nail scrapings may be collected. Clothing may be taken for testing or kept as evidence in some cases.

Regardless of whether you decide to pursue the case through the court system, you can still make use of the

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All the forensic evidence is kept in a sealed envelope until you decide whether you want to pursue a formal police complaint. After 48 hours if you decide not to, the envelope and contents are destroyed. Otherwise, you are asked to sign an authority to release the info to the police and the specimens are sent to the Forensic Lab for testing. This evidence may be presented in court if arrest and charging of an offender takes place. Sexual Assault services are based in hospitals and community health centres everywhere and are staffed by experienced doctors, counsellors and nurses who can help you as well as refer you to additional services including legal assistance. The decision to press charges and go to court is a big one. Making a statement can be exhausting and emotionally upsetting. You need to tell the details of what happened so the police can document it all. You then read it back and amend it if necessary. You sign it when you are happy with it. You can have a friend or counsellor for moral support and you can have an interpreter if desired. You should keep a copy of your statement. If the case goes to court you will usually be required to give evidence as a witness for the prosecution. You don’t need your own solicitor since sexual assault and other crimes are considered offences against the community as well as the actual victim, so the Office of the Director of Public Prosecutions prosecutes the person accused of the crime on behalf of the community.

medical and counselling services that can help mend the hurt and assist you in resuming your life. Just telling someone about it can help relieve the massive psychological burden. You may need to be reassured that it was not your fault, you may need to be reassured that you didn’t ask for it and that you didn’t attract it by simply being yourself. You may need help just feeling safe and secure again. Each of us deserves to feel safe and unthreatened by unwelcome sexual advances. Just because rape has occurred throughout history, especially during wars and during invasions, including the European invasion of our own country, doesn’t make it ‘natural’ or ‘okay’. At the very least we should each have dominion over our own bodies. Let no man cross the boundaries of your personal territory without your consent. If he does, it is he who is in the wrong, not you. And he should be punished and suffer accordingly. Not you. If only it were so.

Anthony Burgess 1917–93: Inside Mr Enderby (1963).

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y Mum was giving my sister-in-law some advice on her upcoming labour. ‘When the pain gets really bad, you can just have an

epidural.’ ‘Oh no, that’ll slow the contractions. I won’t want that.’ ‘But if the pain is really excruciating you might need it . . .’ my mother countered. Here my brother stepped in: ‘What are you trying to do Mum, put her off?’ ‘Well,’ said Mum,‘It’s a bit late for that . . .’

Yes, it’s true, once one has reached the nine-month mark, there is really no turning back. There are however a few stations where you can alight earlier in the journey. For starters, if you want to fornicate but not procreate, you can use contraception. Failing that, there’s always the ‘morningafter pill’, as long as you catch it within the first two to three days. Even if you don’t choose to disembark at that point, there’s still the final stop before you wind up in ‘Cowan’, known as the ‘termination’ terminus.

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‘He said it was artificial respiration, but now I find I am to have his child.’

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Sex and pregnancy

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Most abortion centres won’t do the deed after fifteen weeks at the outside and some are stricter still about the dates, but once you get past fifteen weeks anyway, you’re definitely in it for the long haul. And that doesn’t end at delivery. That one extends past pre-school to graduation and for some parents, well beyond. Be it bailing the scoundrels out at the police station or babysitting the grandkiddies, there is literally no end to the rather one-sided contractual agreement known as parenthood. Looking at mankind’s history with a broad scope, all those options to exit earlier in the deal are really relatively new. Terminations of pregnancy, ‘morning-after pills’ and contraception are newfangled inventions of only the last couple of centuries. Originally, sex and childbirth were compulsorily and inextricably linked. Save a few miscarriages and ‘coitus interruptuses’, if you wanted to baulk at childbirth, you ought to have started thinking that way around the time of the first kiss let alone by the heavypetting stage. Early descriptions of menopause describe it as a time when ‘fleeting fevers’ (also known as ‘hot flushes’) and ‘emotional lability’ (aka ‘God she’s become a moody, irrational bitch . . .’) may become common. Interestingly however, early observers also noted a marked increase in sexual desire and inclination towards sexual activity at the climacteric. Increase in libido is not a commonly noted feature of menopausal onset these days but it is understandable that in pre-contraceptive days this may have been the case since for the first time, these women would have been able to enjoy sex without the spectre of childbirth

