Sex therapy resembles learning much more closely than it does the ordinary chemical or surgical treatment of disease. Finally, the results of treating sexual disorders, like their diagnosis, are subjective, resting largely on the subject’s self-assessment.

- Thomas Szasz, Sex by Prescription: The Startling Truth About Today’s Sex Therapy (1980)

Were there no FBI experts in sexology who could have recognized that Judge Wachtler was manifesting advanced symptoms of the disease, erotomania, known also by the names of two French physicians, as the Clerambault-Kandinsky syndrome (CKS)? This malady had a name long before the media dubbed it fatal attraction.

- John Money, “Law and Order Is No Cure for ‘Sex Crimes,’” Newsday (November 24, 1992)

The psychologized vocabulary of moral evasion afflicts the whole society, but it is most corrosive when it lets the powerful off the hook. If a society is constantly being corrupted from the top, as ours is, it is crucial to our sense of justice that high-placed perpetrators be held accountable, and not disappear into the mists of psychology.

- John Leo, “Society’s Evasion of Moral Responsibility Begins at the Top,” The Daily Herald (December 1, 1992)

If Sol Wachtler had any malady when he committed the crimes, that malady was ‘lovesickness.’

- Steven Simring, qtd. in “Psychiatrist in Harassment Case Says Wachtler Wasn’t Psychotic,” The New York Times (July 25, 1993)

In trying to perform the impossible task of trying to understand the defendant, we cannot forget the victims. The defendant’s behavior was not an expression of love. It was an expression of anger, intimidation, and grotesque control.

- Judge Anne E. Thompson, qtd. by Diana Jean Schemo, in “A Prison Term of 15 Months for Wachtler: Ex-Judge Apologizes for Acts of Harassment,” The New York Times (September 10, 1993)

On September 9, 1993, Sol Wachtler, New York State’s former Chief Judge, received sentencing for 15 months in Federal prison over his threats to kidnap the 14-year-old daughter of American socialite Joy A. Silverman, Wachtler’s former lover. While he did plead guilty to threats of kidnapping Silverman’s daughter, Wachtler had engaged in far more. As reported by Diana Jean Schemo in The New York Times, such threats “grew out of a 13-month campaign of hang-up calls and anonymous, obscene letters.” Wachtler hoped that staging danger for Silverman would lead her to turn to him for help, potentially rekindling their ended four-year affair. In Schemo’s piece, we see the following details:

The bizarre drama featured Judge Wachtler taking on a role as a toothless Texas private eye named David Purdy, who stalked Ms. Silverman and threatened to release compromising photographs of her with her new companion.

Now, reading the above details, we may find Wachtler’s character resembling a badly written television show villain, typically represented in any crime drama. Linda Wolfe’s 1994 book Double Life: The Shattering Affair Between Chief Judge Sol Wachtler and Socialite Joy Silverman gives further details on the relationship. Though, for our purposes, we will not be looking as deeply into Wachtler, per se. Instead, we will be looking at John Money’s response to Wachtler’s case and what it can tell us about the medicalization of everyday life.

In a 1992 commentary for Newsday, John Money expressed his disappointment that, within the FBI, there were no “experts in sexology” who could identify Wachtler as “manifesting advanced symptoms of the disease, erotomania, known also by the names of two French physicians, as the Clerambault-Kandinsky syndrome (CKS).” To clarify, Gaëtan Gatian de Clérambault was a French psychiatrist, while Victor Kandinsky was a Russian one. In addition, as Money designates it “erotomania,” it would be called only Clérambault’s syndrome, not CKS, though contemporary psychiatry textbooks had typically conflated the named conditions without distinction.

Relative to Wachtler’s case, Money cites another comparable one: John Hinkley. Quoted by Money, Hinkley wrote a letter to Jodie Foster at 1:00 a.m. on March 6, 1981:

I love you six trillion times. Don’t you like me just a little bit? (You must admit I’m different). It would make all of this worthwhile.

