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It is theoretically possible to cure one member of a family by treating another. Freud, in the notable “Little Hans” case, did just that, curing a phobia in a small boy through work with the boy’s father. Some people claiming to be family therapists never see families, only individuals, basing their claim on the “ripple” effect of successful individual therapy. Similarly, some family therapists treat all individual intrapsychic problems as family problems, amenable to family therapy techniques. It is true that the resolution of family problems often eases the intensity of the intrapsychic difficulties of family members. Still, these seem inefficient ways of doing therapy: while the individual is being treated, the overall family can deteriorate (such cases are known to the author), or while the family is being treated as a unit, the intrapsychic problems of some members can be slighted or repressed. It would certainly appear to be true, and it has been my own experience (Witkin) that the most efficient individual, dyadic, or family therapy is when all of the significant people in the problem are treated in therapy at an appropriate time.

Holistic therapy, then, is primarily distinguished not by utilizing a variety of modalities but by the therapist’s attitude toward the patient. “What is transpiring in any therapeutic setting is not determined by whether it is distinguished as individual, marital, or family therapy. It is determined by the needs of the patients and the capabilities, versatility, and training of the psychotherapist” (Martin). In brief, the patient is treated as a whole person, the dyad is treated as two whole people trying to maintain a rewarding relationship, and the family is treated as several whole people in various stages of development with various, mutually dependent needs and satisfactions. Many treatment modalities may be required, since techniques sufficient for treating individuals may not be appropriate to treating families.

It seems likely that holistic therapy will develop along the lines of family and dyadic therapy, that is, a host of approaches and techniques deriving from the myriad backgrounds of the practitioners. It also seems likely that the holistic therapist will need a variety of skills and modalities and that among these will be those associated with sex therapy.

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A third stage which was not discussed by Freud but has been suggested as part of the psychosexual progression is that of the urethral stage. Some analysts have envisioned this phase of psychosexual development as a transitional stage between the anal and phallic stages. As such, it shares some of the characteristics of the earlier anal phase and by way of anticipation some from the subsequent phallic phase. More often than not, the characteristics of this urethral phase tend to be subsumed under the phallic phase. Urethral erotism can be taken to refer to pleasure in urination and the pleasure in urethral retention similar to the anal erotic pleasure of retention or expulsion of feces. The issues here are issues of performance and control. The classic image of urethral expression is the pride of the little boy in seeing how far he can project his urinary stream. Such urethral functioning can also be contaminated with sadistic impulses, often reflecting the persistence of residual anal-sadistic urges. Similar to the loss of bowel control, loss of urethral control (enuresis) can often have a regressive significance that reactivates and assimilates itself into underlying anal conflicts.

The pathological traits deriving from this period are those of competitiveness on the one hand and ambition on the other, probably connected with the need for compensating an underlying sense of shame due to the loss of urethral control. The conflicts over this issue may be the beginnings of the development of penis envy in connection with a feminine sense of shame and inadequacy in being unable to match the male urethral performance. Successful resolution of the urethral phase builds healthy personality traits, which are somewhat analogous to those derived from the anal period. Urethral competence offers a sense of pride and a feeling of self-competence derived from successful urethral functioning. The area of urethral functioning is one in which the small boy can begin to imitate his father’s more adult performance. In this sense then the resolution of urethral conflicts begins to set the stage for and make significant contributions to the shaping of gender identity and the subsequent gender-related identifications.

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Changing the attitudes and beliefs of an individual who has accepted a traditional view of women is no easy task. As Rosen and Jerdee have pointed out, there are many potential motivations for holding sex stereotypes. They suggest, for example, that past costly experiences with women, perceptions of women as a potential threat, commitment to traditional values, or needs for clarity in our complex world all are reasons for the maintenance of stereotypes and rigid adherence to them. Depending upon which of these (or other) motivations support stereotypic belief systems, the most effective change-strategy would differ.

It also should be remembered that, as Terborg first suggested, sex stereotypes have two separate although often overlapping components. Different dynamics may underlie each, and thus different change processes may be needed to change them. It is conceivable furthermore that both have to be changed if certain forms of sex discrimination are to be eliminated. Even if one’s stereotypes about women’s attributes are altered successfully, and women are viewed as equally competent as men, it may still seem inappropriate for them to take positions of authority. Or conversely, even if one views a position as suitable to a woman, assumptions about her lesser competence can prevent her from obtaining it. At least in some cases, it would be essential to change both normative expectations and stereotypic perceptions of attributes if women are to be treated in an unbiased manner.