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and ‘another mouth to feed, clothe and take to ballet lessons/ footy practice’ hanging over the ol’ four poster. No wonder in earlier times women were more coy, demure and practised at playing hard to get. They had every reason to shy away from doing the business; it was literally a case of one slip and you’re gone. These days, women can hold the upper hand when it comes to deciding whether fertilisation takes place. Even if the boy won’t buy the ‘If it’s not on, it’s not on’ line, the modern woman can suck in a diaphragm, pop a pill or take the jab (aka Depo provera, a three-month injectable contraceptive). No wonder women of the twentieth century seem like sexual profligates compared to their apparently more discriminating predecessors. Before abortions became safe and semi-legal, many backyard jobs resulted in enormous suffering and frequently, death. I am sad to convey that even today, some women try the DIY with disastrous results; let’s just say that some ladies use knitting needles for more than just knitting. At least for most of the world’s females, termination of pregnancy provides a choice, not to be taken lightly, but in many cases a life-saver as much as a life-taker. Hopefully those who regard abortion as a form of contraception are an exceedingly rare breed. With the advent of so many technologies to bypass the natural direct route between canoodling and reproducing, are we losing sight of what sex was originally supposed to be about? When God made the original pitch, sex was an efficient, and incidentally enjoyable, way to achieve fertilisation. Taken to climax, sex was designed to result in childbirth, thankfully no more than once every nine

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months, but on a regular basis from menarche (time of first menses) to menopause. So what’s happened? OK, so someone figured out it might be fun to play hide the sausage without having to hold the baby. Some turned to checking the cervical mucus, others took morning temperatures. The clever ones said ‘Hey let’s kidnap those spermatozoa in a kind of latex holding bay . . . Yippee!’When the bucks bucked at rolling on the rubber, the (assuredly male) scientists switched on the cerebral light globes and came up with the oral contraceptive pill for women. Science tricking nature has now become a lucrative and much appreciated international pastime, with the result that generations now grow up with the concept of sex being only weakly and tangentially associated with ‘Childbirth? Oh yeah, that . . .’ Just as food used to be for sustenance and survival but now is used largely for indulgence and ‘something to do with your hands between ciggies’, now sex is considered sport, soporific and ‘something to do between sheets with your acquaintances . . . before ciggies’. The insemination/ fertilisation/procreation/commitment element is considered rather unsexy and to be frank, a real mood breaker. Mention vomiting babies, squabbling kids and private school fees and you’ve just wasted a whole lot of wining, dining and French perfume because the pair of you are hardly feeling into it or up to it any more. Intercourse and . . . childbirth? It’s considered quite outside sexual etiquette to even associate the two these days. Fie on you, Neanderthal! Look, I’m not saying that contraception and terminations aren’t a welcome breath of freedom for the modern, sexually

active man and woman about town. And I’m not saying that sex shouldn’t be fun. Heaven forbid. But it shouldn’t be forgotten that originally, sex wasn’t just for fun. Slipping it in isn’t like sliding a coin in a slot for a game of Space Invaders before the movies. It’s sowing the seeds of life.

Sex during pregnancy: the pros vs the cons • Pro: No need for contraception. Con: The bump obstructs the hump. • Pro: Nine months is a long time between drinks. Con: You should stock up on sleep while you still can. • Pro: Fuller, more voluptuous, sensitive breasts. Con: Breasts so exquisitely tender, she bites you if you touch them. • Pro: She feels especially sensual and hyperaware of her body during this time. Con: You feel petrified of harming the baby. • Pro: Can precipitate labour. Con: Can precipitate labour.

P.S. Sex immediately after childbirth is considered a no-no. It is vitally important to allow for the placenta to be delivered first.

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Group sex and grope sex: the ultimate orgy

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Orgy: a wild, drunken festivity, especially one at which indiscriminate sexual activity takes place. Oxford Dictionary.

