Perv: The Sexual Deviant in All of Us (12 page)

With the exception of onanism in adolescent boys, a subject for which physicians and scholars like Kellogg and Hall clearly had a thorn stuck in their paws, clinical descriptions of men whose animalistic desires couldn’t be satisfied are conspicuously scant in the deep historical records. Women who demonstrated some arbitrary level of lust were usually victims of misguided, arrogant doctors (most of whom, of course, were men), whereas men who exhibited licentiousness were far more likely to be shuffled off to the penal system—perceived not as medical or academic curiosities but as criminals. Unlike Rivière’s account of poisonous gases disrupting female sensibilities, there are no convoluted theories about the migratory patterns of frustrated testicles making old widowers woozy. (Ironically enough, we now know that lust
does
affect male cognition dramatically.) Neither will you find medieval prescriptions for treating an aroused man by rubbing his tummy while giving him a gentle hand job in a warm bath so that the water may lap against his prostate gland and relieve his seminal tensions. Lust has always been regarded as status quo for men—as a controllable vice, not a sickness. Unlike “nymphomania,” in which female desire was perceived as anomalous, men who expressed their default lecher were rarely seen as mentally ill. Perverts, maybe, but not crazy.

There’s one notable exception to this sexist historical divide between women who were sick and men who did sick things. This is the work of the psychiatrist Richard von Krafft-Ebing, and more specifically his influential study of sexual deviance that resulted in the 1886 publication of
Psychopathia Sexualis
. Krafft-Ebing believed that some men suffered from a mental condition called “satyriasis”—basically, nymphomania’s male counterpart. Whereas mere masturbation was often enough to get a woman diagnosed with nymphomania, a man had to exhibit an extraordinary degree of carnality to receive the diagnosis of satyriasis. Satyrs weren’t just your average players. These were men on the order of that depraved French nobleman Count Donatien Alphonse François de Sade, better known as the Marquis de Sade. And just like that eponymous father of sadism and its most infamous practitioner, Krafft-Ebing’s male patients had come erotically undone (the marquis’s favorite sex act was sodomizing a young girl while getting violently lashed by another man). The psychiatrist felt that these men couldn’t control themselves due to their medical condition of satyriasis, a neurological disorder of an overwhelming sex drive that he strongly suspected was inherited.
*

In
Psychopathia Sexualis
, Krafft-Ebing provides a few examples of men presumably battling this dreadful disease. One such person was “Clemence,” a successful forty-five-year-old engineer with a familial history of psychiatric disturbances. One oppressively hot summer afternoon in 1874, Krafft-Ebing explains, Clemence was riding on a train bound for his home in Vienna, where his wife and child were eagerly awaiting his return after a long business trip. Suddenly he found himself getting so worked up by the seat vibrations, the incessant prattle of the other passengers, and the roiling temperature that “he could no longer hold out against his sexual excitement and the pressure of blood in his abdomen.” Frothing with lust, Clemence exited the train at the nearest stop, which was the small town of Brück on the German-Austrian border, about ninety-three miles southwest of Vienna. Under the scorching sun, this monstrously aroused engineer dragged himself all over town in hope of finding a stray dog (as in an actual canine; that’s not a euphemism) to relieve his agony discreetly in an alleyway. Failing to do this, and luckily so for the other panting inhabitants of Brück that day, he stumbled with fiery crotch in hand into the neighboring village of St. Ruprecht. Here, in a polluted haze, the befuddled Clemence crossed paths with an elderly woman who he thought might like to see his erect penis. It turns out he was wrong about that. The old lady screamed; he panicked and tried to embrace her and got promptly pounced on by her neighbors, who held him to the ground until the police arrived to arrest him on attempted rape charges. “He said that he often suffered with such sexual excitement,” notes Krafft-Ebing. “He did not deny his act, but excused it as the result of disease.” And, astonishingly, so did the judge when Krafft-Ebing explained his medical theory of satyriasis to him. All charges against Clemence were dismissed.

