Sex is complex for men, too

I found the April “Questionnaire” with Dr. Cindy Meston on her research on women and sex thought-provoking and enlightening. However, her conclusion that women are “much more complex sexually” than men struck me as biased, inaccurate and not reflective of either my professional experience as a clinician focused on men’s issues or my personal experience as a man.

For example, many men I have worked with admit using sex-enhancing drugs to essentially overpower the kinds of psychosocial “distractions” Dr. Meston attributes only to women. Strong feelings such as guilt, shame, anxiety, embarrassment, ambivalence, inadequacy, fear of rejection and even body image often negatively impact a man’s ability to perform, as do social factors such as relationship conflict, job stress and family responsibilities.

Women’s sexual functioning may seem more interesting to Dr. Meston, but I have no doubt that future research will find men’s sexual functioning to be, like women’s, highly complex.

Brady Harnishfeger, PhD
Kalamazoo, Mich.

Evidence of misunderstanding

In a letter in the April Monitor, John Searles supports an attack by the Association for Psychological Science (APS) on APA’s accreditation standards. Searles’s wholesale categorization of the opposing positions in this debate as “scientific” and “unscientific” serves as an index of the misunderstandings and problems of the APS position. Ignoring more than a century of scholarship on scientific methodology, APS and Searles disregard the problems, complications and contradictions that ensue when the definition of scientific evidence is unduly restricted and the contexts and dynamics that give meaning to real social events are left unrecognized. The APS perspective sacrifices external validity for internal validity, often producing knowledge that is mechanical, trivial and unhelpful to real-world clinical practice. Searles excoriates letters to the Monitor referring to APS’s position as “scientism” or “scientific fundamentalism,” but these terms merely designate the sacrifice of accuracy and relevance to an ideologically driven and untenably narrow conception of science. Searles would do well to read APA’s 2006 “Report on Evidence-Based Practice,” which gives a more adequate treatment of these issues.

Michael R. Jackson, PhD
Earlham College

An ethical concern

The April 2010 Monitor  reviews amendments to APA’s Ethics Code, which now clearly avers that psychologists can never defend or justify violating human rights. Question for our leaders: What are these human rights exactly, assuming they are distinct from civil rights or rights protected by the Constitution? Does it encompass psychological pressure in “advanced” interrogation, for example?

My point is not rhetorical, because I suspect that politics and political correctness played a role in APA’s Council of Representatives’ deliberations. Perhaps the next issue could review the specific human rights targeted in the guidelines. If this is not possible, then the new Ethics Code is meaningless.

John W. Moore, PhD
University of Massachusetts, Amherst

The internship process does not reflect our values

I work with two excellent students in their practicum placement at Cleveland Clinic Florida. Due largely to chance, neither of these exceptional candidates was placed with an internship site. The current system does these would-be graduates a great disservice by not providing an internship site for every one of them. I witnessed the stress, self-doubt, emotional toll, time and money it took to apply for internships and travel to interviews, with the end result being another year to wait. The sad truth is that much of this process is largely based on luck and penalizes those without the means to travel to multiple sites.

Our internship system is broken. There are simply not enough sites for the amount of graduates seeking internships. The time has come to consider serious changes to our system. We can graduate fewer psychologists, or we can expand the definition of “internship” to include more real-world work under supervision.

How do we justify putting hundreds of lives and careers on hold based on an outdated and unworkable system? How can we continue using this same system year after year, knowing the price some will pay? How can we justify taking money to educate and then abandon these students to this system? It is time to make some sweeping changes in our preparation of psychologists.

Cynthia L. Alexander, PsyD
Weston, Fla.

Perpetuating a stereotype

I was surprised to note that your otherwise excellent March article on encouraging teens to recognize and report domestic violence, “Ending an epidemic,” did not devote so much as a word to the fact that males can also be the victims of domestic violence—much less to the fact that females can be the aggressors. One of the reasons that male victims of domestic violence are unlikely to receive the potentially lifesaving help they need is the baseless, sexist and unfortunately common belief that all DV is male-on-female. It is disappointing to see an article in the Monitor perpetuating such a dangerous stereotype.

Mylan Kaltman, PsyD
Palm Bay, Fla.

Hair pulling is not a severe psychological problem

I applaud your effort to provide information about the significant increase in college students presenting with serious psychological issues (April’s “More students — with more serious psychological issues — are showing up at campus counseling centers”). This trend was certainly apparent at the three university counseling centers I have worked for over the past six years, and it has important implications for psychologists in academic and nonacademic settings.

However, I was disappointed to see that the article includes misleading and potentially insensitive information about hair pulling. While it is true that many individuals who pull hair engage in this behavior to reduce anxiety, the research indicates that hair pulling is not similar to cutting behavior. Recent research indicates that hair pulling is a body-focused repetitive behavior, similar to problematic nail biting or skin picking. Co-morbidity with depression or anxiety is common, but hair pulling is not a severe psychological problem, and the majority of individuals who engage in hair pulling do not have severe mental illness. Interested readers can visit the Trichotillomania Learning Center for the latest research on this complicated and often misunderstood disorder.

Christine M. Larson, PhD

Please send letters to Sara Martin, Monitor editor, at the APA address. Letters should be no more than 250 words and may be edited for clarity or space.