For the most part, the programs developed in recent years have been built upon the implicit assumption that the basis of the stereotyping of women is ignorance—ignorance of what women really are like and ignorance of what women’s life experiences are. Consequently, their focus is on raising awareness of stereotypical conceptions and on transferring information about the realities of sex discrimination.

Human-relations training and other workshops dealing with these issues have become common within organizational settings. A host of exercises have been developed for individuals and groups to explore personal and societal prejudices and misconceptions. Techniques such as role-playing have been utilized to encourage men and women to experience the other’s dilemmas. Educational programs have become widespread. To fill in the presumed knowledge gap, facts, theory, and research findings are presented and discussed.

Unfortunately, the effects of these programs are rarely assessed systematically, so no conclusions about their effectiveness can be made. It is likely that such programs are successful only when an individual’s assumptions about women have been sustained as a convenience, or because they simply have never been put to the test. In these cases, forcing people to confront their stereotypes about women and to come to grips with the consequences of them should be sufficient to bring about change. But when stereotyped views are deeply rooted in value systems, such programs are likely to fail. Information by itself has little impact on value-laden convictions.

An incidental but nonetheless important point about implementation should be mentioned. Kanter warns of the consequences of using mixed-sex group techniques in change efforts. The very activities necessary to explore sex stereotypes fully—expressing one’s emotions, being open and honest, being concerned about the welfare of others, and collaborating rather than competing—are those consonant with the stereotypic attributes women are assumed to possess. Although Kanter’s concerns were related to the lack of opportunities for skill development available to women in such groups, the point she raises is no less important when one’s concern is the altering of sex stereotypes. Participation in such groups conceivably can reinforce rather than change men’s images of women, unless care is taken to ensure that women also have the opportunity to display behaviors that contradict and challenge the stereotypes men are likely to have.

Changing individuals’ sex stereotypes can be a very complicated process, and it is likely to be an expensive one. The training and development needed to accomplish such a change, if indeed it can be accomplished, are not realistic in terms of the money and time required.

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In many societies, ideas about sexuality assume more concrete form. In fact, the pronounced nature of sexuality in other societies has taken some anthropologists by surprise. For example, Harold Schneider writes of his work with the Turn, “I did not set out to study sexual behavior, but became acquainted with an important dimension of sexual roles in the normal course of a predominantly social anthropological study”. Schapera made much the same transition upon contacting the Kgatla: “I was continually struck by the open importance they attached to the sexual aspect”. In addition to these comments from Africa, the openness of sexuality has left impressions on researchers working in Polynesia, South America, the Caribbean, and Melanesia.

However, that which takes the ethnographer by surprise—sometimes requiring her or him to re-think the focus of a project—comes as no surprise to the native. “Alligatoring” makes sense to the Mehinaku. Sexual segregation at work and in ceremony makes sense to them too. It is this sense that the symbolic anthropologist hopes to reveal and understand. With this approach symbols are investigated as the basic building blocks of the ideological system. Symbols stand in relationships; they do not stand for something else.

Returning to the matter of Mehinaku extramarital sexual activity, we find that Gregor resorts to a Durkheimian notion of mechanical social cohesion in his explanation. Mehinaku affairs create relationships which keep the community together, though one wonders how. “Extramaritality,” to coin a workable expression, is also an important basis of economic distribution, according to Gregor. Women receive “modest but regular amounts of fish throughout the year” if they are sexually active.

There is yet a third component in Gregor’s analysis. Extramaritality engenders what Gregor calls an “underground kinship system,” “wherein the relationships engendered by extra-marital affairs are performed discreetly so as not to embarrass or anger the cuckolded spouses”. Crocker, studying the Canela Indians of Brazil, reports on an “underground kinship system” that goes one step beyond the Mehinaku system. The Canela (or at least the men) appear to speak to their “underground kinsmen,” the consanguinal relatives of the “classificatory wives” or mistresses’ with the appropriate affinal term of address. He will even refer to their children as “my children,” and assume other aspects of the paternal role.

