Overall, young people in America and Europe feel that they are able to discuss sex openly and candidly with their friends, and only a minority feel inhibited to talk about the subject. There was a greater reluctance to talk to their parents, with less than half of those surveyed feeling comfortable discussing sex with them. Indeed a lot of young people said they avoided the embarrassment totally by not discussing sex with their parents at all. In terms of national differences, Germans expressed least embarrassment, whilst the French were the most inhibited.

It seems that whichever country we look at, there is a major communication problem between parents and children when it comes to sex. That’s obvious from the hundreds of letters sent to magazine advice columns. So many of the letters I get start ‘I just didn’t know where else to turn’. No one says it is an easy thing to talk about freely. There are a lot of barriers in the way. One man told me that his parents were totally unwilling to talk to him about sex. ‘I think it was something they hoped I would just figure out for myself. The only clues I got were from school. I went to an all-boys Catholic school and the priests did their best to give us “personal development” lessons. It didn’t occur to me until some years later that this was an attempt at “sex education”, although the word “sex” was never actually mentioned, so the messages were so obscure that they were incomprehensible. When it came to talking to my own kids about sex, I didn’t know where to start!’

So there are generations of parents who have not been taught how to talk about sex, leaving them ill-at-ease with the subject. That is what a ‘taboo’ is all about. It excludes discussion of any sort, and is the greatest barrier to communication between parents and their children.

One widely held myth about sex education is that if you tell young people too much about sex, they’ll go and try it all out. Let me say right here that there has never been any evidence that information about sex leads to promiscuity. On the contrary, it is believed by the experts in the field that withholding information is fraught with danger. Moreover, providing sexual information has been shown to delay the age of first intercourse and prevent unwanted pregnancy.

What we really need is a total restructuring of sex education. In our culture, sex education has traditionally been about biology and physiology, carefully avoiding issues like eroticism, pleasure, negotiation, responsibilities, and choices. This is the really useful information that will determine the success of future sexual relationships, yet this is left to the informal and often inaccurate chats between same sex peers. This means that boys and girls may never get the opportunity to find out about the sexuality of the other gender, and it explains why down the track so many couples in longterm relationships have never learnt to talk to each other about sex. There is a growing awareness among sex educators that one of the main barriers to sexual intimacy for young men is lack of confidence in themselves. Unwilling to admit to any gaps in their sexual knowledge, they cover their feelings of inadequacy with false bravado.

I have said before that sex education is a lifelong process beginning at birth and continuing in millions of tiny lessons. Adolescence is a time when that education needs to be accelerated. Information needs to be tailored to prepare individuals for their first sexual encounters and that information has to be explicit, detailed and easily understood.

Adolescence is also a time when parents are forced to see their children in a new light, but relating to your children doesn’t mean dressing like a teenage pop star. Why can’t we celebrate the differences? Parents can appreciate and accept a young person’s fresh approach to life, and the wisdom and experience of the older generations can be a source of great (ability and security for the young.

Guiding a young person through their adolescence is a huge responsibility and a great challenge. One of the biggest challenges is to find the delicate balance that builds on the security and support they feel as children, but still manages to acknowledge their growing independence. One of the difficult issues is privacy. Where do you draw the line between interest and interference? What is often perceived as secrecy in a young person is in fact the expression of a need for personal space. It is a necessary part of the process of defining ourselves as individuals with rights. Hard as it may be to accept, it is a violation of those rights to read a diary, or listen in on a private telephone conversation with a friend. In general practice I am occasionally confronted with an indignant parent wanting to know the details of consultations with their sons or daughters. In Australia, once a person reaches the age of fourteen they have the right to medical confidentiality. I have to explain that it is not some sort of conspiracy; it is an ethical matter. If a young person did not feel they could speak to their doctor on a confidential basis, many would rather suffer in silence. It would be a disaster if young men or women were discouraged from seeking advice about sexually transmitted diseases or contraception for fear of punishment by their parents (whether that is a realistic fear or not). Obviously there are times when we would encourage the involvement of one or both parents, but that must always be with the consent of the patient.
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Getting your first period is one of the most obvious and symbolic events in the process of a girl’s journey to adulthood. It signals approaching physical maturity, and its arrival can be a cause of great concern for some. If it’s earlier than your peers you’re not prepared for it; if it’s later than the others you feel trapped in childhood, like being shut out from membership of an exclusive club.

