Sexual Arousal and Mental Health in Bisexual Men

There is variation in the extent to which bisexual men get sexually aroused to both sexes. A different line of research suggests that they also vary in how vulnerable they are to mental health problems, compared to gay and straight men. The present study sought to investigate whether variation in bisexual men’s mental health related to their physiological sexual arousal patterns. Based on the literature one of our hypotheses was that bisexual men with bisexual arousal patterns report more mental health problems than other bisexual men, straight men, and gay men. However, an alternative hypothesis was that bisexual men who resemble gay or straight men in physiological arousal would report more mental health problems than those bisexual men who show bisexual arousal, straight men, and gay men. As part of an ongoing project, 125 men watched sexually explicit videos of women and men while their genital arousal and pupil dilation were recorded. 56 of these men also completed a survey of their mental health problems. Bisexual genital arousal was most common in men who identified as bisexual-leaning-straight. Mental health problems did not systematically vary across reported sexual orientations. Moreover, prevalence of mental health problems did not relate to differences in genital arousal patterns in bisexual men. The majority of these patterns were confirmed with pupil dilation as the measure of sexual arousal, although findings with pupil dilation were more complex than those with genital arousal

Reformulation Letters in Cognitive Analytic Therapy: The practitioner’s experience

Aims: This thesis aims to increase our understanding of therapeutic letters and how these are experienced by clients, but also therapists as part of their training. It contains a systematic review of the evidence base for the impact of therapeutic letters presented to clients at the end of therapy which is followed by an empirical exploration of Cognitive Analytic Therapy (CAT) therapists experience of receiving reformulation letters as part of their training. Design: This thesis is structured as a portfolio comprised of a narrative systematic review of research on ending letters, a bridging chapter, a qualitative empirical paper on clinicians’ experience of reformulation letters, an extended bridging chapter to introduce concepts used in the empirical paper, an extended methodology for the empirical paper, and an overall discussion of the thesis portfolio. Findings: The systematic review provides a narrative synthesis of findings in the literature about goodbye letters. The synthesised findings suggests that goodbye letters may impact on how clients deal with endings and how they remember various aspects of the therapy after termination. The empirical paper identified four overarching themes in clinicians’ experiences of receiving reformulation letters as part of their training: The power of the reformulation letter; Inhabiting the client’s role; absorbing thinking as a CAT practitioner; and evolving the therapist’s technique. Value of this work: Despite the increasing use of therapist-written therapeutic letters in services, there is a lack of empirical research to support their use. This thesis contributes towards the evidence base for therapeutic letters by synthesising existing research on those used around the ending of therapies and exploring the use of reformulation letters with a group (clinicians) where this has not been explored previously

Reformulation letters in cognitive analytic therapy: The practitioner's experience

Objectives: The aim of this study was to explore (1) cognitive analytic therapy (CAT) practitioners' experiences of receiving their own reformulation letter as part of their training and (2) CAT practitioners' perceptions about how receiving their own reformulation letter altered their clinical practice. Design: Semi-structured interviews were used to elicit participants' (N= 9) experiences of having received their personal CAT, with a particular focus on the reformulation letter, and their perceptions of its impact on them as clinicians and their clinical practice. Methods: Inductive “bottom up” thematic analysis was used to analyse the interview transcripts and extract overarching themes and subthemes across all participants. Results: Four overarching themes emerged from the data: the power of the reformulation letter; inhabiting the client's role; absorbing thinking as a CAT practitioner; and evolving the therapist's technique. Conclusions: Cognitive analytic therapy practitioners report experiences of the reformulation letter that indicate a positive impact on their self-awareness, learning about CAT and consciousness about how their own clients experience therapy. This was also the case when the reformulation letter did not resonate with them to the desired extent as learning from their therapist's limitations was experienced as having an impact on their learning and subsequent practice

Bisexual Men with Bisexual and Monosexual Genital Arousal Patterns

Some research suggests that bisexual-identified men show bisexual genital arousal, whereas other research indicates monosexual arousal: they are aroused to one sex only. These seemingly contradictory findings may be due to the type of men identifying as bisexual and the performed analyses. We examined whether both bisexual and monosexual arousal patterns could co-occur within the same sample. 114 men of different sexual orientations viewed erotic videos of males or females while their penile circumference was measured. On average, bisexual-identified men were more aroused to males than females, and especially if they identified as “bisexual leaning gay.” However, also on average, bisexual men showed bisexual arousal, and especially if they were “bisexual leaning straight”. Furthermore, there was more variability in the arousal patterns of bisexual-identified men, compared with other men. Based on their physiological sexual arousal, bisexual men appear to be a more diverse group than men who identified as heterosexual or homosexual

The relationship between finger length ratio, masculinity, and sexual orientation in women: A correlational study.

Homosexual women are, on average, more masculine in their appearance and behavior than heterosexual women. We hypothesized that their masculinity was influenced by exposure to elevated levels of prenatal androgen during early development. We recruited 199 women (including 67 homosexual women) and measured their masculinity via self-report and observer ratings. Our measure of prenatal androgen exposure was the ratio of the index to ring finger (2D:4D), which is hypothesized to be lower in women exposed to elevated levels of androgens during prenatal development. Homosexual women were substantially more masculine than heterosexual women in both self-report and observer ratings. However, homosexual women neither had more male-typical finger length ratios, nor did their finger length ratios relate to their masculinity in any predicted direction. Thus, we found no evidence that increased prenatal androgen exposure influenced masculinity in homosexual women

Stability and change in sexual orientation and genital arousal over time

These studies, however, may be susceptible to the bias of self-report. The current study therefore examined self-reported sexual orientation in addition to an objective correlate: genital arousal to erotic videos showing males or females. For 52 men (19 heterosexual, 19 bisexual, 14 homosexual) and 67 women (31 heterosexual, 18 bisexual, 18 homosexual), these measures were taken twice, with approximately one year between sessions. For self-reported sexual orientation, women reported lower relative stability (weaker correlation) than men over time, even though women did not change more overall (no stronger mean difference) than men between sessions. Bisexual individuals reported lower relative stability and more mean change than heterosexual and homosexual individuals. For genital arousal, across all groups, response patterns were correlated over time to a similar extent and showed little difference between sessions. Moreover, change in self-reported sexual orientation did not correspond with the change in genital arousal, regardless of sex. Perhaps self-reports overestimate changes in sexual orientation, since these changes were not reflected in physiological sexual response

Robust evidence for bisexual orientation among men

The question whether some men have a bisexual orientation—that is, whether they are substantially sexually aroused and attracted to both sexes—has remained controversial among both scientists and laypersons. Skeptics believe that male sexual orientation can only be homosexual or heterosexual, and that bisexual identification reflects nonsexual concerns, such as a desire to deemphasize homosexuality. Although most bisexual-identified men report that they are attracted to both men and women, self-report data cannot refute these claims. Patterns of physiological (genital) arousal to male and female erotic stimuli can provide compelling evidence for male sexual orientation. (In contrast, most women provide similar physiological responses to male and female stimuli.) We investigated whether men who self-report bisexual feelings tend to produce bisexual arousal patterns. Prior studies of this issue have been small, used potentially invalid statistical tests, and produced inconsistent findings. We combined nearly all previously published data (from eight previous studies in the United States, United Kingdom, and Canada), yielding a sample of 474 to 588 men (depending on analysis). All participants were cisgender males. Highly robust results showed that bisexual-identified men’s genital and subjective arousal patterns were more bisexual than were those who identified as exclusively heterosexual or homosexual. These findings support the view that male sexual orientation contains a range, from heterosexuality, to bisexuality, to homosexuality