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Scientific studies disprove the belief that the clitoris is the only source of women’s orgasms The clitorocentric dogma It’s a controversy that has lasted a hundred years. Since the earliest studies on sexology, it was believed that the clitoris is the only source of women’s orgasms. That vaginal penetration produced orgasms only by indirectly stimulating the clitoris. Hence, the best way for women to achieve orgasm is to directly stimulate the clitoris. For example, Alfred Kinsey wrote: “The walls of the vagina are ordinarily insensitive. […] All of the clinical and experimental data show that the surface of the cervix is the most completely insensitive part of the female genital anatomy.” (Kinsey et al., 1953). However, Kinsey’s own data contradict these claims: 84% of the women he examined responded to pressure in their cervix, and 93% of them responded to pressure in the anterior wall of their vagina (Jannini et al., 2012). The idea that the vagina is not a source of pleasure was based on the observation that the clitoris has many nerve endings, while the vagina has fewer. However, the vagina has enough nerve terminals to participate in the sexual response, particularly is its most deeper parts. Besides, abundant innervation of a particular area of the body does not correspond with the intensity of the sensation elicited there, but with its accuracy. For example, the fingertips and the tongue are profusely innervated because they have fine tactile discrimination. A few nerve fibers can produce a strong sensation (pain, itch or pleasure) if their signal is amplified in the nervous system. “Ipse dixit is a term labeling a statement, asserted but not proven, to be accepted on faith in the speaker. After Kinsey, Masters and Johnson, and Hite, this was the case of the clitorocentric dogma of female orgasm. The growing fruits of research will definitively change this paradigm.” (Jannini et al., 2012). Vaginal orgasms and the G-spot A large group of women felt that the idea that orgasms come from the clitoris represented their own experience. But an even larger group of women felt that it did not. They preferred to have orgasms from penetration. “However, women anecdotally describe two types of orgasm. The clitoral orgasm obtained by the direct external stimulation is described as “warm” or “electrical,” and the vaginal one, obtained by a vaginal penetration, is depicted as “throbbing,” “deep,” and generally stronger.” (Jannini et al., 2012). Thus, as noted in a recent article about the orgasm gap, 69% percent of women prefer to achieve orgasm through penetration. The paper cited (Blair et al., 2018) attributed this to normative sexual experiences that emphasize the male orgasm. This just parrots some political beliefs presented as feminist but that, in reality, invalidate the feelings of a large group of women, who are deemed to be sexually uneducated and brainwashed by the patriarchy. Indeed, as I discuss in another article, the existence of vaginal orgasms is mired in political ideology. The controversy started with the claim by Sigmund Freud that women who orgasm from clitoral stimulation were psychosexually immature. In 1976, Shere Hite responded with The Hite Report, in which she used informal questionnaires to claim that the best way for women to achieve orgasm was by touching the clitoris. This eventually grew into the belief that the majority of women do not orgasm from penetration, which I debunked in a previous article. Some sexologists, however, grabbed the banner of the vaginal orgasm. By listening to women, Beverly Whipple and John Perry rediscovered a sensitive area in the anterior wall of the vagina that swells when stimulated and can trigger orgasm and female ejaculation (Addiego et al., 1981). They named it the Grafenberg spot, or G-spot, after Ernst Grafenberg, who described it back in 1950. In fact, the G-spot was described in the Kamasutra and in Taoist texts of the 4th century, and in documents of many other civilizations (Korda et al., 2010). Questions that need to be answered Given the political controversy that surrounds this issue, is it possible to find scientific evidence that puts it to rest? Since orgasm is a subjective experience, to compare orgasms form different women, or induced by stimulating the clitoris or the vagina in the same woman, looks like an insoluble philosophical problem. The subjective feelings of orgasms are qualia, conscious experiences that cannot be conveyed from one person to another. However, scientists do not give up as easily as philosophers. They know that subjective experiences can be studied by investigating their neuronal correlates in the brain. What we need is factual evidence that answers the following questions: Can vaginal stimulation alone trigger an orgasm? Is this orgasm different from the clitoral orgasm? There are other related questions, such as whether the G-spot really exists, what is its anatomy and function, the nature of female ejaculation, and the relationship of the internal clitoris with the vagina. However, in this article in will focus on these two questions. They would establish whether vaginal orgasms are real and different from clitoral orgasms. Functional magnetic resonance imaging (fMRI) Today, scientists have several methods to study the activity of the brain in awake humans while they engage in different activities. They include electroencephalogram (EEG), positron emission tomography (PET) and fMRI. fMRI is used to determine what parts of the brain are active in different conditions. When an area of the brain has increased neuronal activity, its cells consume more oxygen. This prompts an increased blood flow to this area to replenish the oxygen called the hemodynamic response. fMRI measures changes in the magnetic properties of the iron atoms in the molecule of hemoglobin of the blood when they bind and unbind oxygen. The activity of brain areas is then mapped in three dimensions. Unlike EEG, fMRI can image the activity of deep brain areas. Women with spinal cord section have orgasms An opportunity to answer the first question presented itself when doctor Beverly Whipple encountered the case of women with complete spinal cord transections. The nerves that gather sensations from the genital area - pelvic, pudendal, hypogastric and lower splanchnic - carry information to the brain by entering the spinal cord at its lower segments, and then running upwards in the spinothalamic tract. If the spinal cord is severed above these lower segments, the spinothalamic tract is interrupted. All sensations below the waist, including those from the clitoris, the vagina and the anus, cannot reach the brain. Therefore, women with complete spinal cord injuries should not be able to feel their genitals and, consequently, to have orgasms. And yet, they do! They can feel when they menstruate and when their vaginas are penetrated. They experience pleasure in their vaginas, sometimes leading to orgasm. But they cannot feel their clitoris. How is this possible? Their gynecologists told them that they were experiencing phantom pleasure, something similar to the phantom sensations that amputees feel as coming from their missing limbs. But these women were experiencing pleasure from real penises and dildos, not phantom ones. fMRI of women with spinal cord sections Doctor Barry Komisaruk hypothesized that the sensations from their vaginas was carried by the vagus nerve. Unlike the sensory nerves I mentioned above, the vagus carries sensation from the internal organs directly to the brain, not through the spinal cord. ‘Vagus’ means ‘errand’ in Latin, because this nerve meanders inside of the body, carrying information back and forth from the heart, stomach, intestines and other internal organs to the brain. The bodies of the neurons that send axons in the vagus nerve are in the nodose ganglion, situated near the base of the skull. The enter the brain in the nucleus of the solitary tract (NTS). To test this hypothesis, Komisaruk, Whipple and their collaborators carefully selected five women with complete spinal cord transections (Komisaruk et al., 2004; Komisaruk and Whipple, 2005). These unfortunate women had spinal cord injuries from bullet wounds, which provide a clean cut of the spinal cord without the messy compression produced by car crashes, falls and similar types of accidents. Compression injuries of the spinal cord make it difficult to determine if all the axons in the spinothalamic tract have been severed. Another criterion to select the women for this study was that their spinal cord injury was above the T10 (tenth thoracic vertebra) spinal segment, to completely rule out that some branches of the genital nerves could enter the spinal cord above the injury. First, Komisaruk and collaborators used fMRI to determine if the NTS was activated when these women self-stimulated their vagina with a dildo. If that happened, that would mean that the sensation from the vagina was carried by the vagus nerve and entered the brain at the NTS. Sure enough, the lower part of the NTS was activated during vaginal stimulation in all five women. The NTS is organized forming a rudimentary map of the body, so its upper part correspond to the mouth and its lower part to the genitals. When the women were given a beverage with a strong taste to provide a sensation to the mouth, the upper part of the NTS was activated. This confirmed the hypothesis that the vagus nerve carries information from the vagina to the brain independently of the spinal cord. As it turns out, the supposedly scant innervation of the vagina serves a powerful function. Vaginal orgasms: brain fMRI of women with spinal cord injury Three of the five women in this study experienced orgasms during vaginal self-stimulation. This offered an opportunity to use fMRI to determine the areas of the brain activated by vaginal orgasms. Since the orgasms in these women were triggered exclusively from the vagina, this may throw some light on the second of the questions above: are vaginal orgasms different from clitoral orgasms? The areas of the brain activated by vaginal orgasms were consistent amongst the three women. Here is a list, with a short explanation of the function of each area. Amygdala. This is the part of the brain that mediates fear and anxiety, but it is also involved in a range of other emotions, like anger and aggression. In one of the women who had multiple orgasms lasting 3 minutes, the amygdala was active only for these 3 minutes and not for the subsequent 2 minutes of fMRI recording. Nucleus accumbens. You may have heard that dopamine release occurs in the brain when we experience pleasure. What actually happens is the activation of a ‘reward pathway’ that goes from the ventral tegmental area (VTA) to the nucleus accumbens, where it releases dopamine. Opioids, nicotine, cocaine, amphetamine and other addictive drugs activate this pathway, leading to dependence. This study showed activation of the nucleus accumbens during vaginal orgasms, which is to be expected from a pleasurable stimulus. This doesn’t mean, however, that orgasms are addictive. Insular cortex. ‘Insula’ means ‘island’ in Latin. This is an area of the cortex that forms an island of grey matter inside the white matter of the cerebral hemispheres. The insula is associated with all kinds of emotions. It mediates the emotional component of pain that tells us that we don’t like it. It is also involved in itch, disgust, anger, trustworthiness and (of course!) sexual pleasure (Craig, 2002). Anterior cingulate cortex (ACC). The cingulate cortex is a part of the cortex located deep inside the fissure that separate the two cerebral hemispheres. It’s one of the targets of the dopamine pathways from the VTA. The ACC, together with the insula and the somatosensory cortex, is at the end of the neural pathways that transmit pain. Its main function is to motivate us to make decisions. Hippocampus means ‘sea horse’ in Latin because it is shaped like this peculiar fish. It is essential for memory formation and the storage of short-term memories. Its links to the amygdala mediate a role in emotions. Cerebellum. This ‘little brain’ in the back of the skull modulates muscular contraction during movement. Its activation during orgasm may reflect the general muscular contractions and spasms during orgasms. Paraventricular nucleus of the hypothalamus. The hypothalamus is the part of the brain that modulates the functions of the body, producing feelings like thirst, hunger and sexual desire. It is located above the pituitary gland, by which it controls the endocrine system that releases hormones in the body. Thus, the hypothalamus-pituitary-adrenal (HPA) system controls the release of adrenaline and cortisol during stress. The fact that the paraventricular nucleus is activated during vaginal orgasms is very important because it releases oxytocin into the blood. This mediates the contraction of the nipples, the uterus and the vagina during orgasm and could be responsible for the bonding effects of sex (Stein, 2009). The sequence of activation of these brain areas is as follows. The amygdala and the insula are activated during the buildup of orgasm. Then the ACC enters the game. At the point of orgasm, the nucleus accumbens, the paraventricular nucleus of the hypothalamus and the hippocampus become activated, while the activation of the insula increases. Clitoral orgasms: brain fMRI of healthy women In a later study (Wise et al., 2017), the group of Komisaruk studied ten healthy women while they reached orgasm through clitoral stimulation, given by themselves or by a partner. Since they found no differences between self-induced and partner-induced orgasms, they pooled both sets of data and analyzed them together. Unlike the study in women with spinal cord injury, the objective here was to get a fine time resolution of the events before, during and after orgasm. I wanted to compare this study with the one on vaginal orgasms to see if there are differences in brain activation between them. Disappointingly, the authors did not do that in their paper. Hence, the conclusions I draw below are mine and not the authors’. Not surprisingly, clitoral orgasms activated some of the same regions activated by vaginal orgasms. These include the amygdala, nucleus accumbens, insula, anterior cingulate cortex, hippocampus and cerebellum. But, in addition, there were brain regions not mentioned in the study on vaginal orgasms: the operculum, parts of the frontal cortex and the right angular gyrus. The operculum is the area of the cortex surrounding the invagination that produces the insula. It is the main area of the brain activated in masochists when they are shown images of masochistic pain (Kamping et al., 2016). It mediates emotional responses to pain and pleasure. The frontal cortex is the area of the brain involved in complex decision-making, setting goals and behavior inhibition. In particular, the study with clitoral stimulation mentions the orbitofrontal cortex, which is a “hedonic hot spot.” The angular gyrus is involved in processing visual information, particularly during reading and other spatial cognition taaks. It is also involved in memory retrieval, attention and theory of mind (the capacity to imagine the mental states of other people). The angular gyrus in the right hemisphere is associate with out-of-body experiences, which the authors relate to the altered states of consciousness produced by orgasm. One potentially interesting difference between clitoral and vaginal orgasms is in the hypothalamus. While vaginal orgasms in women with spinal cord transections activated the paraventricular nucleus of the hypothalamus, clitoral orgasms recruited the mammillary bodies instead. The mammillary bodies are involved in episodic memory. Since the paraventricular nucleus drives the release of oxytocin in the blood, this could mean that vaginal orgasms release more oxytocin and therefore leads to stronger pair-bonding. Mental orgasms Some women can also have orgasms with mental imagery alone, without any genital or body stimulation (Whipple et al., 1992). fMRI showed that these orgasms activated the nucleus accumbens, anterior cingulate cortex, hippocampus and the paraventricular nucleus of the hypothalamus, but not the amygdala or the cerebellum (Komisaruk and Whipple, 2005). This indicates that those four brain regions are specifically related to orgasm, while the amygdala may be related to genital sensation and the cerebellum to muscle tension. The great variety of orgasms The studies on women with spinal cord injury provide compelling evidence that exclusive stimulation of the vagina and the cervix can trigger orgasm. This indicates that women can orgasm from vaginal penetration alone. Whether the internal clitoris, the Skene glands, or the innervation of the vagina