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hat is it about the concept of group sex that makes some people go ‘Wow’ while others go ‘Euugh’? Well first there are the pros: unlimited permutations of gender and sexuality combinations and unlimited configurations of complex sexual positions extending vertically and horizontally through space. Presumably with so much potential for variety and new experiences, one would never be bored. During time out, one could watch one’s co-gropers and get entertained and re-inspired. But then there are the cons. Unforeseen jealousies, possessiveness and insecurities might spring up. You might feel left out and ignored. You might find yourself subject to sexual ministrations that you had neither envisaged nor requested. Safe sexual practices might be harder to ‘enforce’. Intimacy and eroticism might get lost in the mêlée. While for many the ménage à trois is a fantasy second to none, some find that the practicality and reality fall short of expectations. The old adage ‘Two’s company, three’s a

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crowd’ has some basis in truth. Frequently in a threesome or even a major crowd scene, someone may get sidelined and feel rejected and even resentful. Jealousy is a frequent and strong factor in the break-ups that sometimes follow group-sex scenarios. Not all group grope-fests end in disaster. Some people develop understandings and relationship boundaries that allow them to come together for sex without blurring the lines between lovers and life-partners. Sometimes single people might form a group sex club or partner-swapping club. These swingers know what they want, what is on offer and what is not. Some people separate sexual fidelity from emotional fidelity and get genuine pleasure and satisfaction from seeing their life-partner enjoying a variety of sexual liaisons and situations. This is all very open-minded and harmless in theory. In practice, often only one partner is finding it all liberating and exciting while the other may be going along with it just to please or appease the other. Perhaps the adventurous one has hinted at being bored and the partner feels obliged to contribute to the spicing up of the sex life. Perhaps in doing so, he/she discovers hitherto unforeseen pleasures. On the other hand, the group sex experience may further reinforce existing insecurities and low sexual self-esteem. There is definitely merit in the concept of trisexualism: trying everything at least once, but only if one does this willingly and with a genuine sense of curiosity and eagerness. Being coerced, blackmailed or forced into doing something one finds aversive or loathsome is abusive. Each individual needs to feel confident and

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assertive enough to say no or change his/her mind at any stage if he/she feels uncomfortable with things. You can always ‘pull out’, so to speak. There is no need to feel ruled and restricted by conservative values arbitrarily set by narrow-minded parents, religious figures or other such tyrannical social arbiters. Do what feels right for you, using your judgement and following your own sexual tastes. If noone is harmed physically, emotionally or psychologically by your actions, you should not feel guilty for pursuing your pleasure. In the glory days of the Roman Empire, a cult developed following Bacchus, god of drinking, drunkenness and the all-out spree. Initially only held three times a year, these Bacchanalia festivals became so popular they were held five times a month. The revelries took place in the dead of night and were characterised by utter abandonment of emotional and sexual restraint. The only rule was that every conceivable moral code had to be transgressed and as flagrantly as possible. Frenzied dancing, wild debauchery and shameless adultery and incest took place in an atmosphere of highly charged, orgiastic eroticism. Running berserk, hair flowing, the women pounced on their chosen men and boys. Men forcibly initiated teenage girls and boys alike. Attempts to resist would simply result in several more men lending a hand in the young person’s ravishing. Extravagant food and drink were consumed liberally then vomited in due course. It was a free-for-all, anything-goes, knees-up, get-down-and-boogie like you’ve never seen.

These days, teenagers content themselves with revelling in mosh pits. The game ones dive on top of the others and ‘crowd-surf’ over their heads, buoyed by the hands, bodies and pulsating energy of the mass. Dance party lovers of all ages, genders and sexualities come together en masse in gigantic warehouses and pavilions to writhe, torso to torso, glistening with sweat, to techno pop. Fuelled by drugs and powered by Gatorade, they slither, slide, gyrate and pump from dusk till dawn enjoying the intoxication of being part of a massive, sensuous and orgiastic human conglomerate. The power and attraction of close body contact with a number of people is not foreign to most of us. Footballers love their scrums. Most families enjoy a good wrestling, tickling rumble on Mum and Dad’s big bed. And who can forget the jumping, tumbling, squealing, head-over-heels joy of the huge inflatable Jumping Castles that feature at every school fête worth its popcorn? The orgy-urge is natural. In the age of safe sex, the orgyurge requires a degree of modification and restraint. But how do you have a restrained orgy? If you have the urge to merge en masse, orgy-style, do take precautions of the latex and rubber kind and beware of how it may affect your existing relationships. If you prefer to demur and stick with one partner, good for you. At least you won’t be at risk of going home in someone else’s undies and an odd pair of socks. Some say ‘more’s the merrier’. Others say ‘I’m a one-galguy’ (or ‘one-guy-gal’). Who’s to say who’s right? Certainly not me.