Psychopathia Sexualis
also includes the curious case of “Mr. X.,” a man who’d come to the psychiatrist’s attention in the aftermath of a rather eventful wedding ceremony. Mr. X., Krafft-Ebing tells us, was a rakish bachelor who’d finally decided to settle down in matrimony after years of playing the field. Allow me to set the scene for you. Picture, if you will, the affluent Mr. X. attired in a fine suit and being escorted proudly down the church aisle on the arm of his grinning brother. It’s an idyllic image. Dust mites swirl in the sun-drenched rafters like a flock of miniature angels. Family and friends stir eagerly in the pews; the priest clears his throat in preparation for the vows he’s delivered a hundred times before; the organist hunkers down in melodious devotion; and the groom takes his place at the altar to await his bride, prim and coquettish in her spidery veil. But then the mood abruptly changes. Before his future wife is halfway down the aisle herself, Mr. X. turns to face the audience, unzips, and unleashes his priapic demon for all to see. It’s unclear what happened next, but I’m sure you can fill in those gaps easily enough. Stranger things have happened, but I’m guessing the service didn’t end with a kiss.

Krafft-Ebing collected dozens of stories like these of sex-crazed men. To him, satyriasis was a real disease that caused certain males to act out in inappropriate, and potentially harmful, ways. Yet unlike nymphomania, a hypothetical condition that captured the attention of nearly everyone, Krafft-Ebing’s concept of satyriasis languished in both medical and academic obscurity for more than half a century. It’s only in 1966, in fact, that the subject of excessive male lust as a mental illness makes its next earnest appearance, with the American psychotherapist Franklin Klaf’s book
Satyriasis: A Study of Male Nymphomania
helping to give the long-forgotten issue a fresh elbow in the ribs.

Klaf had been troubled by the number of male patients appearing in his office who seemed predisposed to engage in self-defeating bouts of sexual gorging. Taking the old theoretical baton from Krafft-Ebing, he added a number of interesting claims of his own about satyriasis. For example, like other forms of psychotic breaks, he argued, the disease is characterized by a temporary disconnect from reality rather than a continuous mental state, and it’s usually precipitated by a stressful event in the man’s life. Klaf also concluded that “satyrs” were disproportionately attracted to underage teenage girls and as a consequence frequently faced legal problems, which is exactly how those featured in his book had ended up on his couch chatting with him about their problematic sex lives.

Many of Klaf’s observations were quite insightful. His claim that upsetting life events can trigger bouts of satyriasis has found support in recent studies showing that a minority of men responds to feeling depressed by becoming
more
sexually active, not less. For a very long time, it was widely assumed that anhedonia (or depressed mood) goes hand in hand with a reduction in sex drive for both sexes, but it turns out that “hypersexual” men tend to respond to depression very differently, getting more easily aroused when they’re depressed and seeking lust as a transitory escape from their negative feelings.

Nobody’s perfect, though, and some of Klaf’s other claims are indeed a bit suspect today. Take his theory about male-pattern baldness: “Satyrs display more than the ‘normal’ concern about baldness,” he argued. “All men are somewhat self-conscious when it comes to receding hairlines, both front and rear. Most accept this hormonally determined phenomenon as part of the natural course. Not so with satyrs. They look for miraculous cures to wipe away the attrition of time, and they often fall prey to unscrupulous hucksters.” I’m sure my mother would have agreed with Klaf on his baldness theory, since I vaguely recall my dad getting a perm during the Garfunkel era to plump up what hairs remained on his mutinous scalp, and this happened to be a period in my parents’ relationship marked by some extramarital strains. Yet there’s still no evidence that high anxiety over follicular fallout betrays a man’s proclivity to go over the erotic edge.

Klaf was by no means the last scholar to try to confirm the existence of satyriasis. In 1995, for example, the psychologist Wayne Myers wrote a curious little case study about a man named “Alex.” By this point in history, most psychologists had given up on trying to turn homosexuals into heterosexuals and were instead more interested in helping their gay patients adopt healthy sexual behaviors consistent with their own orientation. Alex was a gay case in point. In his early thirties at the time, he had cultivated a distinctive modus operandi in his tireless pursuit of sex on the mean streets of New York City. This involved carrying around a Polaroid image of his erect penis (these were the days before iPhones made penis-photo transport
so
much easier), an organ that he considered exceptionally large. There’s no reason for us to doubt this, really. I guess he figured that his appendage was a work of art that ought to be shared with other men, not kept hidden away where nobody could appreciate it. So he’d wander about in public places flashing this photograph to attractive male strangers, especially those he suspected of having their own extra-large penises and who’d reward his generosity with a complementary erection.