Love here may be less true, taken at face value, than euphemistic for a kind of obsessional neurosis. In both its strong and weak forms, it can be harmful. Autopedophilia, for example, may be called the adult man’s “love” for children so much so that he wants to become a child to “love” for himself. Interviewed in 1991 for Paidika, subtitled “The Journal of Paedophilia,” Money said: 

Paedophilia should just be accepted for its etymological meaning, which is simply the love of children. Neither boys nor girls—just the love of children. It’s not the so-called parent-child, pairbonded love. It includes that and then adds the erotic love or lover bonding.

The reader may recognize the sleight of hand going on, where the naming—in this case, “pedophilia” as “the love of children”—presumes to encompass the reality. One must be critical of the word love as a euphemism for something else. As beauty lies in the eye of the beholder, so “love” for the man, what he calls it, could very well be hate for the object of his “love.” In Hinkley’s case, he attempted to assassinate President Ronald Reagan over “lovesickness” toward Foster as the object of his “love.” Without reading much further, Money supposes it was an attempt on Hinkley’s part to end his life in hopes of getting Foster’s attention. According to Money:

But even in less extreme cases, the Clerambault-Kandinsky syndrome of one-sided love is a devastating illness. It wreaks havoc on the lives of those whom it afflicts, young or old, male or female. Since it is not commonly understood to be an illness, however, those who come under its spell (or observe someone else under its spell) are more likely to report it to a police officer than to a physician.

Defined as some form of “illness,” then, deviant or socially unacceptable behavior comes to fall into an exclusively medical domain where it must be medicalized. “The law-and-order treatment of people with CKS,” Money adds, “is the equivalent of making it a crime to have epileptic spells.” Another psychiatrist named Steven Simring, as quoted in The New York Times, had referred to Wachtler’s disturbed behavior as “lovesickness,” in figurative terms, for he did not take it to be a literal illness necessitating medicalization. Comparing what the sexologist calls “erotomania” with epilepsy, a neurological disorder, seems odd at closer glance. There seems to be a disquieting use of illness as metaphor, claiming diagnosable “mental illness,” when highly subjective and even sometimes incorrect, to be analogous to physical illness.

In treating CKS and other bizarre forms of sexological behavior, medicine today is at the same stage as it is in treating cancer. In other words, it is much better than it used to be, but far from perfection. In some cases, especially for men, a course of hormonal treatment has proved effective. The hormone is an antiandrogen that reduces testosterone in the bloodstream to the prepubertal level, and has a tranquilizing effect on sexuality. In sexological patients who have a predisposition to major mood swings, treatment with lithium carbonate has been effective. Anxiety-prone patients may respond well to buspirone hydrochloride. Patients whose pathological sexual activity occurs in a trance-like state resembling a nonconvulsive type of epileptic seizure are candidates for antiepileptic medications. Still others respond well to antipsychotic medications. Irrespective of the medication, concurrent sexological counseling is always indicated. When there is a spouse or other sexual partner, then couple counseling is strongly advised and, when there is a family, family counseling.

4

Again, we may note Money’s repeated use of illness as metaphor in comparing the treatment of “CKS and other bizarre forms of sexological behavior” with “treating cancer.” Issues that arise from the subjectivity of diagnosis and treatment can always be written off as being “much better than it used to be, but far from perfection.” After all, Money’s experimental treatment on the Reimer twins as children resulted in both males dying by suicide in adulthood. It seems notable that much of the above paragraph, especially the end, basically functions as marketing for pharmaceuticals. Money had long supported the use of Depo-Provera, an anti-androgen that has been used in the presumed treatment of male sex offenders—similar to Lupron also being used for blocking puberty in “trans kids.”

In our time, the mass diagnosis—or, indeed, misdiagnosis—of varying forms of distress among teenage girls as “gender dysphoria” has, at its origin, the framing of incidents of individual distress and socially unacceptable behavior as “sexological ills.” Money nearly perfected this art, and other “professionals” have taken up his work in making “conditions” of any observable behavior, presumably requiring medicalization and therapy. Yet, as Thomas Szasz writes, “the results of treating sexual disorders, like their diagnosis, are subjective, resting largely on the subject’s self-assessment.”