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Celibacy — the pros and the cons

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ell when it comes to celibacy, the real pros would have to be nuns, monks, hermits and the odd Catholic priest. They make a lifetime commitment to a kind of occupationally imposed, professional celibacy. For them it’s a vocational choice just as, say, radio shock-jocks would swear a lifetime commitment to ‘pignorance’. It’s not something you even question let alone feel badly about. For the rest of us, however, celibacy is a state that may be socially imposed with or without our consent and willingness. It can be lonely at the bottom, so to speak. Nonetheless, celibacy has its distinct advantages, medically, socially, psychologically and even financially. For starters there’s the obvious treat of not needing to worry about contraception. No more sneaking around chemists tucking boxes of ‘Trojans’ behind the maxi-pads. Adieu to pill-induced bloating, nausea, moodiness and acne! Goodbye to the anxious monthly checking for the muchanticipated periods. Celibates can rest easy, knowing that immaculate conceptions went out with the ‘loin cloth and sandals’ as statement dressing. No chance of pregnancy means no chance of kids and the responsibilities of parenthood. The oft-touted advantages of

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the DINK (double income no kids) couple are undeniable but the SINS (single income, no sex) individual has yet further advantages over the DINK. Not only can SINS enjoy child-free independence and liberty, they can do so flashily, in a guilt-free environment. No sex also means no sexually transmitted diseases (STDs), unless you are a believer of the ‘caught it from a toilet seat/drinking fountain’ propaganda popular in the early days of government health policy. This idea, scientifically baseless of course, was propagated in order to give an alibi to those gentlefolk who ‘couldn’t possibly have caught it any other way’ in an effort to encourage such ‘respectable’ types to present to doctors for testing and treatment. The necessity of curbing the spread of infections was deemed important enough to warrant a few white lies. For the ‘respectable’ would-be-randies, celibacy obviates the need to resort to deception, self or otherwise. As for the infectiously paranoid STD-phobics, celibacy provides welcome relief from incessant risk calculation: ‘Okay, so the doctor said it was a 1 in 10 000 risk per act of intercourse and I had sex 5 times but the last 2 times were really short, so that’s more like 4 in 10 000 . . .’ Urinary tract infections and thrush aren’t STDs but they might as well be for the fact that many women get them with annoying frequency when they are sexually active, particularly with a new partner. The fact that the antibiotics for the urine infection often exacerbate or trigger further thrush can leave women in a frustrating double bind. To many a female thwarted by such a predicament, celibacy starts to look really good. Think of the savings in doctors’

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bills, antibiotic scripts and thrush cream, not to mention toilet paper and time spent in the bathroom. Let’s not forget the guys in this equation. Yes, guys have something to gain from celibacy too, believe it or not. For starters, they can forgo the often rash-inducing ritual of close-shaving. No longer needing to rub jowls with babysmooth surfaces, they can return to that ruggedly alluring state of ‘Claytons beardedness’ made infamous by George Michael. When George was caterwauling ‘I want your sex’ and lipsticking the word ‘MONOGAMY’ on Kathy Yeung’s bare thighs, the bristling stubble from his neck to nose should have given the game away as to the nature of his personal sexual tastes. After all, how many women could tolerate that Brillo pad texture scouring their sorbolenesoftened cheeks and chins let alone their ‘lower’ lips? The hoary old chestnut of saving one’s seed in order to preserve and strengthen one’s ‘chi’ has weathered much debate. Zen Buddhists, so I’m told, believe that shooting off one’s ammo at the drop of a skirt can leave a man defenceless and sorely depleted, spiritually as well as physically. Tell that to the average male who masturbates at least once a day and the resounding riposte — a sceptical snort — will send most ‘true chi-believers’ scurrying back to the monastery. Which brings us to an important crux in the argument: does celibacy mean no sex with other living things or does genuine celibacy also exclude ‘DIY’ (Do It Yourself)? Does the true celibate masturbate? At the risk of alienating those celibates without nimble fingers or access to a vibrator, I have to announce at this