and the cervix are the trigger of these orgasms is an interesting question to be addressed in future articles. There is also some evidence that vaginal orgasms and clitoral orgasms activate a few different brain areas. This supports the experience of many women, who say that orgasms triggered from the clitoris and the vagina feel different. I am not saying that there are only two different types of orgasms, clitoral and vaginal. In fact, Komisaruk and his collaborators emphasize in their studies on vaginal orgasms that they are triggered by stimulating the vagina and the cervix, which some women consider different types of orgasms. Orgasms can also be elicited by anal intercourse. They feel different because the anus is a sensitive erogenous zone. Given that only two thin membranes separate the rectum from the vagina, anal intercourse stimulates the anterior wall of the vagina, which can trigger an orgasm in much the same as vaginal intercourse. Orgasms in women can also be triggered without any genital stimulation at all: by stimulating the nipples, by spankings and other forms of BDSM play, by exercise (Herbenick et al., 2021), and by mental imagery (Whipple et al., 1992). This shows that orgasms happen in the brain. Whether the stimulus comes from the clitoris, the vagina, the anus or other part of the body seems to be quite incidental. At least, in women. Could men also enjoy this wonderful variety of orgasms? Some men claim that they can orgasm from stimulating their prostate through anal intercourse, dildo insertion or pegging. Perhaps prostate orgasms are the male equivalent of the female vaginal orgasms. But, are men also able to climax from spankings, exercise or mental imagery? Perhaps there is an orgasm gap, but in the opposite direction of the usually proposed. While it is true that some women have difficulty achieving orgasm, others are able to climax repeatedly and with extraordinary intensity. They would make any man envious. Why is this important? We may have been doing sexual education wrong by teaching women that climax should be achieved primarily by stimulating their clits. A study using five national sex surveys in Finland (Kontula and Miettinen, 2016) found that the percentage of young women (18-34 years old) that reached orgasm during sexual intercourse decreased from 1999 to 2015. Ability to reach orgasm did not improve from the 70s to the present in any of the age groups. This is surprising, given that Finland is ranked as one of the leading countries in gender equality in the world, and that substantial advances have been made is the sexual education and liberation of women since the 70s. Why hasn’t this translated in a better ability of women to climax during sex? It is possible that this was caused by an increase in stress and mental pressures as women incorporated into the workforce and took over more demanding careers. However, the findings in the study with Finnish women point at causes directly related to sex. Surprisingly, women who masturbated more often had less frequent orgasms during intercourse than women to masturbate less often. This contradicts the common assumption that masturbation is the best way for women to teach themselves to climax. Perhaps too much emphasis on clitoral stimulation locks women into a single pathway to reach orgasm, instead of encouraging them to explore other erogenous zones and their great variety of possible orgasmic experiences. In this they have become similar to men, who have been taught to look at their penises as their only source of sexual pleasure. Here are a few things that contributed to frequent orgasms during intercourse: The importance given to orgasms. High sexual self-esteem (“I am good in bed”). High sexual desire and sexual motivation. Open and easy sexual communication with their partner. Ability to focus in the moment and mindfulness during sex. An appreciation for sex. Good sexual techniques. A talent to be aroused by sexual stimulation. Love-making sessions that are frequent and long-lasting. Novelty. Sexual fantasies and role-playing. Anal stimulation. Letting go of control. “Women need to be encouraged to feel good about the variety of ways they experience sexual pleasure, without setting up specific goals (such as finding the G-spot, experiencing female ejaculation, or experiencing a vaginal orgasm). Healthy sexuality begins with acceptance of the self, in addition to an emphasis of the process, rather than the goals, of sexual interactions.” Dr. Beverly Whipple (Jannini et al., 2012). References Addiego F, Belzer EG, Comolli J, Moger W, Perry JD, Whipple B (1981) Female ejaculation: A case study. The Journal of Sex Research 17:13-21. Blair KL, Cappell J, Pukall CF (2018) Not All Orgasms Were Created Equal: Differences in Frequency and Satisfaction of Orgasm Experiences by Sexual Activity in Same-Sex Versus Mixed-Sex Relationships. The Journal of Sex Research 55:719-733. Craig AD (2002) How do you feel? Interoception: the sense of the physiological condition of the body. NatRevNeurosci 3:655-666. Herbenick D, Fu T-c, Patterson C, Dennis Fortenberry J (2021) Exercise-Induced Orgasm and Its Association with Sleep Orgasms and Orgasms During Partnered Sex: Findings From a U.S. Probability Survey. Arch Sex Behav 50:2631-2640. Jannini EA, Rubio-Casillas A, Whipple B, Buisson O, Komisaruk BR, Brody S (2012) Female orgasm(s): one, two, several. The journal of sexual medicine 9:956-965. Kamping S, Andoh J, Bomba IC, Diers M, Diesch E, Flor H (2016) Contextual modulation of pain in masochists: involvement of the parietal operculum and insula. Pain 157:445-455. Kinsey AC, Pomeroy WB, Martin CE, Gebhard PH (1953) Sexual behaviour in the human female. Philadelphia: WB Sanders Co. Komisaruk BR, Whipple B (2005) Functional MRI of the brain during orgasm in women. Annu Rev Sex Res 16:62-86. Komisaruk BR, Whipple B, Crawford A, Liu WC, Kalnin A, Mosier K (2004) Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. Brain Research 1024:77-88. Kontula O, Miettinen A (2016) Determinants of female sexual orgasms. Socioaffective neuroscience & psychology 6:31624-31624. Korda JB, Goldstein SW, Sommer F (2010) The History of Female Ejaculation. The journal of sexual medicine 7:1965-1975. Stein DJ (2009) Oxytocin and vasopressin: social neuropeptides. CNS spectrums 14:602-606. Whipple B, Ogden G, Komisaruk BR (1992) Physiological correlates of imagery-induced orgasm in women. Arch Sex Behav 21:121-133. Wise NJ, Frangos E, Komisaruk BR (2017) Brain Activity Unique to Orgasm in Women: An fMRI Analysis. The journal of sexual medicine 14:1380-1391. Copyright 2023 Hermes Solenzol.

Shame and pride produce an anxiety that can be relieved by sexual dominance or submission While sadomasochism can be justified by the ability of pain to enhance pleasure and by the happiness brought by the endorphin high, the dominance/submission side of the BDSM equation is not so easily explained. The standard answer to the question of why do we like to submit to or to dominate is still “because you are sick”. All the efforts of the BDSM community had barely managed to keep sadomasochism out of the psychology diagnosis books. We heartily reject the idea that the desire to submit or dominate comes from childhood trauma, but when asked for alternative explanations we have nothing to offer. The few studies that have been done revealed that people who practice BDSM are actually psychologically healthier than the average. We just don’t know why. Do we eroticize what we fear? One possible explanation is that we eroticize what scares us. For example, in his podcast, Dan Savage often talks about how self-assured gay men like to be called “faggots” during sex. Or how feminist women, who are all about female power in real life, like to be dominated in bed. This makes sense: after all, fear releases adrenaline, which is a great aphrodisiac. However, this idea takes us back to the trauma paradigm: we were scared by early events in our life and now we exorcise them by reproducing them in a controlled environment. I don’t find that explanation satisfactory. After all, most submissives are not scared of submitting, they see it as sexy and liberating. And Doms are certainly not scared of what they do. Shame and pride A few years ago, I found an explanation for dominance-submission that presents it as a healthy response to the normal pressures of life. It is based on two opposite emotions that play a large role in our lives: shame and pride. Shame is one of our most powerful emotions, so powerful that it can lead to suicide. We all have heard stories of how bullying or persecution for being gay lead teenagers to kill themselves. Shame is an emotion that seems to be uniquely human (it is still hotly debated whether dogs feel shame) and yet seems to be deeply rooted in physiological responses. It causes blushing, which is an involuntary vascular response, and a specific body position consisting of dropping the head and hunching the shoulders. It also leads to immobility and withdrawal. The opposite of shame, pride, makes us lift our head, engage socially and feel full of energy. It is likely that pride activates the reward system in our brain linking the ventral tegmental area (VTA) of the striatum with the nucleus accumbens, releasing dopamine there. This is the same response produced by addictive drugs like heroin and cocaine. It makes us feel good and to want to repeat the behavior that triggered this response. The evolutionary logic of shame and pride All this shows that shame and pride are an essential part of human nature. They likely evolved as indicators of social status: shame warns us that our social status has declined while pride tells us that our social status has increased. In the tribes in which we lived for hundreds of thousands of years before modern societies were formed, social status was a matter of life and death. High social status gave you preferential access to food, shelter, power and sex. Low social status could make you a castaway, condemning you to an almost certain death. According to the reasoning used by evolutionary psychology, we could see why this is so. The biggest advantage we humans have over other animals is our ability to cooperate. In a tribe, everything is shared: food, protection against predators, shelter and the care of children. This creates one strategic problem: how to avoid cheaters. The guy that falls behind in the hunting party, the gal that has a siesta instead of gathering berries, they would have an evolutionary advantage because they get the same amount of food with less energy expending. Computer models have shown that genes for free-riding would take over the population in just a few generations. We would have evolved back to the kind of societies that chimps have, where no food is shared (other than with infants) and there is very little cooperation. That is why we developed powerful drives to eliminate cheaters. One of them is called “altruistic punishment”: the desire to punish people that we see as behaving in an unethical way, even if that takes a lot of energy and it doesn’t benefit us personally (hence the qualifier “altruistic”). It is based on emotions like indignation and self-righteousness. However, if this was the only way to eliminate cheaters, we would have societies with lots of internal conflicts. And, while this strategy punishes cheaters, it does not reward cooperators. Thus, the emotions of shame and pride evolved as internal motivators for cooperative behavior. When you do something against the common good, or when you fail to do your duty, people around you will make you feel ashamed. Conversely, when you achieve something that increases the common good, you are praised and you feel pride. Guilt is the other emotion for social control. However, the key difference between guilt and shame is that you feel guilty when you do something bad, whereas shame comes also from failing to do something good. Guilt tells us “you are bad”, while shame tells us “you are not good enough”. Why is sex shameful? But then, why is sex shameful? Is this largely a cultural thing, driven by religion and cultural norms? Well, not completely. In practically all cultures, sex is done in private, and nakedness (at minimum, exposing the genitals) is also a universal taboo. Well, if shame is linked to social status, so is sex. And not just in humans, but also in our primate cousins. In chimp troupes, when a female comes in heat almost every male gets to mate with her, but it is the alpha male who decides in what order and how often. In some monkeys, mating with high-ranking individuals increases social status, regardless of whether you are male or female. And in many monkey species, sex is used to assert dominance: low-ranking individuals offer their backsides to appease dominant ones and avoid being beaten. And yes, they do get fucked. And then there are the bonobos, famous for being total sluts. They use sex for bonding and for resolving social conflicts. They are promiscuous, pan-sexual, and do manual, anal and oral, not just penis-in-vagina. Therefore, even in our primate ancestors sex has been hijacked away from mere procreation to be used for bonding and to establish social status. Sex can express different things, not just love and bonding, but also dominance. Ultimately, the pleasure (and sometimes pain) associated with sex makes us feel vulnerable and exposed. Because of that, getting fucked implies a loss of face and being put in a submissive role. That is probably what causes its association with shame. Shame and pride in modern society Managing shame and pride was a relatively simple matter in the tribal societies of our evolutionary environment, but it became hugely complicated once the agricultural revolution took place 10,000 years ago. Before, if you hunted a nice prey, scared the bear away or gathered a basketful of berries you could feel proud and enjoy the appreciation of your fellow tribe people. Afterward, the limits of what you could achieve were vastly expanded: you could own land and animals, you could command workers and soldiers. You could never be successful enough to feel proud; there was always somebody who was better than you. And there were also plenty more opportunities to fail and feel ashamed. In our modern industrial societies, things are becoming even direr. Since childhood, we are taught to be proud of our successes and ashamed of our failures. “The sky is the limit!” we are told, and it really is. There are so many things at which we can succeed or fail! Reading, math, sports, arts, getting money, being famous… We interiorized these cultural imperatives, so that nobody needs to tell us anymore; we are our harshest judges. Somehow, our failures seem to count more than our successes. We can never achieve enough; we live in a state of constant craving for success. Ultimately, the twin emotions of shame and pride join forces to bring about our sense of self-worth, our self-esteem. Over time, they create an internal narrative of who we are: our ego, which we try to protect by propping up our pride and hide our shame. This creates a strong psychological tension. It makes us unhappy because we are never enough. We need to keep running the rat race away from failure and shame and in search of success and pride. Dominance-submission relieves the anxiety produced by shame This is where dominance-submission can come to our rescue by providing a way out of the rat race. This is how I think it works… The submissive gives up all social status by assuming the lowest possible rank. On top of that, obeying takes away the pressure to make the right decisions. Conversely, high status is granted to the Dominant without the effort that it normally entails. He or she gets to feel all-powerful for free. Success and failure are taken out of the equation: the submissive handles power to the Dominant simply because this is mutually beneficial. This ties to sex because of the ability of sex to symbolize social status. The submissive is used sexually by the Dominant and, paradoxically, this is perceived as liberating because it breaks the interior psychological tension created by shame and pride. Shame is embraced, and this frees us from the struggle. This is why humiliation is perceived as liberating by the submissive. Moreover, since internalized repression is a barrier to sexual pleasure, when the constraints created by internalized cultural norms are broken by the D/S power exchange, pleasure and orgasm become easier to achieve. Conclusion In conclusion, dominance-submission unleashes powerful emotions anchored deep in our evolutionary past. This serves to de-program reactions that society has taught us since childhood and that have become so ingrained that we cannot escape them even when we realize how unhappy they make us. That is why we perceive submitting as so liberating and empowering.

