newsmaker: Sandra Leiblum, PhD
BBC News, Publishers Weekly, Library Journal, Contemporary Psychology, Science Daily
by Eve Jacobs
Sandra Leiblum may be many things, but boring is not one of them. The title of her most recent book, Getting the Sex You Want - A Woman's Guide to Becoming Proud, Passionate, and Pleased in Bed (co-author Judith Sachs), is a definite conversation opener - or occasionally a stopper. The book may sound "pop," but between the covers are Leiblum's decades of experience as a psychologist, sex therapist, researcher, educator, writer and woman. She may have thought more about this subject than most people can even imagine and she's proud of it!
Leiblum smiles as she mentions her mother, who was an "indirect influence" on the course of her career: "She gave me no information. Sex was not discussed, so, like most people, I had to go find the information myself."
But she learned from the "masters" at a pivotal time in the history of this specialty. Leiblum was a doctoral student in psychology at the University of Illinois when, in 1966, William Masters and Virginia Johnson published their landmark study, Human Sexual Response. They were among the first to undertake a comprehensive physiological investigation of human sexual response in a research laboratory, devising tools and methods to scientifically measure the responses of 700 men and women.
"The Kinsey Report had shocked Americans in 1948 and 1953 with its description of the kind and variety of sexual behavior. It was a real eye-opener," Leiblum recalls. "But Masters and Johnson took the next step in revolutionizing the field. We were amazed, impressed, enthusiastic; we devoured the book. It represented the beginning of serious scientific research in the area."
Her post doc supervisor, she says, was trained by the famous duo, and Leiblum proudly remembers her personal interactions with both Masters and Johnson. "It was incredibly exciting to be involved in something so cutting-edge."
The psychologist arrived in New Jersey in 1972 to assume faculty positions in the Department of Psychiatry at Robert Wood Johnson Medical School (RWJMS) and the Rutgers graduate psychology program. Richard Cross, MD, then chair of environmental and community medicine at RWJMS, recruited her for the human sexuality course he had launched for medical students. Again, Leiblum had the rare opportunity to work with a pioneer. She calls Cross "my mentor, larger than life, a dignified man who was passionate about educating medical students about human sexuality and thought it was important long before anyone else did."
He encouraged Leiblum to attend the Sex Attitude Reassessment Seminar (SARS) at the University of Minnesota in 1973, which she describes as "quite a memorable experience - three days of lively exchange, sometimes provoked by sexually explicit films and other media."
In some ways, this experience was pivotal in directing Leiblum's subsequent work - teaching the importance of sexuality with emphasis on its meaning, associations and values for the individual. "You can fill students with facts about human sexuality but not affect their attitudes," she explains. "Doctors need to be cognizant of their own feelings in this area."
In 1974, Cross, Leiblum, and Raymond Rosen, PhD, also on the faculty of the RWJMS Department of Psychiatry, launched a full week course on human sexuality - which students came to refer to as "Sex Week." The participants included not only second year RWJMS medical students but also students in social work, psychology, theology, and nursing. Leiblum took over the program in 1988 after Cross retired, and remained course director until 2001. She believes that while times have changed, the need for "Sex Week" remains since both physicians and patients still feel awkward about initiating or admitting to sexual questions or concerns, and, increasingly, physicians are the "front line" of treatment for sexual problems.
Although educating future practitioners is a "passion" for her, clinical work, research and writing have come to occupy center stage in her career. In the mid-'70s she became director of the Center for Sexual and Relationship Health at the medical school, offering group and individual therapy for men and women, running weekend workshops for "dysfunctional couples," and talking to physician groups about the kinds of sexual problems they might encounter in their practices. "At that time, there was no one else doing this in the state," she remembers, and people teasingly called her and Rosen "the Masters and Johnson of New Jersey."
There has been a sea change in the types of problems for which most people seek professional help, she observes. "Back when we started, the most common complaint for women was an inability to achieve orgasm and for men it was early ejaculation," she explains. With the aging of the population, she says that those seeking her help are often in their 40s, 50s, 60s and even 70s; and women most often complain about a lack of desire, while men worry about erectile problems or lack of sexual interest.
Leiblum explains that her professional focus has paralleled her life, changing with each decade. In her early 30s, she started researching infertility when she had a problem conceiving. (She was successful and her son is now 24.) "Women feel desperate, anxious, deficient when they are trying to conceive and can't," she says. "They ask themselves, 'Did I wait too long? At what point should I try infertility treatments?' These life issues become your preoccupation." She served as the psychologist for the RWJMS infertility group - a position she held for 15 years - and published some of her research in 1996.
There are many issues surrounding fertility, she observes: "If someone knows they are at risk for passing on the Huntington's gene, for instance, should they opt for artificial insemination in order to avoid the possibility of passing on the gene? Should children conceived through third party reproductive options involving the use of donated eggs or sperm be told about their genetic heritage? Should couples be vetted before being accepted for third party reproduction? Who gets to decide? "
Having moved on to mid-life sexuality of men and women, she tries to refocus the attention couples place on intercourse and performance to an emphasis on intimacy and quality of sexual exchange. Leiblum is also co-chair of an interdisciplinary group of experts on female sexuality that is challenging existing definitions of female dysfunction. They are trying to "depathologize" the normal changes in sexual interest that are characteristic of women as they age. She explains that in general, "Women don't usually initiate sex out of a physical need for release but are more often sexually motivated out of a wish to be close to their partner. While it is normal for many older women or women in established relationships to report a lack of sexual desire, once they become aroused, they do want to keep going," she explains.
She points out that the pendulum in treating sexual problems has swung from long-term psychological treatment (on the proverbial "couch") to a learning approach (bad habits need to be unlearned) and now to a medical model. "By no means do pills solve these problems," she warns. "It's relatively easy to give men an erection with medications, but they still may have lack of desire, serious inhibitions, anger, anxieties and negative expectations."
Leiblum continues to be inquisitive. Recently she recognized and named a phenomenon that had probably always existed, but which had been denied - Persistent Sexual Arousal Syndrome in women. "This is genital arousal in the absence of desire or subjective pleasure," she explains. "It's a constant feeling of genital tension; it doesn't go away and it's intrusive and distressing."
She launched an Internet survey and has received responses from close to 200 women world-wide. "Women with this condition feel humiliated and embarrassed, so they suffer in silence," she says. "By taking it seriously, we can begin to conduct research into its etiology and treatment."
Author and co-author of 10 books, which are among the recognized texts in her field, and more than 100 articles, she is also the editor or associate editor of several journals. In 2001, she was awarded the Masters and Johnson Lifetime Achievement Award from the Society for Sex Therapy and Research, and in 2003, the Distinguished Scientific Achievement Award from the Society for the Scientific Study of Sex.
Leiblum also directs the psychology internship program at RWJMS and UMDNJ's University Behavioral Healthcare, which allows her to practice her second passion, the training and supervision of psychologists. Teaching - whether of interns or residents or of a wider audience - will always be a crucial part of her professional life. "What could be more important than guiding the next generation of practitioners?" she says. But she is equally determined to overturn the "mixed messages about sexuality which begin when we are born and follow all of us through every stage of our lives."
"So much about sexuality is treated as if it is shameful and secret," she concludes. "Your sexuality is special - enjoy it!"