“Successful encounters led to transient feelings of relief,” writes Myers, “but unsuccessful ones where he could not produce an erection or the man would not examine his photograph led to tortures of the damned.” Alex, we’re told, typically had at least one sexual encounter a day over a ten-year period while cruising the bars and bathhouses of Manhattan. But his not-so-subtle method of seduction wasn’t limited to gay-friendly establishments, and when you’re displaying your penis to random strangers, this can cause problems with ambiguously oriented passersby (which is to say, straight men who didn’t take too kindly to a photograph of his rigid member being shoved under their noses).

*   *   *

When Myers was writing about Alex in 1995, most North American and British psychiatrists had already stopped using old-fashioned terms like “nymphomania” and “satyriasis” to describe those with an unusually active sex life. The more gender-neutral “hypersexual” is favored today, but the evolution of this terminology for excessive sex over the latter half of the twentieth century belies the messiness of the central construct. Some terms remained just as sexist as “madness from the womb” (for example, the “Messalina complex” or “Don Juanitaism”), whereas others conveyed a patently moralistic view or tone of judgment about the appropriate levels and forms of sexuality (such as “libertinism,” “erotomania,” “urethromania,” “oversexuality,” “compulsive promiscuity,” and “pathologic multipartnerism”). There were even subtypes, such as “the frigid nymph,” “the Casanova type,” and “the sexual compensator.” (Incidentally, being compared to Casanova may sound like a compliment, since history has a way of sanitizing its heroes, but this icon of chivalry had a decidedly less glowing reputation in his own day. Over his long and prolific career charting miles of untrammeled female flesh, Casanova also liked having sex with boys, cost several nuns their hallowed positions in the Church, was rumored to have nearly wedded a young woman who turned out to be his own estranged daughter, was robbed of a small fortune by a light-fingered prostitute, and is believed to have been infected with gonorrhea more often than not.)

When it comes to ascertaining sexual excess, modern clinicians have two main diagnostic guides at their disposal: the
International Classification of Diseases
(presently in its tenth version as the
ICD-10
), which is a publication of the World Health Organization and the primary reference for practitioners in Europe, Australia, and some Asian regions; and the
Diagnostic and Statistical Manual of Mental Disorders
(currently in its fifth incarnation, the
DSM-5
), which is the go-to source in the United States and Canada and the flagship book of the American Psychiatric Association. The
ICD-10
includes the diagnosis of “excessive sexual drive,” and believe it or not, it’s
still
subdivided by the antiquated gender terms of “satyriasis” (for males with excessive sex drives) and “nymphomania” (for females with excessive sex drives). By contrast, despite some recent attempts to add “hypersexual disorder” to the
DSM-5
as a genuine psychiatric illness, North American “hypersexuals” or “sex addicts” are today diagnosed under the umbrella label of “sexual disorder not otherwise specified.”
*

It was the psychiatrist Martin Kafka, a physician at Harvard’s McLean Hospital, who led the charge in 2012 to get “hypersexual disorder” formally recognized by his peers as a real phenomenon with well-defined diagnostic criteria. Kafka’s definition of hypersexuality was “excessive expressions of culturally tolerated heterosexual or homosexual behaviors”—for example, porn, random hookups, cybersex, strip clubs, erotic massage parlors, or masturbating so often that your exhausted genitals have recently started recoiling in fear at the sight of your hand.
*
In other words, Kafka’s diagnosis was reserved for people engaging in “too much” socially permitted sex or having “excessive desire” for other consenting adults.
†
These he called “normophiles.”

Yet Kafka narrowed down the criteria for his proposed diagnosis even further, so that it wasn’t simply the fact that you partook in such behaviors—or even that you did so frequently—but that your urges were interfering with other important (nonsexual) activities and obligations, such as, you know, eating meals, bathing, remembering to pick up the kids from school, that sort of thing. Kafka knew from many years of experience with treating so-called sex addicts that patients’ unsuccessful efforts to curb their problematic habits could cause tremendous difficulties in their lives. And it was this distress over what the
patient
perceived to be his or her own erotic overindulgences that motivated Kafka to push for “hypersexual disorder” to be added to the
DSM-5
. In fact, I think his position on these grounds—that is to say, basing the diagnosis on the subjective negative experience of the patient, not on some attempt by psychiatrists to objectively define sexual excess—is both reasonable and based on admirable intentions.