The neuropeptides oxytocin and vasopressin drive altruistic punishment, social bonding and monogamy The faithful prairie vole and the promiscuous montane vole Let me introduce you to the prairie vole, a small mammal that has attracted considerable attention in scientific circles. They are rodents with short tails and small ears that are found in North America, from west of the Rockies to east of Appalachia. What is so notorious about them is that they are strictly monogamous: a male and a female form a bond for life. However, a very close cousin of the prairie vole, the montane vole, is completely promiscuous. Males mate with multiple females if they can. Females become fertile in the proximity of males. Oxytocin induces monogamy Some scientists decided to find out how the brain of the prairie vole is different from that of the montane vole (Young et al., 2011). They found that female prairie voles have more oxytocin and oxytocin receptors in the nucleus accumbens and the amygdala, which are areas of the brain important in emotions and decision-making. Oxytocin was first recognized as the peptide that induces uterine contractions during labor. More recently, it has been shown to be crucial for many forms of social bonding. For example, it increases in the blood when a dog is being petted, in both the dog and the human! Back to our friends the voles… scientists genetically modified montane voles by increasing the production of oxytocin in the brain. These montane voles became as monogamous as their cousins the prairie voles. What about the male voles? Well, in them monogamous behavior seems to be determined by another peptide, vasopressin (Gobrogge et al., 2009; Donaldson et al., 2010), which is quite similar to oxytocin. Altruistic punishment Oxytocin also attracted the attention of researchers of a totally unrelated field: economics. Some unconventional economists decided to put to the test a basic belief of capitalism: that market decisions are rational. They found that they are not. Human transactions are based more on trust and empathy that on dispassionate decisions on what is to lose and what is to gain. For example, in all cultures, people engage in something called altruistic punishment (Fehr and Gachter, 2002): they will go at great length to punish individuals that they perceive as being unfair and untrustworthy. The ultimatum game One way they determined this was with an experiment called the ultimatum game. There are two players. Player one is given a sum of money, say $10, of which he has to offer a certain amount to player 2. If player 2 takes the offer, both get to keep the agreed amount of money. However, if player 2 rejects to offer, both of them lose the money. The results of the ultimatum game are consistent between people of all sexes, religions and cultures. Below a certain amount (about $3-4 if the total amount is $10), player 2 decides that player 1 is not being fair and rejects the offer. That means that he is willing to lose 2, 3 or even 4 bucks to punish player 1 for being greedy. That’s why this is called “altruistic punishment”. When levels of oxytocin were increased, player 1 tended to be more generous in his monetary offers. Testosterone did the opposite of oxytocin (Burnham, 2007; Zak et al., 2009; Dreher et al., 2016). In fact, men are more inclined to altruistic punishment than women (Zheng et al., 2017). The female sex hormone estradiol had more complex effects. When offers in the ultimatum game were framed as fair, estradiol increases acceptance in men but reduced acceptance in women (Coenjaerts et al., 2021). Oxytocin, vasopressin and social bonding Oxytocin and vasopressin are now called the social hormones because they strongly influence social behaviors like bonding, trust and empathy (Stein, 2009). However, we should not fall into the simplistic belief that oxytocin makes us good. It has been observed that this neuropeptide is involved in some nasty human behaviors, like xenophobia and intolerance. This is because oxytocin increases both bonding with the members of our group and exclusion of anybody perceived as a stranger (Radke and de Bruijn, 2012). Monogamy entails both feeling close to our spouse and rejecting member of the opposite sex that are not our spouse: bonding and exclusion. On the other hand, the role of vasopressin in monogamy may be related with possessiveness and territoriality: the male perceives the female as part of his territory and defends her as such. Likewise, altruistic punishment has a good side - like deterring crime-, and a bad side -like road rage and other confrontation when we think that somebody is taking advantage of us. References Burnham TC (2007) High-testosterone men reject low ultimatum game offers. Proceedings Biological sciences 274:2327-2330. Coenjaerts M, Pape F, Santoso V, Grau F, Stoffel-Wagner B, Philipsen A, Schultz J, Hurlemann R, Scheele D (2021) Sex differences in economic decision-making: Exogenous estradiol has opposing effects on fairness framing in women and men. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 50:46-54. Donaldson ZR, Spiegel L, Young LJ (2010) Central vasopressin V1a receptor activation is independently necessary for both partner preference formation and expression in socially monogamous male prairie voles. Behav Neurosci 124:159-163. Dreher JC, Dunne S, Pazderska A, Frodl T, Nolan JJ, O'Doherty JP (2016) Testosterone causes both prosocial and antisocial status-enhancing behaviors in human males. Proc Natl Acad Sci U S A 113:11633-11638. Fehr E, Gachter S (2002) Altruistic punishment in humans. Nature 415:137-140. Gobrogge KL, Liu Y, Young LJ, Wang Z (2009) Anterior hypothalamic vasopressin regulates pair-bonding and drug-induced aggression in a monogamous rodent. Proc Natl Acad Sci U S A 106:19144-19149. Radke S, de Bruijn ER (2012) The other side of the coin: oxytocin decreases the adherence to fairness norms. Frontiers in human neuroscience 6:193. Stein DJ (2009) Oxytocin and vasopressin: social neuropeptides. CNS spectrums 14:602-606. Young KA, Gobrogge KL, Liu Y, Wang Z (2011) The neurobiology of pair bonding: insights from a socially monogamous rodent. Front Neuroendocrinol 32:53-69. Zak PJ, Kurzban R, Ahmadi S, Swerdloff RS, Park J, Efremidze L, Redwine K, Morgan K, Matzner W (2009) Testosterone administration decreases generosity in the ultimatum game. PLoS One 4:e8330. Zheng L, Ning R, Li L, Wei C, Cheng X, Zhou C, Guo X (2017) Gender Differences in Behavioral and Neural Responses to Unfairness Under Social Pressure. Scientific reports 7:13498.

Memory formation, inhibition of pain and anxiety, and other interesting facts about the brain’s own cannabinoids This is the second in a series of articles about the neuroscience of cannabis: Cannabinoid Receptors Cannabinoids and Endocannabinoids THC (trans-delta-9-tetrahydrocannabinol) THC, or trans-delta-9-tetrahydrocannabinol, is the main psychoactive compound in the cannabis or marihuana plants, Cannabis sativa and Cannabis indica - it is still debated if these are one or two species. In fact, the cannabis plant contains at least 113 cannabinoids, including THC, cannabidiol (CBD), cannabigerol (CBG), cannabinol (CBN) and trans-delta-9-tetrahydrocannabivarin (THCV) (Pertwee, 2008; Bow and Rimoldi, 2016). It is still unknown how many of these cannabinoids are psychoactive or able to bind to the cannabinoid receptors: CB1, CB2 and GPR55. Keep in mind that a compound may not be psychoactive and yet bind to the cannabinoid receptors, acting at only one of them, or behaving as an antagonist or inverse agonist. This explains why different strains of cannabis have different effects on the brain. The many cannabinoids that they contain modulate the actions of THC. THC is a partial agonist of CB1 and CB2 receptors. Full agonists are compounds that completely activate the G protein when they bind to the receptor. Partial agonists only partially activate the G protein associated with their receptor. Antagonists bind to the receptor and they do not activate the G protein at all. Since they occupy the agonist binding site, they prevent it from activating the G protein. Inverse agonists not only fail to activate the G protein, but decrease a basal level of G protein activation that the receptor has, called constitutive activity. Efficacy is the level of activation of the receptor produced by a partial agonist, which varies from 100% (full agonist) to 0% (antagonist). Inverse agonists have negative efficacies. Potency indicates the amount of a compound required to produce their full effect. It is measured as their concentration in water in moles per liter, or molar (M). Its numbers are usually micromolar (µM) - one millionth of molar or 10 to the -6 - or nanomolar (nM) - a thousandth millionth of a molar or 10 to the -9. It is expressed as the Ki, which is a chemical constant derived from the binding reaction of a drug to its receptor. The lower the Ki, the higher the potency. Compounds with smaller Ki will out-compete compounds with higher Ki at the receptor. Efficacy and potency are unrelated. A drug could have high potency by low efficacy - it would a potent partial agonist. Or it could have low potency and high efficacy - in which case it would be less potent full agonist. THC binds to CB1 and CB2 receptors with similar potencies (Ki of 41 nM at CB1 and 36 nM at CB2) (Pertwee, 2008), which are quite high compared to other cannabinoids. CBD (cannabidiol) CBD, or cannabidiol, is an antagonist of both CB1 and CB2 receptors (Pertwee, 2008). Since CB1 and CB2 receptors have constitutive activity (they are a bit active in the absence of an agonist), CBD could be an inverse agonist instead of an antagonist. This means that CBD would not only displace agonists - THC or endocannabinoids - from the receptors, but also inhibit their constitutive activity. CB1 receptors are the ones responsible for the psychoactive effects of THC, so CBD will decrease the effect of THC on these receptors. Therefore, the cannabis strains that have high CBD content produce milder psychoactive effects. CBD is also an antagonist of GPR55, the third cannabinoid receptor. This is why it can be used to treat epilepsy, as I will explain in another article. Endocannabinoids Endocannabinoids are compounds produced in the body that are able to activate cannabinoid receptors. That is, they are neurotransmitters that are the endogenous ligands of the cannabinoid receptors, just like the endorphins are the endogenous ligands of the opioid receptors. Endogenous means produced inside the body. The two main endocannabinoids are anandamide (N-arachidonoyl-ethanolamine) (Devane et al., 1992) and 2-arachidonoyl-glycerol (2-AG). They are synthesized from arachidonic acid, which is one of the lipids found in fat and in the cell membrane. Arachidonic acid is also converted into prostaglandins, which are inflammatory substances. The name ‘anandamide’ comes from the Sanskrit word Ananda, meaning joy and bliss. THC (Ki of 41 nM at CB1 and 36 nM at CB2) is more potent than anandamide (Ki of 61 nM at CB1 and 1930 nM at CB2) and 2-AG (Ki of 472 nM at CB1 and 1400 nM at CB2) (Bow and Rimoldi, 2016). The lower the Ki, the higher the potency. Compounds with smaller Ki will out-compete compounds with higher Ki at the receptor, so THC displaces the endocannabinoids from CB1 and CB2 receptors. Endocannabinoids are retrograde neurotransmitters Endocannabinoids are weird neurotransmitters. Everything about them is atypical. Instead of being stored and released from synaptic vesicles, like other neurotransmitters, endocannabinoids are synthesized on demand. Because they are soluble in lipids, they can just cross the cell membrane. No fusion of synaptic vesicles with the membrane is necessary. Endocannabinoids function as retrograde neurotransmitters: they carry signals from the postsynaptic terminals in the dendrites to the presynaptic terminals of axons. Postsynaptic terminals do not have synaptic vesicles, so this is consistent with the fact that they are not released from those vesicles. Depolarization of the postsynaptic dendrites triggers the entry of calcium, which activates the enzymes that make endocannabinoids. Then they cross the synapse, going backwards, to activate CB1 receptors at the presynaptic terminal. There, CB1 receptors decrease the release of GABA from inhibitory interneurons in the hippocampus (Wilson and Nicoll, 2001), a brain region critical for memory formation. This whole phenomenon is called depolarization-induced suppression of inhibition (DSI) and it is thought to be involved in synaptic plasticity and, therefore, the formation of memories. This is probably the reason why cannabis decreases memory. Later research (Iremonger et al., 2011) found that endocannabinoids released from neurons in the hypothalamus inhibit the release of glutamate, the main excitatory neurotransmitter. This is called depolarization-induced suppression of excitation (DSE). In these synapses, CB1 receptors prevent the development