The Mehinaku and the Canela provide examples of systems in which the form of kinship relationships is extended to persons (and to persons related to persons, in the Canela case) understood to share paternity through sexual acts. In one case from Africa, however, the political dimension is constructed somewhat differently. Harold Schneider’s analysis of mbuya (“lover,” or “paramour”) among the Turn of Tanzania argues that the Turn family organization is based on productive cooperation, not romantic love. Apparently the Turu have learned that the political dimension of marriage is complicated enough without adding to that burden the emotional peaks and valleys of romantic love. In short, Turu love and marriage do not go together. Marriage is a “lease of rights in a woman to her husband in return for bridewealth”. A smart husband would hesitate to divorce a productive wife, so presumably the fact that they have romantic affairs outside of marriage is tolerated by the husbands. Wives show similar tolerance. Schneider argues that “this tenuous marriage . . . would be endangered by romantic love, with its ups and downs”. Whether or not Schneider is correct, that is, if romantic love would indeed contribute serious instability in a basically political relationship, he has directed our attention to a group whose ideology places marital relationships (I hesitate to call them sexual) and extramarital sexual relationships in tension and opposition.

The opposition appears to be somewhat differently structured among the Mehinaku and Canela for whom it has been reported that “kinship” is extended through the possibility of “multiple paternity.” For these people we probably will not find a sexual/political opposition as with the Turu; instead, they have achieved levels of kinship structure—the so-called underground and above-ground system of ratified kinsmen—that contribute to the tensions of social life. Although a Mehinaku or a Canela may have scores of kinsmen, groups of kinsmen are set off through an opposition between those who are related to ego through ego’s mother’s husband, and those whom ego knows to be related to him or her as partial fathers through their sexual activity with ego’s mother during her pregnancy. Acknowledgement of this latter group of kinsmen, on the instructions of ego’s mother, is a recognition of the multiple sexual relationships of the mother, in which case we can say that her sexuality contextualizes the child’s social world.

This cultural structure contrasts with the ideological universe of the Turu, who live in two worlds, a body politic and a body sexual, as it were. The important point here is that sexual symbolism can form part of the structure of a bisected world, the other world being political (e.g. the Turu case), or it can provide an overarching structure in which ratified and surreptitious kinsmen are identified and opposed (e.g., Mehinaku, Canela). These two contrasting cases illustrate the insight into cultural systems possible when sexuality is studied within a framework of ideology, rather than separately.

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According to the Kinsey data, masturbation is chiefly a phenomenon of young unmarried men, although it occurs to some extent among both sexes at every age and marital status level. Eighty-eight percent of the single males from sixteen to twenty in the Kinsey sample masturbated; the proportion of married males at this age level was considerably less (39%), presumably because marital intercourse was a preferred substitute. For young single males, masturbation represented the highest proportion of total outlet (60%). After age forty, masturbation was a relatively lower percentage of the total outlet (about 40% for the active sample). The average frequency of masturbation in the active single male sample dropped from 1.7 times per week in the teens to once a week or less by age forty. Kinsey did not report masturbation data for single males over fifty. Masturbation accounted for a lower proportion of the total outlet for married males than single males at every age. The average frequencies per week were from four to five times lower for married men.

Sixty-two percent of Kinsey’s total female sample reported that they had masturbated at some time, and 58% of these women had masturbated to orgasm. Among the single active sample, the average frequency of masturbation was .3 to .4 per week; for married females the mean was directionally lower (.2 per week). There was very little change in the active median frequencies for single and married women from the late teens through the fifties. Masturbation represented the highest percentage of total sexual outlet for single women; for married women, it accounted for 10% of the total outlet. Average frequencies of masturbation for single women showed virtually no decline with age (about 1 per week from the late teens through the fifties). For married women, average frequencies per week went from 1 in the teens, to .60 at age forty, to .2 at age fifty. For every age group, the percentage of total outlet was from three to seven times as great for single as for married women. Based on their clinical experience, Masters and Johnson suggest that both married and single women who masturbated during their adult years continue to masturbate in old age, although the frequency declines after age sixty. Christenson and Gagnon reported that 25% of a sample of postmarital women in their seventies were masturbating.

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