Sexuality And The Passions Of The Brain Introductory Remarks

Social stress is one of the prime vectors for quality-of-life issues in both humans and other animals (Sgoifo et al., 2001). This is especially evident in the capacity to sustain and enjoy sexual relationships. Sexual motivational systems lie at the root of some of the most intense human feelings, ranging from the eroticism and cravings of sexual arousal to the delights and disappointments of orgasm, not to mention social bondings and attachments, not to mention the ongoing dynamics of social relationships and dependencies. Sexual motivation and sexual performance are often dissociated (Everitt, 1990), as are social urges and commitments, especially in the presence of negative mood and emotional states. To better grasp how these relationships may permeate psychiatric concerns, the aim of this brief section is to provide an overview of the neural underpinnings of mammalian sexuality.

Reproductive fitness is the ultimate currency of evolution. Sexual selection and the sources of human moral principles were the topics Darwin struggled with in his second great book on evolution Descent of Man (1871, 1874, 1st and 2nd editions; for more on related evolutionary psychiatry issues, see Chapter 20). In laying the groundwork for modern sociobiology, Darwin made many provocative and often troublesome assertions, especially since human sexuality is politicized and regulated in most cultures. For instance, he asserted that "man is more courageous, pugnacious and energetic than woman, and has a more inventive genius" (1874, p. 552). We now know that this viewpoint reflects more cultural misconception than true biological fact. We now know that there are quite real gender differences in emotional/cognitive strengths/weaknesses at the population level, as well as at the level of brain structure and function (Kimura, 1999; Mealey, 2000), but it is exceedingly difficult to link the two. But one must proceed with caution since prejudicial attitudes incubate easily in human minds, perhaps in part due to our evolutionary heritage (Chapter 20).

To this day we struggle with our inability to distinguish biological fact from cultural fiction (Panksepp et al., 2002; Pinker, 2002). There was a time when diagnostic manuals placed homosexuality in the category of mental deviance, but now we recognize cross-gender psychological identities as a natural part of the way our brains are organized. At the social level we easily accept the dictum that "exotic is erotic" (Bem, 2000). At the same time it has been exceedingly difficult to accept that there are eroticism-promoting molecules in our brains, and that there may be many differences among the sexes and genders in the evolved mental aspects of sexuality. Still, during the past century we gradually came to accept sexual variety as the norm, with only two major remaining problem areas: the consequences of individual lives when people harm or offend each other, and the psychological difficulties that ensue when one cannot function sexually at the level one desires. When our complex sociosexual apparatus does not work properly, there can be a great deal of emotional distress.

Let us briefly consider these topics in reverse order: (1) What are the factors that impair sexual ability? (2) What is it about the organization of our brains that creates, at least at a statistical level, the neurophysiology of maleness and femaleness? (3) What leads us to have sexual urges? and (4) How can we minimize harm in sociosexual activities? Since there is not sufficient space to probe such issues in depth, we will restrict our discussion to those issues we feel are pertinent to treatment strategies in biological psychiatry.

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