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point, that medically speaking, masturbation is the thinking person’s answer to truly safe sex and bounding sexual health. Non-masturbating celibates are not so much sexually unhealthy, as, well, semi-asexual. Dating flexes the romantic muscles but does nothing for the pelvic floor. The vibrator-wielding prestidigitator on the other hand is likely to be highly orgasmic and sexually evolved, while at the same time evading pregnancy, STDs and unwanted social entanglements. In short, the man or woman in control of his or her own genitals is a person to be reckoned with, indeed, a person in control of life itself. Don’t get me wrong. I’m not a believer in the ‘use it or lose it’ theory. For one thing penile erection relies on venous engorgement, not muscles, so it’s not as if it’s a fifth limb that needs to be stretched and exercised. For women, increasing blood flow to the vaginal mucosa can help delay mucosal atrophy and thinning post-menopausally. But so does estrogen replacement therapy, much more effectively. Pelvic floor muscle strength does count for something in later life too, when strident coughs, sneezes or guffaws could lead to embarrassing leaks. But pelvic floor muscle exercises can be practised behind the wheel at traffic lights just as easily. So basically there’s no medical necessity to be sexually active with other living things, particularly if you are handy with the digits and other ingeniously designed instruments. The truly ‘fiercely independent’ amongst us can attest to that. Even non-masturbators can certainly get by, not so much as winners but as non-participants and spectators. These conscientious objectors doubtless have other ways of

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exerting themselves and letting out their passions and frustrations. Heaven forbid, they might even be able to concentrate their energies on loftier pursuits! (Um, what loftier pursuits?)

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The pros vs the cons of celibacy: • Pro: Zero risk of pregnancy. Con: Deafening sound of biological clock ticktock. • Pro: No need to scrupulously maintain physical allure. Con: Take on uncanny resemblance to ‘Catweasel’. • Pro: No longer at the beck and call of an insatiable libido. Con: Now at beck and call of insatiable appetite. • Pro: No risk of STDs. Con: Increased risk of RSI of wrist. • Pro: Never again be labelled ‘Lothario’, ‘Casanova’, ‘lecher’, ‘sleaze’ or ‘slut’. Con: Start answering to ‘prude’, ‘loser’, ‘old maid’, ‘bitter old spinster’ and ‘wallflower’.

• Pro: Sex during pregnancy can precipitate premature labour, so celibacy is advantageous before term. Con: True celibates don’t get pregnant. • Pro: When the mates get together and brag about how they’ve been ‘playing around’, you can join in. Con: You’re the only one talking about a round of golf. • Pro: Singledom can be an extremely clarifying opportunity to thoroughly experience yourself and your own thoughts. Con: And then what? • Pro: The experience of singledom helps us make sense of and teaches us what’s important about togetherness and connectedness. Con: Yeah, and then what? • Pro: Celibacy doesn’t exclude sexual thoughts and fantasies which can be enjoyed without necessitating actual real-life practice with all its attendant risks — physical and emotional. Con: Thorough enjoyment and fulfilment may require some degree of risk-taking. A life lived in fear is a life half-lived. Or so they say.

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Coming clean to your sexual partner

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elling a potential or current partner about a sexually transmitted disease is never easy. You risk rejection and have to face up to social stigma, both of which can be rather overwhelming when you yourself may be only just coming to terms with the news. So why tell? Well in fact some people don’t. But there are many reasons why you should. For one thing, you want to minimise the risk of spreading the infection to your partner and if he/she has already contracted it without knowing, you want him/her to get it checked out and treated. You may, in certain circumstances, need to discuss the possibility that you actually caught the infection from him/her. Depending on the nature of the particular infection, the nature of your relationship and the existence of other liaisons in each of your lives, the discovery of a sexually transmitted infection may have a different significance and quite a different impact. Chlamydia is an example of an infection that is not only very common but which often may be present without any obvious symptoms. It is highly significant, particularly in women, in whom it can cause PID (pelvic inflammatory disease) which can lead to infertility. If a man is diagnosed with this condition either in the course of an STD check-up or after presenting to the doctor with symptoms such as discomfort in the urethra, pain with urination or discharge