of long-term depression (LTD), a component of synaptic plasticity that makes synapses shrink. Interestingly, another retrograde transmitter in these synapses is dynorphin, and endogenous opioid, which activates presynaptic kappa opioid receptors. This shows how cannabinoid and opioid receptors can work together. Differences between THC and endocannabinoids THC is a partial agonist at both CB1 and CB2 receptors, while the endocannabinoids are full agonists. This means that the effect of THC depends on the amount of endocannabinoids that are being produced. If there are no endocannabinoids present, THC will behave as an agonist, activating CB1 and CB2 receptors, although not as effectively as the endocannabinoids. If there are endocannabinoids already activating the CB1 and CB2 receptors, THC will compete with them, displacing them from the receptors. Since THC is not as effective as the endocannabinoids, the end result will be a lowering of the activity of CB1 and CB2 receptors. This means that THC would act as an antagonist in this case. Different brain regions may be releasing different amounts of endocannabinoids, so that THC may increase cannabinoid receptor activity in some brain areas and decreasing it in some others. Endocannabinoids decrease anxiety For example, THC sometimes increases anxiety, explaining the paranoia often felt by people who consume cannabis. CB1 receptor antagonists also increase anxiety. In contrast, inhibiting endocannabinoid degradation decreases anxiety, as do synthetic full agonist of CB1 receptors (Patel and Hillard, 2006). Therefore, THC behaves like a CB1 antagonist, and not an agonist, when it comes to anxiety. Since the endocannabinoids are full agonists of CB1 receptors, they likely reduce anxiety. Whether THC does or does not trigger paranoia could depend on the amount of basal CB1 activation that a person is getting from their own endocannabinoids. If this sounds complicated, it’s because it is! It would be difficult to know where in the brain THC is activating cannabinoid receptors and where it is inhibiting them. What we need to remember, however, is that the effect of endocannabinoids may be quite different from the effect of taking cannabis. Pain inhibition by endocannabinoids The effects of endocannabinoids are rapidly terminated by two enzymes: fatty acid amide hydrolase (FAAH), which breaks down anandamide, and monoacylglycerol lipase (MAGL), which degrades 2-AG. Inhibiting FAAH (Ghosh et al., 2015) or MAGL (Ignatowska-Jankowska et al., 2015) decreases pain by allowing anandamide and 2-AG, respectively, to activate CB1 receptors for longer times. This shows that one of the effects of endocannabinoids in the central nervous system is to decrease pain. References Bow EW, Rimoldi JM (2016) The Structure-Function Relationships of Classical Cannabinoids: CB1/CB2 Modulation. Perspect Medicin Chem 8:17-39. Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, Gibson D, Mandelbaum A, Etinger A, Mechoulam R (1992) Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science 258:1946-1949. Ghosh S, Kinsey SG, Liu QS, Hruba L, McMahon LR, Grim TW, Merritt CR, Wise LE, Abdullah RA, Selley DE, Sim-Selley LJ, Cravatt BF, Lichtman AH (2015) Full Fatty Acid Amide Hydrolase Inhibition Combined with Partial Monoacylglycerol Lipase Inhibition: Augmented and Sustained Antinociceptive Effects with Reduced Cannabimimetic Side Effects in Mice. J Pharmacol Exp Ther 354:111-120. Ignatowska-Jankowska B, Wilkerson JL, Mustafa M, Abdullah R, Niphakis M, Wiley JL, Cravatt BF, Lichtman AH (2015) Selective monoacylglycerol lipase inhibitors: antinociceptive versus cannabimimetic effects in mice. J Pharmacol Exp Ther 353:424-432. Iremonger KJ, Kuzmiski JB, Baimoukhametova DV, Bains JS (2011) Dual Regulation of Anterograde and Retrograde Transmission by Endocannabinoids. The Journal of Neuroscience 31:12011-12020. Patel S, Hillard CJ (2006) Pharmacological evaluation of cannabinoid receptor ligands in a mouse model of anxiety: further evidence for an anxiolytic role for endogenous cannabinoid signaling. J Pharmacol Exp Ther 318:304-311. Pertwee RG (2008) The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol 153:199-215. Wilson RI, Nicoll RA (2001) Endogenous cannabinoids mediate retrograde signalling at hippocampal synapses. Nature 410:588-592.

The moving stories of the parents who gave their children cannabis to save their lives Today is April 20, a day when many people celebrate the wonderful properties of cannabis. For the last few days, I have been publishing one article a day about the neuroscience of cannabis and the endocannabinoid system: Cannabinoid Receptors (Medium) Cannabinoids and Endocannabinoids (Medium) Charlotte’s Web (this article) I heard the moving story of Charlotte Figi and Charlotte’s Web in the opening talk at the Winter Conference in Brain Research (WCBR), an annual meeting of neuroscientists held at a ski resort in North America. The talk was given by one of the scientists who found the connection between cannabis and epilepsy. Dravet Syndrome Dravet Syndrome is an epileptic disorder in children of genetic origin. The seizures are unpredictable, but often triggered by heat. It’s so severe that sometimes it can lead to death. It typically appears when the child is 6 months old and becomes worse as the child ages. Their seizures are terribly debilitating. Apart from them, the children affected show motor problems, autism, hyperactivity, impulsivity, somnolence and insomnia. These problems, together with the fact that a seizure represents a mortal danger, makes impossible for the child to attend school. He or she requires constant attention. It’s hard to imagine what it must be like to be the parent of a child with this disease. The story of Charlotte One of these children was a little girl named Charlotte Figi, who lived with her parents in Colorado. She had a twin named Chase, who was healthy. They were born on October 18, 2006. Charlotte’s seizures started when she was 3 months old. The first one lasted 30 minutes. Over the next few months, Charlotte had seizures lasting two to four hours. She was hospitalized, but the doctors could not find what was wrong with her. They put her on benzodiazepines and barbiturates, drugs that affect normal behavior and are addictive. Maybe it was these drugs, maybe it was the seizures, but by age two Charlotte started to decline cognitively. When she was two and a half, the doctors were finally able to diagnose her. She had the Scn1a mutation in the gene that encodes for the Nav1.1 voltage-gated sodium channel, one of the proteins in the axons of neurons that mediate action potentials. The Scn1a mutation is present in 80% of the cases of Dravet Syndrome. A Dravet specialist put Charlotte in a ketonic diet, because high levels of ketones suppress seizures. But they also caused bone loss and weakened Charlotte’s immune system. And then, after two years, the seizures came back. Charlotte’s father, Matt, looked on the internet for solutions. He found a boy in California with Dravet Syndrome who was being successfully treated with cannabis. At age 5, Charlotte couldn’t walk, talk or eat. She was having 300 seizures a week. She was taken to the hospital several times at the edge of death. Her parents hesitated to give her cannabis. Scientists had been cautioning parents that cannabis had nasty effects on the developing bodies of children, affecting the lungs, the heart and the brain. They consulted two more specialists. But, since Charlotte was at the edge of death, they finally decided to give her cannabis. They found a strain of marijuana called R4, which was low in THC and high on CBD. They gave it to Charlotte. Her seizures went away for seven days. The Charlotte’s Web strain of cannabis Looking for a consistent supply of cannabis with low THC and high CBD, Charlotte’s parents met the Stanley brothers, Joel, Jesse, Jon, Jordan, Jared and Josh, who were one of the largest legal growers of cannabis in Colorado. They had developed a strain of marijuana with low THC content and high in CBD. Because it didn’t get people high, they couldn’t sell it, so they initially called it Hippie’s Disappointment. When they saw what it did to Charlotte, they renamed it Charlotte’s Web, after the popular children’s book and little Charlotte. By age 6, Charlotte was thriving. She was walking and riding her bike. For the first time in years, her parents heard her laugh. Her seizures happened only two or three times per months, mostly while she slept. The Stanley brothers started the Realm of Caring Foundation, a non-profit dedicated to provide special strains of cannabis to children suffering from Dravet Syndrome, and also to adults suffering from Parkinson’s Disease, multiple sclerosis, epilepsy and cancer. It was 2012. Cannabis was already legal in many states of the USA, but moving it from one state to another was still illegal under federal law. That meant that you could not buy Charlotte’s Web outside Colorado. Parents of children with Dravet Syndrome starting moving to Colorado, so they could give their children the life-saving Charlotte’s Web strain of cannabis (Whiting et al., 2015). Unfortunately, Charlotte’s story doesn’t have a happy ending. She died of pneumonia with complications related to her disease on April 7, 2020. The neuroscience However, the connection between CBD and the mutated Nav1.1 sodium channel that causes Dravet Syndrome was still unknown. It was important to find it in order to give the treatment of children with cannabis a solid scientific basis. Besides, unraveling such a mechanism could lead to the discovery of other drugs to treat epilepsy. A team of scientist from the University of Washington in Seattle set to work on this (Kaplan et al., 2017). The first thing they did was to find a strain of mice with the mutation Scn1a, so that the mice would have the same defective Nav1.1 sodium channel as the children with Dravet Syndrome. These mice had epileptic seizures triggered by heat and deficits in social behavior that resemble autism. Previous work had shown that the Scn1a mutation caused the Nav1.1 sodium channels to stop working. These Nav1.1 channels are present in neurons that release the neurotransmitter GABA (GABAergic interneurons), which inhibits other neurons. When the GABAergic interneurons do not fire enough action potentials, they cannot oppose the build-up of excitation in the brain, and an epileptic attack ensues. When Kaplan et al. gave CBD to the mice with the Scn1a mutation, the severity, duration and number of their seizures were significantly decreased. CBD also reduced the autistic-like social behavior of the mutant mice. Moreover, CBD increased the excitability of the GABAergic interneurons in the hippocampus of the mutant mice, a part of the brain essential for memory formation and that is the origin of epileptic seizures. The effect of CBD was not mediated by CB1 receptors, which are the receptors responsible for the psychotropic effects of THC. Blocking CB1 receptors with their inverse agonist AM281 did not affect the increase in the activity of the GABAergic interneurons produced by CBD. However, blocking GPR55, the third cannabinoid receptor, with its antagonist CID16020046 increased the activity of the GABAergic interneurons, just like CBD. CBD did not increase the excitability of GABAergic interneurons over the increase already produced by the GPR55 antagonist. The investigators concluded that the effect of CBD was mediated by the cannabinoid receptor GPR55. What CBD does is to inhibit GPR55 because is an antagonist of these receptors. GPR55 receptors inhibit Nav1.1 channels. When CBD blocks GPR55, this restores the function of Nav1.1 channels, preventing the epileptic attacks in Dravet syndrome. Epidiolex: a new drug to treat Dravet Syndrome CBD is now sold as an oral solution by GW Pharmaceuticals as Epidiolex ™ (Gray and Whalley, 2020). It was approved by the Food and Drug Administration in 2018 to treat Dravet Syndrome and other epileptic disorders. In September 2019, it was approved for European consumption as Epidyolex. The parents of children with Dravet Syndrome no longer have to relocate to Colorado to buy Charlotte’s Web for their children. They can just give them Epidiolex. If President Nixon would not have declared cannabis a Schedule I drug with no therapeutic use for political reasons, the use of CBD to treat Dravet Syndrome may have been discovered much sooner. Perhaps even before Charlotte was born. References Gray RA, Whalley BJ (2020) The proposed mechanisms of action of CBD in epilepsy. Epileptic Disord 22:10-15. Kaplan JS, Stella N, Catterall WA, Westenbroek RE (2017) Cannabidiol attenuates seizures and social deficits in a mouse model of Dravet syndrome. Proc Natl Acad Sci U S A 114:11229-11234. Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, Lang S, Misso K, Ryder S, Schmidlkofer S, Westwood M, Kleijnen J (2015) Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. Jama 313:2456-2473.