Julie recalled when she was fifteen: ‘All of the friends in my group had started their periods except for me. They had long conversations about which brand of tampons they liked better and whether they used an applicator or not. I felt really left out, and I thought it was never going to happen to me. My mum tried to help by telling me that it was bound to happen soon, and once it did I’d wonder why I’d wanted to rush it. I got to the point where I thought I’d just lie and tell my friends I had them anyway.’

Shelley tells a different story. ‘I was only ten and a half. I hadn’t even heard of a period, so it had never occurred to me to ask. When I discovered blood in my underpants, I thought I was going to die. Literally. I really thought I had cancer or something. Mum was just as surprised as I was. She said that she would have told me, but she thought she had plenty of time yet. At least it got us talking about other things too, like sex and what happens to boys … that sort of thing.’

The messages for girls about periods are traditionally very negative. Expressions like ‘The Curse’ don’t exactly sell the concept of ‘happy to be a woman’. Mind you, it’s a bit hard to be thrilled about premenstrual syndrome or period pains. These are a fact of life but you don’t have to be a passive victim of them. Regular aerobic exercise (especially in the premenstrual week) and learning to deal with stressful situations will fight the symptoms. There is growing support for dietary measures such as reducing alcohol, caffeine and refined sugar intake in the week before the period is due. Sometimes medication will be needed and the group of drugs called non-steroidal anti-inflammatory agents (NSAIDs) are quite effective.

The way parents react when their daughters start their periods can heavily influence girls’ attitudes to these natural changes. For some parents it is a sad event, as they mourn the passing of their daughter’s childhood. For others it is a welcome milestone in their child’s development, just as hearing their baby’s first words or seeing their first steps.
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Glandular fever is caused by a virus called the Epstein-Barr virus which is commonly transmitted through saliva (hence its nickname of ‘the kissing disease’).

Clinical features

The incubation period for glandular fever is from 3 days to 2 weeks. The onset of the illness is gradual and at first the child may just feel generally unwell and tired. A fever usually develops, followed by a sore throat and tender, swollen lymph glands. The sore throat tends to continue for a week or two, and does not respond to antibiotics. Occasionally your child may complain of upper abdominal pain due to enlargement of the liver and spleen.

A red, spotty rash may appear on the trunk. Symptoms, especially tiredness or general lethargy, can last for weeks or even months.

It is unusual to see complications with glandular fever, and most children recover completely with time. If the spleen is enlarged, it may be wise to avoid body contact sports, because of the increased risk of rupturing or tearing the spleen (although your child may be too tired to participate in sports). Other complications include hepatitis, meningitis and pneumonia.

Investigations

A blood test which is specific for glandular fever (Monospot) will usually confirm the diagnosis.

Treatment

Glandular fever is a viral illness, so there is no specific treatment or cure. It is unwise to use antibiotics; not only are they ineffective against viruses, but ampicil-lin in particular may cause a nasty rash. Treatment is geared towards the relief of symptoms, such as lowering the fever with paracetamol, and making sure that your child gets plenty of rest and eats well.

When to see your doctor

• if your child has a sore throat that does not improve after 3-4 days;

• if your child complains of extreme tiredness which does not improve after a day or two of rest;

• if your child has any combination of the symptoms described above;

• if you are concerned or have any questions.

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Tell me exactly, in no uncertain terms, what you hope they will do sexually Offer them the use of your home for sex. It’s your choice. They will do it somewhere. Where is up to you. Be explicit and direct. “If you’re going to make out, make out here in your room. It’s safer. Don’t do anything but make out. No intercourse. We won’t interrupt you if you don’t interrupt us when we make out. Of course, we can have intercourse. We’re married.” Don’t let the car, motels, or the homes of less caring or absent parents determine the sexual destiny of your children.

Sexual education does not have to be same-gender-oriented. The “talk to your father” or “go ask your mother” routine is totally unnecessary if both parents are comfortable with sexuality. Your sexual insignia, your genitals, are not prerequisites for sexual educating. As a matter of fact, both parents together are the best arrangement, because you are discussing sex and love education, best illustrated by a model of love and loving. *

The focus in sexual and love education must be on “do’s” and not “don’ts.” Presenting a list of fears and sanctions against sexual behaviors can result in a list of “sounds interesting, I should try that.” Give them ideas of what to do. “Touch, hold, kiss, and fondle” is much more intriguing than “don’t have sex until you’re married.” There are two exceptions to this focus on the “do.” Always teach two “don’ts” along with the “do’s.” Don’t have intercourse until you are married, and don’t ever hurt anyone else.