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from the urethra, he not only needs to be treated and needs to abstain from further sexual contact until successful treatment is completed, he also needs to inform any sexual partners exposed by vaginal, oral or anal sex as they are at high risk of having the infection. They should be treated, regardless of symptoms or test results, with the appropriate antibiotics. The question of how far back to trace partners is a difficult one because, although if symptoms occur they usually occur within 2–14 days of infection, it is also possible for a woman or a man to have the infection for months or even years without knowing it. Depending on the person’s sexual history and various practical aspects, tracing partners back at least six months might be reasonable. The practical value of informing a partner of the risk of a potentially devastating condition that is fairly easily cured if detected early, is undeniable. The risk of suffering as well as risk of transmission to others is minimised. But what about an infection for which there is no cure, such as herpes? Herpes is extremely common but most people who have the virus are symptom free. If symptoms do occur, it may be anything from two days to many years after the infection took place. What is more, there is no absolutely sure-fire way of preventing transmission to your current partner other than avoiding skin-to-skin contact altogether. Condoms may decrease the risk of spread but they won’t eliminate it. If you are diagnosed with herpes it may well be impossible to determine when you actually contracted it: from your first partner, your current partner or in fact anyone who may have come in between. The person from whom you caught the infection may have been completely

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unaware of their infection and may have shed the virus onto you and other partners without ever experiencing symptoms themselves. Needless to say, being diagnosed with herpes may raise many questions for you and your partner that have no definitive answer. So again you may be inclined to ask ‘Why tell?’ Like all ethical questions, this issue is highly personal, but there are numerous reasons why it’s best for all concerned if you don’t keep your herpes a secret from your partner. First of all, keeping this part of your medical history hidden is at odds with the type of trust and honesty most of us want in our relationships. Forcing yourself to cope with this infection all alone not only places too much responsibility on you, it also denies your partner the opportunity to offer love and support. Speaking with current or potential partners gives them the opportunity to understand the issues as you do and put the condition in perspective as a common infection that generally poses no major threat to health. Having to make up excuses to postpone sexual activity during outbreaks is not only stressful but these lies and unexplained half-truths may undermine your relationship. Herpes in itself will not limit your ability to form strong healthy relationships but the way you deal with it can. If you delay too long before disclosing the truth you will not only have the issue of herpes to deal with but the potentially more crucial issue of trust. Before you can address the topic with a partner you must try yourself to become informed and accepting of your condition. If you haven’t come to terms with it it’s unrealistic to expect your partner to become comfortable

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with it. Your partner may know little about the area and what he/she does know may be coloured by myth and misinformation, so be prepared to answer questions or provide reading material that your doctor can supply to you. If you’re not sure, ask your doctor or go to see your doctor together for a hearty three-way discussion. Knowing when to broach the subject is important. If it is an ongoing relationship you don’t want to wait until the truth comes out in the form of your partner’s first attack. Even if your own experience of herpes was very mild, this may not be the case for your partner. Dealing with your deceit at the same time as dealing with the painful physical consequences thereof may really put a strain on the relationship. If you know you have herpes and are contemplating telling a new partner, it’s a good idea to let the relationship develop a bit first, but try to talk about it before you become sexually intimate so your partner has the chance to make an informed choice. Talking about sexual health in general, including not just herpes but other STDs, shows you care about the both of you and are willing to overcome possible embarrassment in order to be responsible and open. Discussing safe sex practices, contraception and issues like fidelity and monogamy is important not only at the beginning of a sexual liaison but throughout your time together. Many couples at the beginning of their relationship may choose to undergo an ‘STD screen’ where the doctor tests them both for any detectable infections. This is an act of trust and a gift well worthwhile exchanging. Once you have gotten to know your partner and have decided he/she is open-minded enough for you to confide

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in, pick a neutral setting in which you are unlikely to be interrupted. Try to be natural and confident. Your body language and delivery affect your message and if you are obviously upset your partner will pick up on that and may perceive the situation to be worse than it really is. Often people will react as you seem to expect them to, so behave as if you expect them to be accepting, calm and supportive. You are definitely doing the right thing, for both of you.