A quick review of the receptors that mediate the effects of cannabinoids Cannabis or marihuana is one of the oldest known drugs. Its use goes back to the dawn of time. The cannabis plant has more than a hundred psychoactive compounds besides delta(9)-tetrahydrocannabinol (THC), the most potent of them. Another important cannabinoids are cannabidiol (CBD), cannabinol (CBN) and cannabigerol (CBG) (Pertwee, 2008). Cannabinoid receptors Cannabinoids bind to three receptors that mediate their effects: CB1, CB2 and GPR55. All three are G protein-coupled receptors (GPCRs). G proteins are proteins that serve to carry signals inside the cells. They are formed by three subunits, α, β and γ. Normally, the G protein is attached to the GPCR in the inside of the cell membrane. When the GPCR binds its neurotransmitter, the G protein dissociates, with the α and the βγ subunits going separate ways to carry signals inside the cell. There are different G proteins. They have the same βγ subunits but different α subunits. Each α subunit activates a different second messenger system. Like the opioid receptors, CB1 and CB2 act through the inhibitory αi G proteins, which decrease the synthesis of the second messenger cyclic AMP (cAMP). In neurons, this leads to a decrease in the firing of action potentials and a decrease in neurotransmitter release. CB1 receptors mediate most of the psychoactive effects of THC: analgesia, euphoria and sometimes paranoia. It is the most abundant GPCR in the brain, being found in most brain regions. CB2 receptors were initially thought to exist only in non-brain tissues, like immune cells. However, more recently it was found in the brain, where it modulates the actions of CB1. They have important functions in the immune system and other organs of the body. GPR55 was an ‘orphan’ receptor, that is, a receptor whose gene was found first, before its ligand was known (Lauckner et al., 2008). GPR stands for ‘G protein-coupled receptor’. It signals through Gq and G12 proteins, releasing calcium from intracellular stores and inhibiting M current potassium channels (Lauckner et al., 2008). All that means that it excites neurons, instead of inhibiting them like CB1 and CB2 receptors. GPR119 and GPR18 are other orphan receptors that may also be cannabinoid receptors. TRPV1 (the capsaicin receptor), TRPV2 and TRPV3 are other receptors that can be activated by cannabinoids and endocannabinoids (Santha et al., 2010). They act as heat sensors in the skin, with TRPV1 detecting burning temperatures and TRPV2 and TRPV3 detecting milder temperatures. But they are also present in neurons in the central nervous system, playing roles still not well understood. CB1 and CB2 agonists There are many synthetic compounds that are agonists of CB1 and CB2 receptors (Patel and Hillard, 2006; Bow and Rimoldi, 2016). WIN 55,212-2 is one of the oldest of these compounds. It is an agonist of both CB1 and CB2 receptors. Arachidonyl-2'-chloroethylamide (ACEA) is a selective agonist of CB1 receptors. CB 65, HU 308 and JWH 133 are selective agonists of CB2 receptors. Abnormal-cannabidiol, ML 184 and O-1602 are selective agonists of GPR55 (Ross, 2009). These compounds are important tools for discriminating the effects of these three receptors. Constitutive activity of CB1 and CB2 receptors Like the µ-opioid receptor, CB1 and CB2 receptors have constitutive activity. This means that they have a little bit of activity, even when they do not bind an agonist, activating their associated G proteins to a certain extent. Therefore, there are compounds that act as inverse agonists of these receptors, that is, not only they inhibit the effect of the agonists, but are also able to inhibit the constitutive activity. Most of the substances identified as CB1 receptors antagonist, like rimonabant (or SR 141716A), AM 251 and AM 281, are in fact inverse agonists. AM 630 and GP 1a are inverse agonists of CB2 receptors. What is important about these compounds is that scientists have the ability to selectively block each one of the three cannabinoid receptors in order to determine how they contribute to the effects of THC, CBD and the endocannabinoids. However, since these compounds are inverse agonists, they would also block the constitutive activity that CB1 and CB2 receptors may have in the absence of any agonist. References Bow EW, Rimoldi JM (2016) The Structure-Function Relationships of Classical Cannabinoids: CB1/CB2 Modulation. Perspect Medicin Chem 8:17-39. Lauckner JE, Jensen JB, Chen HY, Lu HC, Hille B, Mackie K (2008) GPR55 is a cannabinoid receptor that increases intracellular calcium and inhibits M current. Proc Natl Acad Sci U S A 105:2699-2704. Patel S, Hillard CJ (2006) Pharmacological evaluation of cannabinoid receptor ligands in a mouse model of anxiety: further evidence for an anxiolytic role for endogenous cannabinoid signaling. J Pharmacol Exp Ther 318:304-311. Pertwee RG (2008) The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol 153:199-215. Ross RA (2009) The enigmatic pharmacology of GPR55. Trends Pharmacol Sci 30:156-163. Santha P, Jenes A, Somogyi C, Nagy I (2010) The endogenous cannabinoid anandamide inhibits transient receptor potential vanilloid type 1 receptor-mediated currents in rat cultured primary sensory neurons. Acta Physiol Hung 97:149-158.

Market forces induce the over-exploitation of common resources The basic problems of capitalism This is the second in a series of articles about the fundamental problems of capitalism. These problems are intrinsic to the nature of capitalism. They cannot be solved by market forces. These problems are: Perverse incentives. The tragedy of the commons. Unequal wealth distribution. Exploitation of workers. Exploitation of consumers. The merging of corporations leading to monopolies. The political influence of the corporations. Conservatives and libertarians argue that these problems can be solved by the raw market forces of capitalism: the invisible hand. I want to analyze these problems, one by one, to see if this is true. Sheep pastures A small village of shepherds has pastures in common. Since the shepherds are highly individualistic and greedy, they all try to raise more sheep than their neighbors. As the result, the pastures are overgrazed and the sheep starve. The shepherds are ruined. This actually happened in the Sierra Nevada of California. Big flocks of sheep were brought in to graze on the rich meadows of the sierras. They promptly destroyed them, causing the native bighorn sheep and deer to starve and wreaking havoc on the entire ecosystem. The shepherds just moved the sheep to other meadows, extending the damage. The government banned grazing sheep in the mountains, but the shepherds knew the intricate geography of these high mountains and refused to leave. Ultimately, the army had to be brought in to dislodge them. But, by then, irreparable damage was done to this fragile ecosystem. One of the shepherds was John Muir. Witnessing the damage done by the sheep started his environmental activism. [Source: The High Sierra: Peaks - Passes - Trails, by RJ Secor.] These are textbook examples of an economic problem called the tragedy of the commons. When a certain resource is held as a community property, greed and competition drive individuals to disregard the common good and use as much of the resource as they can. Whoever wants to take care of the common good makes less profit, while cheaters benefit. Over time, competition drives those that try to take care of the common good out of business, in favor of the exploiters. The cod fishery of the North Atlantic Here is another example. There used to be an enormous cod fishery off the coast of Newfoundland in the North Atlantic. Fishermen from Spain, France and Portugal discovered it and sailed across the Atlantic to get the fish. To keep the fish from rotting during the long traverse back, they salted it. To this day, salted cod is a traditional dish in Spain and Portugal. Salted cod kept so well that it was used to feed the armies during the endless European wars. The North Atlantic cod fishery lasted until the 20th century, when it collapsed. A similar threat exists for fish in international waters, where fisheries cannot be regulated. Even the coastal fisheries of poor countries get poached by factory fishing boats from rich countries. Planet Earth Ultimately, there is one resource common to all Humanity: planet Earth. The current climate crisis shows that the ‘invisible hand’ of capitalism will exploit it until its destruction. When it comes to the health of the planet, nations have to join forces to create laws to regulate the exploitation of oceans, the composition of the atmosphere, and other key systems for the well-being of the planet. An international system able to enforce these laws against pariah states is necessary. Conclusion There is no way that market forces can self-regulate to avoid the tragedy of the commons. Consumers are too uninformed, powerless and poorly organized to do anything about it. Any corporation that tries to take care of the commons will lose money. Eventually, it will be taken over by corporations dedicated to mindless exploitation. As in the example with the shepherds, the ultimate disappearance of the common resource will mean the ruin of the corporations. Unfortunately, modern corporations have a limited time outlook. It’s years, even months. Plans for the future are limited by the human lifespan. Few people care to do something when they will not live long enough to see the outcome of their efforts. And those idealistic few are certainly not the CEOs of big corporations. Unfortunately, changes in the environment occur over very long timeframes. A hundred years is an eye blink. Changes in global weather patterns usually take tens of thousands of years. We are forcing a global climate change on Earth in barely a hundred years. It’s way too fast for the biosphere of our planet to manage it. And yet, few of us will live long enough to see its full consequences. As it happened with the sheep in the California sierras, the only solution for the tragedy of the commons is for the State to use its power to regulate the use of common resources.