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WIFE

I hate the damn thing. Sometimes she wants me to use it on her. I can hear her using it sometimes. Buzz, buzz, buzz. What does she need me for anyway? She says she has better orgasms with her vibrator than with me. The damn thing has three speeds. It probably has an overdrive. I just hope she doesn’t use it near water. If she does, when she comes, she’ll go.

HUSBAND

Invention number two in the quest for quick, convenient female orgasms was the vibrator, an electrical or battery-operated device used to apply direct stimulation to the Ñ area. One sex therapist called it the greatest discovery for women, perhaps as important for sex as the discovery of Pompeii was to world history.

The concept of “vibratory orgasm” grew from the myth of the first perspectives of sexuality that men come by friction and women come by vibration. Men seldom report using vibrators on their penis, and, as the man above, sometimes report a form of “gadget envy” regarding this device.

Research indicates that many women find the vibrator enjoyable. Some women report that they find the vibrator painful, annoying, and distracting to their sexual response. It is not likely that there will be a successful invention for making men come quicker. The male inventions have more to do with making genitals bigger and less sensitive.

As an occasional source of fun, variety, and different stimulation, the vibrator seems to be enjoyable for the women in my group of couples. When it, like anything else, becomes a focus, a replacement, even an expediter to save erotic time, problems result.

“He knows the vibrator always works,” reported one wife.

“Now he just tells me to get it out and start it up. It gets me more than ready, saves us time. We always use it now. I can’t remember a time when we just made love the two of us, without the vibrator. It has gotten so I hate the sound of it. I associate it with orgasm, but not with lovemaking. It’s group sex, and one of us is a sex robot. The thing used to be mine; now it seems to be his, some type of sexual power buffer.”

As you consider the husband’s and wife’s sexual response systems in Chapters Six and Seven, you will see the orgasmic focus for women and ejaculatory focus for men that was so strongly emphasized in the early sexual perspectives. This focus resulted in the destructive effort by men to “hold back” and by women to “hurry up.” Men mislearned that pelvic contractions and emission of fluid were synonymous with sexual fulfillment, while women experienced an obligation to have intense, rapid, and multiple orgasms as a sign not only of their own sexual fulfillment but of the sexual skill of their male partner.

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It is best to experience a sauna in short 10-15 minute sessions, with 5-10 minute “cooling down” intervals, repeating such a cycle 3-4 times. During the “cooling down” intervals do not use pool or showers which have chlorinated water. Ozone treated water, clean river, rain, lake or sea water is OK. Your skin has been cleansed by the flow of the sweat and in such a clean state it will absorb the chlorine from the water into your body. It is best to use a towel to dry the sweat from your body. Do not allow the sweat to evaporate, because it contains toxins your body has just excreted, and you do not want any of them to be reabsorbed back.

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Myalgia means painful muscles, and encephalomyelitis means inflammation of the brain and spinal nerves.

This disease is uncommon and the cause unknown, but it is believed to be either a viral infection or a reaction of the body to recent infection with a virus.

The symptoms vary widely and are often present without specific signs. It is not surprising that many sufferers have been thought to be overreacting to some simple illness or to have emotional rather than physical problems.

Following what appears to be a simple respiratory or bowel infection, the symptoms of ME may come on suddenly or slowly.

There may be headache and muscle pains, but particularly muscle weakness and fatigue.

While there may be sporadic cases, often there is a minor epidemic with a cluster of cases eventually being recognised.

There is no specific treatment. Most sufferers do get better, but relapses are common. In a few, the condition runs a chronic course.

Both sexes and all age groups are susceptible.

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To the sufferer, it seems as if he is looking through glass which is gradually frosting. Even when fully developed, light can always be perceived and shadowy movements may be seen.

The opacity is more marked in the middle of the lens so that vision is often better in dim light when the pupil is dilated and vision is perceived through the edges of the lens.

In bright light, the pupil contracts and light entering the eye must pass through the centre of the lens where the opacity is more marked and so vision is not as clear.

Because the cataract progresses so slowly, treatment may not be necessary for years. Operation is the only effective treatment. Vitamins or drops are of no use. At operation, the lens and sometimes its capsule are removed.

The operation may be done under local or general anaesthetic. After this glasses are necessary to focus the light rays on the retina.

A newer operation is the insertion of an artificial lens following removal of the opaque natural one. This removes the need for thick glasses which may distort vision.

The timing of the operation may depend on how far the vision has deteriorated, the level of vision in the other eye and how important clear vision is to the lifestyle of the person.

The use of contact lenses after the removal of cataracts in association with glasses may avoid the need for very thick glasses and improve vision.

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