What’s a NORMAL sex life? First of all, let’s dispel some myths. If you’re not having sex, you die. In fact the converse can occasionally be true. Many people including some prominent politicians have actually died ‘in flagrante’. The increase in cardiovascular effort has been known to trigger heart attacks. But don’t let that put you off. Sex is a sport. Just how fit you can get through sex alone is questionable. It may depend on how hard you have to chase your prospective partner.

Most people have sex at least daily. Twice daily if they’re in a relationship. Thrice daily if they’re in love. To tell the truth, the only people who have sex several times a day, every day, are probably getting paid for it, if you know what I mean.

Sex should always be exciting. As with a good meal, satisfying, comforting and sustaining are probably what we shoot for more frequently. Just as you don’t necessarily want to be greeted with sparklers in your dinner plate, you don’t necessarily need ‘surprise’ in the bedroom. Occasional novelty is enough. I should always come with my partner. Why? Are you identical twins? Siamese twins I grant you but anyone who has a discrete body and mind should not be expected to orgasm simultaneously with another person any more than they should be expected to sneeze in synchrony.

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If the relationship is bad, the sex is likely to suffer but the relationship may be great without great sex necessarily following. Sex-skills, like conversation skills and ball skills, take practice.

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If the sex is bad, the relationship is bad.

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Sex makes you younger.

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Grand delusion! Let’s see, the study that reached this startling conclusion was performed by asking people to volunteer facts about their sex lives if they thought, or their friends thought, they looked younger than they really were. Self-report, when it comes to sex, is notoriously variable in validity. As for ‘How young do I look?’ . . . well let’s just say when Mrs Gullible died from repeated traction to the lower limbs she was 63 but goodness she looked just 21! If you’re not having sex there must be something wrong with you. Not at all. In fact the converse can apply. Some people use sex as an antidote to anything from poor self-esteem to reality overdose. Using sex as an escape to ‘ride over’ difficulties is a Bandaid approach. And the ‘ouchless’ variety is hard to come by. So how much sex is good for you? Well it really depends on what you’re doing and how and why you’re doing it. It’s a matter of keeping it in perspective in the context of your life as a whole. Being obsessed with sex could be as unhealthy as being a workaholic. At the other extreme, being a sex-free zone for long enough can have the same effect on your selfesteem as being long-term unemployed. Society’s response to the ‘proud and happy dole bludger’ is as disapproving as its attitude to the ‘single and loving it’ sexual abstainer. Just as those ‘between jobs’ feel the pressure to at least profess to be ‘looking for something in

retail/finance/basket-weaving’, singletons or SINS (singleincome-no-sex) feel obliged to excuse themselves with ‘No, I’m not seeing anyone at the moment, but I’m looking . . . for a large hole to disappear into/to change the subject/for a sock to stuff your gob.’ Just as there may be times when we choose not to work, there may be times when we are not sexually active, although given that the brain is the largest and most important sexual organ in the body, we are probably ‘sexually active’ more often than we’d care to admit! Fortunately not using it doesn’t mean you lose it, and in any case there are many forms of autostimulation; the list is as long as your arm. There are a multitude of variables that influence when you start your sexual career and how you pursue it. Cultural background, marital status, religion, socioeconomic status, physical disability, gender, sexual preference, where you live, who you share digs with, education, attitudes to contraception, awareness of sexually transmitted disease, inclination or aversion to risk, early sexual experiences, personality traits, drug and alcohol habits, self-esteem — these are just some of the myriad factors that determine not just what your sex life is like, but who you are. These are the things that make you an individual, as unique and extraordinary as we, each of us, are. Who wants to be normal? Of all the aspects of our lives, the one in which we should least be expected to conform to a standard is the sexual. (Humbert Humbert, this does not apply to you.) So throw away statistics and bell curves. As long as you know why you’re doing what you’re doing, just keep doing it and stop wondering if you’re normal. ‘Run-of-the-mill’ is for the miller.

thankyou ‘Well, here we are, Mr Pilgrim, trapped in the amber of this moment. There is no why.’ Slaughterhouse 5 by Kurt Vonnegut Jr.