Breath play, sexual predators, mental conditions, switching, domestic discipline, and other topics debated in the BDSM community. Controversies and debates are good. That’s how we learn from each other and reach a consensus on the important matters. Most of today’s BDSM culture arose from past debates. However, there are still some unresolved issues. I list here 12 of them, trying to present both sides fairly and to withhold my own position. Each one of these issues deserves an article for itself. However, I think that is nice to have them all in one place to decide on their relative importance. I put those that I think are more controversial towards the top of the list. 1) How to fight predators in the BDSM community I put this one at the top because it is so controversial that is tearing some BDSM communities apart. Fetlife.com, the gathering site of millions of kinksters around the world, is routinely accused of not being tough enough on sex predators. Of enabling them. Of silencing victims. Is this a Trojan Horse used by radical feminists to keep attacking BDSM, after being defeated in the Feminist Sex Wars? Or are there conspiracies to protect some powerful people so that they can continue to prey on unsuspecting victims? Have some people been falsely accused of breaking consent and being predators? Or is the BDSM community too soft on sexual predators? 2) Is breath play safe? Proponents of breath play say that it is perfectly safe when done the right way. It induces an altered state of consciousness that is very pleasurable and different from that produced by drugs. Asphyxiation also increases enormously the intensity of orgasm. Opponents say that breath play is the most life-threatening BDSM activity, by far. There is no really safe way to do it because it is impossible to predict how the cardiovascular system is going to react. Repeated asphyxia may cause hidden brain damage. The pleasure it provides can be reached by other means, and it is certainly not worth the risk. 3) SSC or RACK? SSC - safe, sane and consensual - is the old standard, created in 1983 to define the limits between ethical BDSM and abuse. It is defended as the clearer and safer standard. These are the best criteria to present to the vanilla society. If things go wrong in a scene, do you want to tell a judge and jury that you were practicing “safe, sane and consensual” or “risk-aware consensual kink”? RACK - risk-aware consensual kink - was proposed later (1990s?) by people who thought that BDSM could never be totally safe or sane. ‘Safe and sane’ provided an excuse to be judgmental about some of the more extreme BDSM practices. It is up to the participants to inform themselves and decide what risks they are will to take, i.e., be “risk-aware”. Informed consent should be the main, and perhaps the only, concern. 4) Should people with mental problems practice BDSM? What do we exactly mean by ‘sane’ in SSC? It is usually understood as being aware of the potential psychological trauma that can be caused by BDSM. But there are people who are more psychologically vulnerable. And there are those who argue that they should not play in the bottom or submissive roles, because this would be inherently unsafe for them. At the very least, they should disclose their mental problems to their scene partners. And aren’t people with mental problems disqualified to play as tops or dominants? On the other hand, isn’t excluding neurodivergent people from the BDSM community discriminatory and ableist? It is the prerogative of each person to decide what is safe for them. Besides, there are a multitude of mental diseases. If we started judging people because of that, we may end up excluding those that are aware of them and taking care of themselves with medication or therapy, while accepting those in denial about their mental problems. 5) Is BDSM therapeutic? A lot of neurodivergent people who practice BDSM will tell you that, in fact, BDSM is good for them and helps them deal with their problems. BDSM can also help with chronic pain by teaching people emotionally healthy ways to deal with pain. However, other bristle at the idea that BDSM can be therapeutic. ‘BDSM is not therapy!’ they say. Shouldn’t therapy be left to qualified psychologists? Should tops walk into a minefield of hidden traumas in their bottoms? 6) Drug use in BDSM There is a consensus that people should not be on drugs during a BDSM scene. Dominants cannot make safe decisions if they are high. Submissives cannot give full consent or use a safeword if they are on drugs. However, I suspect that there is a bit of hypocrisy in this. That, in reality, there are people who use drugs in BDSM scenes. Shouldn’t this be just another decision that people are allowed to make after informing themselves? We are just awakening from a lot of misinformation spread by the government during the War on Drugs. President Nixon imposed a classification of drug risks based on his political ideas, because he didn’t like “those hippies”. In doing that, he destroyed the therapeutic potential of cannabis and psychotropic substances, which was being investigated in the 60s and is back into consideration today. Not all drugs are the same. On the one hand, the USA has been having an opioid epidemic for two decades that has caused hundreds of thousands of deaths. However, it was not started by “those hippies”, but by the greed of Purdue Pharma and the wrongdoing of many American doctors that prescribed their product, OxyContin, without checking is addictive potential. The danger of opioid abuse in the BDSM community is very small. On the other hand, the legalization of cannabis in most of the USA has made us aware that it is not as dangerous as we were told. Famous podcaster Dan Savage often recommends cannabis to deal with sexual problems. It is certainly healthier than the long-held tradition of getting drunk to ease sexual inhibitions during sex. The argument that submissives shouldn't take drugs because it prevents them from consenting and using the safeword is weakened by the fact that endorphins released during a BDSM scene are just as potent as any opiate. When they enter the sub space, submissives become just as unable to make decisions and use a safeword as if they were high. Taking a little cannabis to relax and overcome inhibitions produces a much less altered state of mind. Today, many people take micro-doses of cannabis and psychotropics like Psilocybe mushrooms and LSD in their daily life. Then again, drugs can incapacitate you from entering the submission space. Or create unpredictable problems by interacting with it. Maybe is time to have an honest conversation about this? 7) Is BDSM a sexual orientation? The politically correct belief is that homosexuality is from birth and unchangeable. People are attracted to people of the same gender because they are born that way. But people who like spankings, bondage or submission, somehow, picked those sexual tastes later in life. Never mind that a lot of BDSMers had kinky fantasies early in their childhood. We cannot even suggest that children can be sexual, let alone be perverts! Maybe the problem is that ‘sexual orientation’ are words that convey a lot of political privilege these days. If BDSM was a sexual orientation, then we would have the same right not to be discriminated against that gays and lesbians have. And they would have to stop criminalizing BDSM, as still happens in many countries where gay sex has been legal for a long, long time. 8) Is domestic discipline part of BDSM? Most people who practice domestic discipline see themselves as different from BDSMers. They dislike the fetish clothes, the special furniture, the implements and the attitude of BDSM. They wear normal clothes and don’t go to kinky parties. They just have a person who is in charge, some rules that need to be followed, and punishments when those rules are broken. In particular, people who practice Christian domestic discipline are very adamant that they are not like ‘those perverts’. They are just following the will of God, clearly explained in the Bible, that a wife must obey and be disciplined by her husband. People into BDSM just shrug and say: “You have similar fantasies than us, just a different style. The basics are the same: submission and spankings. But it’s okay if you want to feel special. Everybody does.” 9) Are switches authentic dominants and submissives? Switches, in case you didn’t know, are people who like to change roles between dominant and submissive, or between top and bottom. They are BDSM sluts who want to have their cake and eat it, too. They don’t care if they are tops or bottoms, as long as somebody gets spanked. There always has been an anti-switch attitude in the BDSM community. Some people think that being dominant or submissive is something essential to their personality, so that they could never be in the opposite role. Which is fine. The unspoken corollary, however, is that switches do not have that essence, so when they are dominants or submissives, they are faking it. On the other hand, there are those who say that experiencing BDSM from both sides makes it possible to truly empathize with your partner. You know exactly how they feel. And, to truly master an implement like a cane or a whip, you need to know what it feels like. 10) Is BDSM a game or a lifestyle? This is an old debate of the 90s that seems to have largely died off. However, some of its undercurrents still persist. Lifestylers look down on ‘gamers’ as unauthentic. They feel that being dominant or submissive is something essential to their personalities, not an outfit that they put on and take off. BDSM is something that completely permeates their life, an attitude that is always present. They don’t have ‘roles’. They do not ‘play’. They do not have ‘scenes’. Most of us see BDSM as a game. Scenes that we play for a time, and then we go back to our egalitarian roles. Being dominant or submissive may be something that we feel deeply, but it is a role that we only adopt in appropriate times. And there is nothing wrong with that. 11) Is kink different from BDSM? It seems that all BDSM is kink, but not all kink is BDSM. However, it is not clear what are those kinky activities beside BDSM. Some people say that anal sex and even oral sex are kink. Others say that just wearing sexy clothes like leather or rubber is kinky. Have BDSM looks, like wearing a collar, come into fashion to the detriment of authentic BDSM? 12) Who is really in control, the submissive or the dominant? Some people say that the submissive is the one really in control in a BDSM scene, because negotiations, limits, and having a safeword determine that the scene really plays to their fantasies. Other people say that the dominant is, and should be, in control. He starts with the fantasies and desires of the submissive and gradually folds them to his/her will. Yet other people say that both the dominant and the submissive are in service to the scene, which is something beautiful that they create together and ends up enveloping them.

A fundamental problem of Capitalism that cannot be solved by market forces Has the Left lost its way? The workers and the farmers that used to form the core of the Left are increasingly voting conservative. In the United States, they support Donald Trump and his acolytes in the Republican Party. In Europe, they vote for the National Rally in France, Vox in Spain and Fratelli d’Italia in Italy. We cannot afford to lose any more elections. There is too much at stake. Perhaps the solution is for progressives to stop emphasizing identity politics, which are divisive and turn off a large part of the voters. We need to go back to the core issues that concern the poor and the middle class. The main issues are capitalism and wealth inequality. Modern thinkers like Steven Pinker and Yuval Noah Harari argue that capitalism and democracy are intrinsically linked. To a certain extent, I think they are correct. Owning property, choosing your job and creating enterprises are important aspects of individual freedom. However, capitalism has a number of fundamental problems that cause it to work against the common interests of society. This is the first in a series of articles listing these fundamental problems. I will show that these problems are intrinsic to the nature of capitalism, so they cannot be solved by market forces alone. These problems are: Perverse incentives. The tragedy of the commons. Unequal wealth distribution. Exploitation of workers. Exploitation of consumers. The merging of corporations leading to monopolies. The political influence of the corporations. In the final articles, I will argue that solving these problems needs the intervention of the State, which should be democratically controlled, independent of the wealthy and strong enough to reign in the corporations. I will also present historic evidence that European-style socialism is the best formula to achieve this. Perverse Incentives A perverse incentive is when a company can make money by doing something that is against the common good. Wikipedia gives some great examples of perverse incentives: The British government in colonial India offered a reward for death cobras in Delhi. Some enterprising people started breeding cobras to sell them to the government. Similarly, in Hanoi, Vietnam, a reward was offered for rat tails to eliminate these pests. People cut the tails of rats and released them into the sewers to make sure that they had more rats to continue their business. However, most of the perverse incentives listed by Wikipedia involve well-intended government rules backfiring one way But not all perverse incentives are created by governments making stupid decisions. The Opioid Epidemic in the United States Purdue Pharma rewarded its sales people when they convinced doctors to prescribe their new pain medication, OxyContin. OxyContin is a pill that releases the potent opioid oxycodone slowly to lengthen its analgesic effects. Although OxyContin was advertised as a non-addictive alternative to morphine, it is, in fact, highly addictive. Moreover, opioids taken regularly increase chronic pain, a phenomenon known as opioid-induced hyperalgesia. The result was that hundreds of thousands of Americans got addicted to opioids by following their doctor’s prescriptions. Soon, they started to die. Driven by their endless pain and their addiction, they overdosed on OxyContin or turned to street drugs like heroin or fentanyl when their doctor refused to prescribe them more opioids. This is known as the Opioid Epidemic in the United States, which started in the 1990s and is still ongoing. The Sackler family, owner of Purdue Pharma, made millions of dollars selling OxyContin. Protected by an army of lawyers, they were able to avoid jail and kept most of their fortune. [Source: Empire of Pain, by Patrick Radden Keefe.] Looking for alternatives to opioids to cure chronic pain To solve this problem, the National Institutes of Health created the HEAL Initiative, which provides funding for researchers who look for alternatives to opioids as analgesics. I participated in the HEAL Initiative as a grant reviewer. Also, my work as a scientist was directed towards finding alternatives to opioids to alleviate pain. My ambitious goal was to find a cure for chronic pain. I dreamed about a pill that, once taken, would make chronic pain go away, so that people with this disease wouldn’t need to take any drugs anymore. Of course, my small lab would not be able to achieve this hefty objective, but it would be possible with the joint work of pain neuroscientists like me. In my last two papers, we identified two classes of compounds that show promise in an animal model of chronic pain: neurokinin 1 receptor antagonists (Chen and Marvizon, 2020a, BioRxiv) and Src kinase inhibitors (Chen and Marvizon, 2020b, BioRxiv). Unfortunately, I had trouble getting grants to continue this project. Then Covid-19 hit, and I had to close my lab and retire. The perverse incentive not to find cures for chronic pain But also came to the realization that, even if scientists achieved the goal of finding a cure for chronic pain, it would not be passed on to patients. Because of a perverse incentive. The only way to get new medication to the public is to have a pharmaceutical company develop it, test it in animals, and take it through expensive clinical trials. But pharmaceutical companies make billions of dollars selling analgesic drugs to people with chronic pain. Not just opioids like OxyContin and Tramadol, and opioid combinations like Vicodin, but also NSAIDs (nonsteroidal anti-inflammatory) like ibuprofen and calcium channel blockers like pregabalin and gabapentin. If somebody were to develop a medicament to cure chronic pain, it would wipe out this immense profit. No matter how high a price you put on that cure, it couldn’t possibly make up for lost revenue on pain palliatives. Since pharmaceutical companies control the development of any new drug, they can easily prevent these cures from being found, just by doing nothing. I wrote a more in-depth explanation of this problem in my article Big Pharma Will Not Cure Your Pain. Cures for other chronic diseases are also compromised It’s not just pain. The same thing can be said about other chronic diseases like anxiety and depression. They generate millions of dollars in palliatives that patients have to take every day, for the rest of their lives. Curing these diseases would represent a tremendous financial loss for big pharmaceutical corporations. As the scandal with Purdue Pharma and the American opioid epidemic shows, turning the development of new medication to for-profit pharmaceutical companies could prove to be a gigantic mistake. Perhaps drug development should be entrusted to the government and non-profit organizations, instead. Conclusion Perverse incentives are not limited to case in which government enacts the wrong kind of reward without considering unwanted consequences. They are embedded in many of the problems faced by society, like developing safe and efficacious new medication. The market forces of supply and demand often work contrary to the common good. For example, selling medicaments that get people addicted increases demand. And so is selling medication that alleviate the symptoms of a disease instead of curing it. In fact, cures are not good for business because they eliminate customers by turning patients into healthy people. The market operate in a Darwinian way. Suppose that a pharmaceutical company wants to do the right thing and develop a cure for a disease, even when it is not profitable. That company would make less profit than other companies that are guided solely by their self-interest. It would be outcompeted and eventually swallowed by the other companies. The problem is not bad companies like Purdue Pharma. The problem is the capitalist system itself because it is based on greed and not the common good. Only public vigilance and the strict control by the State can ensure that corporations work for the common good.

