To print this page, select "Print" from the File menu of your browser salon.com > Health & Body Sept. 20, 1999 URL: http://www.salon.com/health/col/bob/1999/09/20/dr_bob It might be the wiring Don't kill yourself trying to change your behavior. You may just have to learn to apologize. Plus: Is there such a thing as female ejaculate? - - - - - - - - - - - - By Robert Burton, M.D. How does a person change behavioral patterns that seem to crop up? Not big enough for psych counseling, yet annoyingly controlling over a general demeanor. For instance, chewing off fingernails or binging on food when you're not hungry, or snapping first and asking questions later. The problem lies in understanding the difference between learned behavior and biological traits that are primarily in the wiring. Imagine being a feisty, snappy vocal little Chihuahua and waking up one day and thinking that you'd be better off if you acted like the mellow, tail-wagging Labrador next door. You try. You bite your lip every time you want to jump up and bark. Eventually, if your owners live in Marin, Malibu or Westchester, you will end up on the dog shrink's couch. The shrink's first question: How long have you wanted to be a Labrador? And then he'll treat you for delusional behavior. Conversely, if you were a very smart, MIT-educated Chihuahua, had studied with Steven Pinker or others of the mind-as-composed-of-innate-modules school of thought, you might have asked yourself what part of your behavior was actually within your conscious control. As neurobiology advances, we have weekly discoveries of genes controlling everything from risk taking to neatness. Does that mean that a person without such genes will necessarily be a messy couch potato? Maybe not, but it definitely will make consistent neatness and adventure a major effort. Much of present-day neurosis stems from stewing over the difference between the way we are and the way we want to be. What makes the problem so much worse is that many of the traits we want to have aren't ours to have. What to do? No matter how great our attempts at self-awareness, we do not have access to the blueprints of our biology. But we need to know which of your habits are breakable. If you bite your nails, you can develop any of a number of cognitive retraining programs that might reset your circuitry to diminish the urge for nail biting. But you need to keep in mind that nail biting may be the outward manifestation of an inner nervousness that is less malleable. I have no way to know if this is true, but in my practice I have often felt that a certain innate anxiety seems to run in families. Go easy on yourself. Accept that nail biting and binge eating may be the manifestations of an inner urge not entirely within your control. Try cognitive-behavioral methods for change, but do not put undue pressure on yourself. As to snapping before asking questions: Recent neurophysiological studies show that emotional stimuli reach the unconscious areas of the brain (the limbic system of the temporal regions) before reaching conscious awareness. Your brain responds emotionally before it has a chance to think. Perhaps this is evolutionary, part of the fight-or-flight mechanism. But if the immediate response occurs before you are aware of the stimulus, it is difficult to conceptualize how to change your immediate response. This is the great value of the apology. Practice trying to restrain from speaking out. If you fail, practice the fine art of apology, self-deprecation and dirt-eating. And blame evolution. I am a 30-year-old woman in otherwise normal health but for the past year I've been experiencing an unusual, unpleasant problem. Occasionally, upon orgasm I urinate. It is not "female ejaculate." (My husband and I have determined that it is definitely urine.) It does not happen every single time, but it happens often enough to have me extremely embarrassed and worried. The amount can be substantial and it only happens during orgasm. It happens even when I pee before sex. Could this be a symptom of a medical problem? A confession. My formal sex education was primarily from Henry Miller's "Tropic of Cancer" and Terry Southern's "Candy," both anatomically inaccurate, but still highly recommended, if you think of sex as amusing. Terms like "honey pot" and "mountain of Venus" described the lay of the land, not clitoris and female ejaculate. In fact, I do not believe that clitoris was front and center in the American sexual liturgy until after man landed on the moon. After being eternally hidden behind a cloud bank of ignorance, the anatomic basis for female orgasm broke through into pubic consciousness. Happiness descended upon the land. Hallelujah, sang the newly ecstatic. Love was everywhere until, in an apparent final assault on pure pleasure, some Olympian sexpert urged us on to simultaneous orgasm. A generation of frustrated believers followed. It was sexual misunderstanding raised to cultural myth. Now comes a new threat to male-female bonding -- the female ejaculate. I am not talking about ordinary vaginal lubrication, but the forceful expulsion of fluid from the vagina during orgasm. This concept is as foreign to most of us as the clitoris was to the high school student in the '50s. I received several letters about this so I checked out the medical literature, found almost nothing, except one curious, offbeat article indicating that such ejaculate was biochemically similar to urine. Since mentioning this arcane fact in this space, there has been another flood of letters. But what is curious is that some women seem proud of their over-arching sexuality while others seem worried about the same phenomenon. And what this phenomenon would require is a contracting muscle (no problem there) and a volume of fluid sufficient to create an ejaculation. And there is the rub. No one seems to have discovered the fountain of Venus. So, I sit in awe and await further cards and letters. Maybe your e-mail will be sufficient to count as the mother of all surveys. Meanwhile, I would advise the above questioner not to be concerned over what appears to be nothing but a confusion in labeling. I am considered highly intelligent and well-read in a wide range of subjects, and I know several languages. But this intelligence has not helped much in my professional life. The same pattern keeps repeating and causing me to get fired from one job after another. I am blessed with self-confidence and don't feel the need to keep seeking validation from others. I am reserved, if not shy, by nature: Thus I am content to remain in solitude without hanging around and schmoozing with everybody else. I am schmooze-impaired. Others take this (unjustly) to mean that I am arrogant and rude. Actually, I always speak softly and gently, and give pleasant greetings to everyone. But I am not an ass-kisser. It's a shame that because of socialization problems, my considerable intellectual skills are going to waste. It seems there is no place in this world for quiet, reserved intellectuals, no matter how nice they are. I just turned 40 today and lost my job because of this. Happy birthday. And keep in mind that the 40th is often tough, a time for reflection as to where you've been and where you're going. Often pretty scary and unnerving. Years at the university have shown me how unhappy many are in corporate environments. So many of my medical colleagues stay on, year after year, grumbling and protesting, yet unsure what else to do. Among my writer friends, I do not know any that could tolerate the structure, rules and regulations of a corporation. They do not blame themselves for lower wages and tougher living conditions; they accept who they are. You raise the difficult problem of how to assess your own personality -- how to recognize that what you might consider an attribute, someone else might consider a flaw. I remember my department chairman of neurology once taking me aside and mentioning that I was not "a team man." What he meant as a criticism, I took as a compliment. As an example, I have two very stubborn, idiosyncratic, intelligent friends. One was a decent guy and a very promising student at my college. Because of something I'll never know about, he dropped out and has essentially had a vagabond life. The other persisted despite ongoing criticism and attempts to get him removed from the med school. He recently received the Nobel Prize. If only personality were a golf swing, you could go to a golf pro and have it analyzed by video camera, take apart the various components and see what, if anything, needed improvement. What is unclear from your letter is whether you are constitutionally incapable of working in the corporate world (ass-kissing is an acquired taste) or you are irritating your co-workers with a trait or habit of which you are not aware. I would recommend that you step back and take an objective look at why you've had such difficulty on the job. If you conclude that it really is the corporate world, then get some good career counseling. If you see that you might have a crimp in your personality, then find someone to work with you on it. Again: Happy birthday. salon.com | Sept. 20, 1999