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hose of you who have made it to the end will know by now how long-winded I am. So my thanks will not be brief . . . in the name of consistency. Alison Urquhart made my heart leap when she asked me, ‘Now what kind of book would you like to write?’ I said ‘I want it to be sort of all out of order and not make any sense . . .’ She said ‘Great!’ I thought ‘Wow. Cool.’ Thank you Alison for commissioning this book and granting me the sweetest blessing a writer ever knew in the form of the divine Vanessa Radnidge and the extraordinary Melanie Calabretta. To Alison, Vanessa, Mel and all at HarperCollins, thank you for giving me so much good advice and such blissful freedom. To my literary agent Rose Creswell, thank you for taking me on. Good luck. I am so grateful to have the benefit of your wisdom and the pleasure of your sense of humour.

thankyou

Useful Contacts Thank you to Jane Southward and Christine Hogan at the Sun-Herald for giving me the idea that I might write, and thank you to Working Dog and all at ‘The Panel’ since it was because of your show that Jane got the idea of asking me. If you don’t mind, I’d also like to thank Tim Clucas and all at ‘Sex/Life’ because it’s only ’cos of your show that the Working Dog people asked me on. I could keep working backwards telling you how this led to that and so on but I’m told that usually the ‘thanks’ section should not exceed the body of the book in length. To my friends: Andrew, Asma, Knut, Lejla, Sydel and bonny Honni (why do all my

friends have such weird names?) thank you for letting me exasperate you ‘once a day, aaaaall day.’ Thank you Kevin Palmer and Jackie Hewitt for keeping me snug in your fold. And to my workmates who tolerate me, teach me and make my life one endless song (‘Where does she get off?’) I say a hearty Merci! Thanks especially to Drs Doug Hor, Cathy Fraser, Fiona Dennison, Nicola Duncan and Wendy Morgan, and deepest kowtow to the kindest, most understanding receptionistangels in the universe: Ann Clayton, Bronwyn Collins, Barbara Davies, Ann Hall, Jenifer Snelling, Deirdre Fountain, Elizabeth Hanna and Stephanie Thielbeer.

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Cancer help/screening

And that’s where I get off.

CONTACTS

– Australian Cancer Society, Level 9/140 William St, SYDNEY NSW (02) 9358 2066 – Cancer Information and Support Service 1300 361 366 – Cancer Help Line 131 120 – The NSW Cancer Council FREECALL 1800 422 760 – Breast and Cervical Cancer Infoline (03) 9374 3233 – Breast Cancer Support Service 131 120 – Skin Cancer Clinic 1800 422 337 – Sydney Square/MBF Breast Clinic Level 12/97–99 Bathurst St, Sydney NSW (02) 9323 9999

Counselling services – Crisis Care 131 611 – Lifeline (24 Hours, 7 days a week) 131 114 (cost of a local call) – Kids’ Help Line (24 Hours) FREECALL 1800 551 800 – Counselling care 1/2A Florence St, Hornsby NSW FREECALL 1800 652 025

Depression/suicide help – Lifeline (24 Hours, 7 days a week) 131 114 – Kids’ Help Line (24 Hours) FREECALL 1800 551 800 – Suicide Prevention Australia, 198 Commonwealth St, Surry Hills NSW (02) 9211 1788 – The Rose Foundation (suicide prevention, counselling and community education) (02) 9606 6853 (referrals to appropriate numbers in other states provided). – Reachout! http://www.reachout.asn.au – Care Ring 136 169 http://www.carering.org.au

About the Author Dr. Cindy Pan is a practicing General Practitioner who lectures on women’s health and sexuality. She is a regular guest on Channel Ten’s ‘The Panel’ and an occasional columnist for The Sun Herald.

Credits Cover and internal design by HarperCollins Design Studio

PANDORA’S BOX Copyright © 2001 by Dr Cindy Pan. All rights reserved under International and PanAmerican Copyright Conventions. By payment of the required fees, you have been granted the nonexclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, down-loaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of PerfectBound™. PerfectBound™ and the PerfectBound™ logo are trademarks of HarperCollins Publishers, Inc. Adobe Acrobat eBook Reader 10/2003 eISBN 0-7322-7942-9 Print edition first published in 2001 by HarperCollins Publishers, Inc. 10 9 8 7 6 5 4 3 2 1

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