Prostitution is a service work that requires both empathy and strong emotional boundaries Do prostitutes hate their job? The belief that trading sex for money is degrading implies that the prostitute has to feel bad about it. Here the ideologue is trying to invade the prostitute’s mind to implant extraneous feelings into it. He believes that she has to violate some innate instinct to do this kind of work. He negates her agency by implying that she is not able to freely choose to do sex work. However, the testimony of many prostitutes is that they actually enjoy their work. Others have the same kind mix-feelings about their job that most workers have about employment that has nothing to do with sex. There are good parts and bad parts; good days and bad days. Even the most rewarding and prestigious jobs - like scientific research, in my case - involve endless hours of drudgery, fighting red tape, bureaucracy and mindless repetition. In fact, the most rewarding jobs are the ones that involve human contact. And you can’t deny that there is a lot of that in prostitution. Prostitution is a service job Like other service jobs, prostitution mainly involves a lot of human contact, not only physical but also emotional. There is much good in that. Far from it being perceived as a violation, it is rewarding to give something to others that makes them a bit happier. We humans are social animals. We thrive by helping and pleasuring others. Of course, a prostitute has to develop emotional mechanisms to protect herself from the psychological baggage of her clients. But, in that, hers is not different from other professions that expose you to human suffering, like being a medical doctor or a therapist. Here is how an escort describes her experience: “Escorting was a new environment with new social dynamics and incentives, and thus I found a new character emerge. I was there to please, and so my character compartmentalized my own preferences. I didn’t lay there actively hating the experience; I simply became someone who enjoyed it. If the experience was too hard to enjoy, I became someone who didn’t mind enduring it. I didn’t force myself to be authentic, but I actively looked for ways to express authenticity if I could without disrupting the character I was inhabiting. For many clients this was easy - I would often lay there feeling myself love them. Sometimes I cried with them. I let my heart move. To this day I feel like pieces of my soul lie with a few clients I’ve seen, and I’m happy for them to have it.” Escorting Was Good For Me, Aella, escort and blogger. If prostitutes feel bad, it’s not about actually doing their job, but because of the slut-shaming and marginalization that society heaps on them. However, modern sex-positive culture has given them the tools to identify these instruments of oppression and free themselves from them. Consequently, there are more and more sex workers that have come to appreciate their jobs and even speak highly of it. The myth that prostitutes secretly hate their clients Since prostitutes feel degraded and exploited by their work - argue the prohibitionists - they must hate their clients. They see sex is an intimate act that must be done with somebody you love. So, surely, doing it with somebody you have no intimacy with must lead to resentment. Therefore, while externally being all sugar and spice, internally the prostitute hates her clients. The other side of that coin is that the client deludes himself into believing that he has some kind of intimacy or connection with the prostitute, while in fact she despises him. Johns are dupes looking for love in all the wrong places. They are victims of their own desires. But none of this is true. Prostitutes have a whole range of feelings towards their job and their clients. Many have a professional relationship with their clients, similar to the provider-client relationship of other jobs that require intimacy, like psychotherapists or couple counselors. These professionals have to connect with their clients at an emotional level, but they also have to develop defense mechanisms to keep that connection from spilling over to their own emotional lives. Other jobs, like masseuse, physical therapist or sport trainer, require physical contact with the clients, which is often experienced as intimate. In all these professions, some kind of internal psychological barrier has to be developed between the emotions of the client and the emotional life of the professional. We can see that in the quote from Aella above. A psychotherapist cannot avoid interacting with his client as a human being, being empathetic to his emotions. On the other hand, it would not be healthy for him to take on the emotions of the client. He has to develop internal boundaries between his mental life and that of his clients. The same happens with prostitution. The prostitute knows how to get intimate with the client during her time with him. But she also knows how to let this intimacy walk out the door with the client when he leaves. “The structure of escorting protected this for me. I had to maintain really clear boundaries - I left on time, I didn’t make any special exceptions even for people I really genuinely liked, I didn’t give discounts. Blurring any boundaries would have triggered that anxiety, suddenly made it personal, and destroyed my ability to enjoy the experience with them.” Escorting Was Good For Me, Aella, escort and blogger. Sex work provides emotional support to the client Good prostitutes do not provide just sex. They listen and provide emotional support and validation. “Because ours, like it or not, is a very personal and tremendously human work. Sex may or may not be part of a service. But what takes place, in a very high percentage of cases, is an intimate and personal conversation. Customers usually want similar things, there are no differences in what human beings need. We are talking about affection, deference, attention, tenderness, respect and consideration.” Paula VIP, sex worker (translated from Spanish). Sometimes, the client does not even want sex. He may want to chat and have physical contact. This is especially true for clients who develop ongoing relationships with prostitutes, sometimes lasting many years. One type of relationship that is becoming more frequent these days is the Sugar Daddy, where the man provides ongoing financial support to the woman in exchange for regular sex and time together. The relationship may, or may not, be exclusive. It is not uncommon for the Sugar Daddy and the woman to fall in love with each other. How is this different from marrying for money? Copyright 2022 Hermes Solenzol.

The idea that prostitution degrades women is based in the belief that sex is sacred and money is bad Consent and personal autonomy Prostitution is trading sex for money in a consensual way. If it were non-consensual, then it would be sexual slavery, not prostitution. Radical feminists and anti-prostitution politicians secretly hate the word “consent”, because what they want is to impose their morality on other people. Which, of course, is non-consensual. The underlying ethical value here is personal autonomy. My body is mine to do with it what I want. However, this is not an absolute ethical principle. There are some occasions in which the State can impose certain things on me for the protection of the community. Like paying taxes or getting vaccinated. So, in the case of prostitution, is there a reason for the State to prohibit it? What is involved is the personal autonomy of two people: the prostitute and her client, who want to consensually engage in sex in exchange for money. This is a private, indeed intimate, transaction that should not concern the State. Just like any other instance in which two people choose to engage in consensual sex. The best way to fight exploitation In the previous article in this series, I have addressed the argument that the State should prohibit prostitution to avoid human trafficking. I argued that prostitution and human trafficking are entirely different things. Trafficking for the purpose of sexual exploitation could be fought more effectively if prostitution was legal, just like any other instance of labor exploitation. Non-exploited workers would be the first to point out the cases of sexual slavery because it represents a double threat to them: unfair competition and the danger that they could become sex slaves. Unions of prostitutes - like OTRAS in Spain - would be a place where sexually exploited women could seek help. Does prostitution degrade the prostitute? This would be for the prostitute to decide, just like we decide whether any other sex act is degrading. Chances are that, if the prostitute has freely decided this kind of work, that she doesn’t find that it detracts from her self-esteem. For many sex workers, converting sex into a professional activity comes after a personal quest about what sex means for them. Saying that prostitution degrades the prostitute is slut-shaming her. It’s an act of psychological violence not different from shaming gays, trans people or promiscuous women. It’s emotional violence done with the specific purpose of curtailing the sexual freedom of a person. Is prostitution degrading for all women? The reasoning gets more ideological when the degradation supposedly produced by prostitution is extended to all women. Saying this assumes that there is something sacred about sex that gets soiled when sex is not done in a socially approved way. Moreover, this soiling produced by sex somehow gets magically transmitted even to women that do not engage in prostitution. This is basically a purity argument, similar to what has been used by religions like Christianity or Islam (by most religions, indeed) to justify sexual repression. Defenders of the specialness of sex may argue that sex is only legitimate when done between people who love each other. In other words, sex is only ethically admissible when done to fulfill the higher goals of fulfilling the obligations or marriage or establishing emotional intimacy. However, as I argued in a my previous article Is Sex Sacred?, this would make masturbation and casual sex unethical. However, most people in the Western world are past that repressive stage. Or, at least, past the stage in which they accept that the State dictates what happens in our bedroom. Another argument is that it is money, when traded for sex, what sullies the woman. This is a favorite of anti-capitalist radical feminists, who like to view prostitution as another sin of capitalism. However, money is good when we get it as pay for our labor, or when we sell things, or when we inherit it. Why is it suddenly bad when one gets it in exchange for sex? Sex is not bad, even when it’s casual. Money is not bad. There is no logical reason why trading sex for money should be bad. What makes it so it’s just the remains of religious dogmas that were widely used to repress women and keep them disempowered and poor. Does prostitution maintain the patriarchy? This is an argument often used by radical feminists. It goes like this: women have been sexually exploited by men through the centuries, so any sexual act between men and women has to be examined for signs of this exploitation. The examiners should not be the people having sex, but the radical feminists themselves, or the State acting in their name. But, by doing so, the radical feminists or the State breach the consent, the right to intimacy, and the personal autonomy of the people having sex. This is an injustice similar to prohibiting sodomy, gay sex or any other consensual sex act. Why should exchanging sex for money be an act of exploitation? How is this different from any other transaction of service for money? The only argument to justify this would have to resort to sex being special or sacred. Sex cannot be exchanged for money, they argue. Why? Because there is something about sex that makes it different from other human activity. Unlike anything else we do, it cannot be done to earn a wage. So we are back to the “sex is sacred” argument. The patriarchal system in which women are always the providers of sex and, therefore, the sex workers, is starting to break down. As women become empowered, men are increasingly performing sex work as strippers, as porn models and even as gigolos or male prostitutes. In fact, the idea that sex can soil women, but not men, is at the core of the patriarchy. In a sex-positive culture in which sex is divested of its magical qualities as guarantor of personal purity, sex work is just one more manifestation of our increased personal freedom. Prohibiting any consensual sex act should be seen as an intrusion of the State in our intimate lives. Copyright 2022 Hermes Solenzol.

How to live a life worth living through action instead of contemplation. The archetype of the warrior Please, don’t be put off by the word warrior. Although it suggests war and aggression, the warrior is an archetype found in most cultures. In the psychology of Carl Jung, archetypes are mythical characters present in the collective subconscious. Other archetypes are the Wizard, the Witch, the Joker, the Mother, the Goddess, the Wise Old Man, the Demon and Death. The archetype of the warrior appears frequently in popular culture. For example, the Jedi of Star Wars are warriors. Before that, it could be found in the 70s television series Kung Fu, where Kwai Chang Caine, a Buddhist monk trained in the Shaolin Monastery, wanders through the old West using his martial arts to face challenges. There are also women warriors, like Princess Leia of Star Wars, Yu Shu Lien of Crouching Tiger, Hidden Dragon, Wonder Woman, and Ripley in the Alien movie series. The Way of the Warrior is related to the Bushido: the moral code of the samurai of Japan. It is also reminiscent of the medieval knights. A warrior is different from a soldier. A soldier follows orders as part of an army. A warrior follows his own path according to his own goals and moral code. A warrior does not seek war but peace. He fights evil because it causes suffering. The monks of the Shaolin Monastery were spiritual warriors who invented martial arts to defend themselves from marauders that tried to rob them. However, as Buddhist monks, their core practice was enlightenment and compassion. Carlos Castaneda I first heard about the Way of the Warrior when I was in college and read the books by Carlos Castaneda. He was an anthropology student at UCLA who decided to do a doctoral thesis about the sorcerers in Mexico. He found a Yaqui shaman, don Juan Matus, who initiated him in the use of peyote, Psilocybe mushrooms and Datura to access an alternate reality populated by powerful entities who could guide him. But to properly use the knowledge gained by using these drugs, a wizard has to follow a disciplined way of life: the Way of the Warrior. There was a wisdom in that philosophy of life that appealed much more to me than taking psychedelics. Carlos Castaneda turned his doctoral thesis at UCLA into a book that became a worldwide bestseller: The Teachings of Don Juan. I read it several times, and then the whole series of books that Castaneda wrote after that. Eventually, I became convinced that he was making up all that stuff about the occult traditions of Mexican wizards. The books were entertaining, but nothing more. Still, it is undeniable that Castaneda was a masterful weaver of mythology and philosophy of life. It is possible that he drew from the Bushido, Zen, Stoicism and other ancient traditions to create his own version of the Way of the Warrior. If so, he was truly brilliant in this synthesis. He also seems to have followed the Way of the Warrior in his own life. Zen I turned to other sources of wisdom in my spiritual quest. I learned yoga, studied with the Siloists, and finally settled for Zen Buddhism, which I practiced for 10 years, first with the disciples of Taisen Deshimaru, later with Eido Shimano Roshi and Maezumi Roshi. Eventually, I became disenchanted with Buddhism because of its beliefs in supernatural things like reincarnation and Nirvana, and its denial of the pleasures of life. I needed a philosophy of life that was more down to earth, that taught how to live my life balancing a quest for happiness and working for the common good. That accepted the fact that death means my complete disappearance, and show me how to deal with that. Rock climbing What brought my attention back to the Way of the Warrior was my passion for rock climbing. My rock-climbing buddies recommended the book The Rock Warrior’s Way, by Arno Ilgner. It teaches the right mental attitude for rock-climbing: a way to overcome fear, maximize performance and enjoy climbing. As I was reading it, I realized that it is about much more than just rock-climbing. It taught a way of life that was both disciplined and joyful. And the best part was that my beloved sport of rock climbing provided a simple way to train my mind to follow it. That philosophy of life was a distillation of the Way of the Warrior of the books by Castaneda, mixed up with a bit of Stoic philosophy and Zen Buddhism, as recognized by Arlo Ilgner himself. All this truly speaks to me. I found a way to integrate the best aspects of many things that I had learned in life. The Way is the Tao The word Way has a profound meaning: is the Tao, the flowing energy that shapes the world, according to Taoism. The Way has no destination; it exists on itself. The Tao flows by balancing the Yin and the Yang, the masculine and the feminine. From a personal point of view, the Way is a path of inner discovery and transformation. A warrior’s quest is one of constant improving, learning and letting go of the Ego. From the societal point of view, we should realize that we have inherited a wonderful civilization created by the warriors of the past: warrior scientists, warrior philosophers, warrior artists, warrior leaders of social movements. Now, we have the duty to continue improving the world to pass it to future generations. The Way of the Warrior reaches its cusp when the personal path of the warrior gets in harmony with the Way in which the world flows. Mindfulness versus active attention Mindfulness is a practice consisting of directing our attention to our senses in a relaxed, non-judgmental way, turning off our internal dialogue. The best benefit of mindfulness practice is the development of meta-attention: being aware of the state of our attention. When meta-attention becomes a habit, we become aware of how our emotions drive our consciousness, and thus develop the ability to subtly direct our emotions toward a state of mental calmness and control. The Way of the Warrior uses the challenges placed on us by risky situations to practice a particular form of mindfulness based on action instead of contemplation. This discipline arose from the demands placed on warriors like the samurai, who may confront each other in deadly duels. “[The warrior] must perform with absolute mastery and calm in the face of horrendous mortal danger. […] If he clings too dearly to his own life, or is ruled by his Ego, he will seek escape; his attention will waver; he will be destroyed. Paradoxically, if he adopts a stance of embracing the risk and accepting the consequences, he is far more likely to survive.” Arno Ilgner, The Rock Warrior’s Way. The danger doesn’t need to be extreme. It just needs to evoke enough fear to challenge the mechanisms of our attention. That’s why climbing and martial arts are perfect ways to train us to become warriors. These sports put us in challenging situations in which the risk is real, but less than it appears. The demand to perform well physically in the face of fear exposes defense mechanisms of our mind that weaken us and drive bad emotional habits. However, one doesn’t need to practice martial arts or risky sports to be a warrior. We can find our own Way of the Warrior in writing, scientific research, art, political activism and other worthwhile pursuits. “It is the warrior’s way to follow the paths of both the sword and the brush (pen).” Miyamoto Musashi, The Book of Five Rings. We are our worst enemy. Our Ego, which is our self-image, controls much of our behavior, leading us to focus on our achievements instead of the task at hand. Only by letting go of the Ego we can get into a flow zone of unrestricted attention that we need to perform masterfully. But what really matters is not our performance, but the mental state that leads to it. While regular mindfulness is a passive state of letting perceptions flow unimpeded into our consciousness, attention in the Warrior’s Way is directed towards action. “In warrior-speak, the active form of awareness is called attention. Attention is awareness heightened and focused, the intentional directing of awareness.” Arno Ilgner, The Rock Warrior’s Way. What we do, how we feel, is deeply affected by the unconscious parts of our mind. The Way of the Warrior does not fight the unconscious. Instead, it seeks to merge the conscious and the unconscious through impeccable actions. Impeccability Impeccability consists of using attention in order to perform flawlessly. We don’t perform flawlessly to feed our Ego, but as a way to verify that we have achieved a good mental state in which we are not controlled by our emotions or our Ego. This has an ethical component. The warrior chooses his own moral code, but then he has to follow it by practicing the virtue of integrity. He answers to himself, taking full responsibility for the consequences of his actions. Motivation is the key. We need to learn to move from a motivation based on fear, shame and pride to one based on love and joy. “The courage a warrior must cultivate is not just for overcoming personal fears, but the courage to live life at its fullest, which entails taking chances. Following the path of the warrior is the most difficult of the spiritual ways and requires courage to practice since you must also live life in your own terms. This means one must fight through the everyday worry, fear, sadness, anxiety, and depression to live with vitality and vigor.” Stephan H. Verstappen in A Master’s Guide to The Way of the Warrior. A path with a heart The Way of the Warrior is a happy way, a path with a heart. We need to change our core motivation from being based on fear, shame and pride to one based on joy and love. This is not an easy process. It consists of using our intuition to polish our moral code, our system of values, so that in brings meaning to our life. This is not a lonely task. We develop our love by giving to others, helping them grow as we grow. “This question is one that only a very old man asks. Does this path have a heart? All paths are the same: they lead nowhere. They are paths going through the bush, or into the bush. In my own life I could say I have traversed long, long paths, but I am not anywhere. Does this path have a heart? If it does, the path is good; if it doesn't, it is of no use. Both paths lead nowhere; but one has a heart, the other doesn't. One makes for a joyful journey; as long as you follow it, you are one with it. The other will make you curse your life. One makes you strong; the other weakens you.” Carlos Castaneda, The Teachings of Don Juan. By finding the things that bring us joy when we do them, the values that we cherish, the people that we love, we follow a path with a heart. The journey of a meaningful life. "For me there is only the traveling on paths that have heart, on any path that may have heart. There I travel, and the only worthwhile challenge is to traverse its full length. And there I travel, looking, looking, breathlessly." Carlos Castaneda, The Teachings of Don Juan. Personal power Personal power is a concept found in the books of Carlos Castaneda that can be easily misunderstood. We normally associate power with wealth, political influence and dominion over others. Hence, acquiring power sounds selfish. However, in the Way of the Warrior, personal power means self-knowledge, self-control and the ability to generate sustained attention and effort. It means controlling ourselves in a quest for self-knowledge, impeccable action and, ultimately, finding meaning in life. “Power manifest itself as clarity of thought and decisiveness in action. It is the totality of the resources you bring to a given situation with special emphasis on the mental aspect.” Arno Ilgner, The Rock Warrior’s Way. According to Arno Ilgner, gathering personal power entails: letting go of the Ego, focusing on the process and not the destination, cultivating our love of life, encouraging our curiosity, plugging power drains, not wasting energy on unimportant things, training our attention, keeping our body healthy. Personal power consists of a mixture of emotional strength, stoicism, resilience, wisdom, good habits and learned knowledge. Paradoxically, power consists of giving, not taking. You are powerful when you can give your full energy and attention to what you are doing. If, instead, you focus on the reward that you will receive if you succeed or on the consequences of failure, you are falling into the trap of the Ego. Your attention is leaking away from focusing on what you are doing, producing a mental state that leads to faulty action. You fumble. You curse. You seek excuses. You cling to hope. You blame others. You feel ashamed of yourself. Death as our advisor Being aware of our mortality helps us focus on what is really important in life. Normally, death terrifies and paralyzes us. However, being aware of the certainty of dying lets us know that there is no time to waste. We need to focus on what brings meaning to our life. This sharpens our motivation. Do we want to live a life full of fear or a life full of love and joy? A path with a heart leads to nowhere. To death and oblivion. Its value resides in having a heart. Abandoning self-importance In the books by Carlos Castaneda, to survive an encounter with the powerful entities of the world of the sorcerers, the apprentice has to abandon his self-importance. Likewise, according to Arno Ilgner, to ‘send’ a difficult climb one has to abandon the Ego and completely focus the attention on executing each move impeccably. “You can feel pretty worthless at times because reward and punishment have molded you. When you did something that was considered good by your caregivers, you were rewarded, and when you did something that was considered bad, you were punished. Your caregivers associated your worth with your performance - your behavior. Then, as you grew older, your caregivers’ expectations became embodied in the Ego, which took over the job of rewarding and punishing. Your caregivers’ expectations were supplemented or replaced by the expectations of a peer group, or the expectations established by a set of beliefs you adopted with little critical thought. Regardless of the source of the Ego’s expectations, the result is the same: we are slaves to externally driven influences, rather than being the masters of our internal, mental environment.” Arno Ilgner, The Rock Warrior’s Way. I conceive the Ego as a part of our mind that arises during childhood by internalizing the instructions of our parents and teachers, all the while driven by pride and shame. Pride and shame are two powerful emotions that evolved to enable social control and to motivate cooperation. As Ilgner explains, their joined effect during childhood creates the Ego. When our actions are driven by the Ego, they become just blind pursuits for validation. We try to earn praise and to avoid shame. That makes us dependent on external influences and vulnerable to societal pressure. The Ego constantly chases approval and fears shame. It is goal-oriented. When driven by the Ego, our inner chatter is all about the reward we are going to get if we succeed and how awful failure is going to feel. Only when we abandon our self-importance we can completely focus on executing our action impeccably. Letting go of the Ego leads to the state of flow: a playful, carefree state of physical and intellectual flexibility in which we seem to accomplish things effortlessly. According to Ilgner, a warrior lets go of the Ego and nurtures his Higher Self instead: “The Higher Self isn’t competitive, defensive, or conniving, as the Ego. It sees through such petty ploys. The Higher Self derives self-worth not from comparison with others, but from an internal focus that is based on valuing growth and learning.” Arno Ilgner, The Rock Warrior’s Way. The humbleness of the warrior does not consist of dwelling on his weaknesses or affecting a false modesty, but of a constant struggle to cultivate inner motivation and personal power. “The humbleness of a warrior is not the humbleness of the beggar. The warrior lowers his head to no one, but at the same time, he doesn't permit anyone to lower his head to him. The beggar, on the other hand, falls to his knees at the drop of a hat and scrapes the floor to anyone he deems to be higher; but at the same time, he demands that someone lower than him scrape the floor for him.” Carlos Castaneda. Erasing our personal history According to Castaneda, erasing our personal history is another facet of the Way of the Warrior. This is because our inner talk reminds us constantly of who we are, especially of our weaknesses. It may say ‘I can’t do this’ or ‘I got this’, but both messages have an undertone of self-doubt. In the state of flow, we forget who we are to focus completely on what we are doing. Impeccable action has no self-doubt, because there is no self in it. Conclusion The Way of the Warrior is a philosophy of life more in accordance with the demands of modern culture than contemplative traditions like Buddhism or Taoism. It focuses our attention on our actions, so everything we do at work, at home and in our social life becomes a path of self-discovery and self-transformation. The demands and stresses of life, instead of draining our energy, become a source of inner power. However, the Way of the Warrior is an empty path. It is up to ourselves to fill it with what we learn along the way. The warrior chooses his own values and goals. These are not cast in stone, but evolve as he learns. Ultimately, the Way of the Warrior is a quest for the meaning of life. Books about the Way of the Warrior The Rock Warrior’s Way, by Arno Ilgner. Amazon. Goodreads. The Craft of the Warrior, by Robert L. Spencer. Amazon. Goodreads. Way of the Peaceful Warrior, by Dan Millman. Amazon. Goodreads. Wikipedia. A Masters Guide to The Way of the Warrior, by Stefan H. Verstappen. Amazon. Goodreads. The Teachings of Don Juan, by Carlos Castaneda. Amazon. Goodreads. Wikipedia.