Myriam Puig, M.D.

Dr. Puig, pediatrician, holds medical degrees from Central University of Venezuela and from the University of Navarre, and a Ph.D. in nutritional biochemistry and metabolism from Massachusetts Institute of Technology. She is on staff at two hospitals in Caracas. She has held teaching positions at Harvard Medical School, the University of Navarre, and Central University of Venezuela. She has published over 160 articles in international journals and books and has spoken at over 100 conference for parents and families.

First I would like to thank the organizing committee for allowing me to participate in this event in Prague. I am happy to be here in this great city of this much admired country. I was curious to visit this capital, but I wanted more to meet its people who must have such a sensibility and insight to produce so many deep thinkers, poets, and writers.

"How should we understand human sexuality in the postmodern age?" is the title that was given to me to address today in this magnificent congress, and I will try to transmit what I see not as understanding but as a big misunderstanding—a "big lie"—that is presented to us by the multicultural world in which we live.

I would like to give my talk in five parts:

1. What do we mean by the postmodern age?

2. What are the characteristics of the postmodern mentality?

3. How this postmodern mentality affects the way human sexuality is considered.

4. The different ingredients of human sexuality.

5. How should we teach our future generations in this aspect?

But before beginning my talk, yesterday we heard a lot about crisis in the family, but I will tell you when it all began. In some beautiful part of this world, from which a couple were walking away, the man, whose name was Adam, put his arm on his companion’s shoulder and told her, "Eve, we are beginning a crisis." All crisis started at that moment.

l. What do we mean by the postmodern age?

Postmodernism was a movement in architecture in the late 1950s that rejected the modernist, avant garde passion for the new. Afterwards it extended into other forms of artistic expression, even to language, invading all the human areas and giving rise to a different way of understanding life.

The term postmodern was used in Arnold Toynbee’s "A Study of History," published in 1947, in referring to the end of Western dominance, Christian culture, and individualism, as well as the appearance of pluralism, which has remained a defining aspect of all subsequent postmodernisms.

Your president, Vaclav Havel, in a talk given in Philadelphia in 1994, states that the postmodern age started in 1969 when America sent the first men to the moon. Other thinkers say that it was the result of the revolutionary movements of May 1968, and still others claim that it was the appearance of the pill, which permitted secure contraception.

Postmodernism calls into question enlightenment values such as rationality, truth, knowledge, science, and progress. But if I had to define the postmodern culture in one sentence, I would say that it is "an eclipse of the truth about man."

The truth about man has been darkened by the civilization of technology presented to us by the media and reduced to "utilitarianism in practice and in ethics. Utilitarianism is a civilization of production and of use, a civilization of things and not of persons, a civilization in which persons are used in the same way as things are used."

How should we understand human sexuality in the postmodern age? I would say that we may understand it as a frozen lake. We see the surface—cold and difficult to penetrate—but we don’t see the wonderful world beneath. The ice layer is just the aspect reflected in the media, a mirage of illusions and fantasies that conceal a world below which is full of life and humanity.

I will like to quote President Havel:

Today’s civilization envelops indeed the whole planet, thus allowing us to see nearly everywhere the same products, the same ads, the same TV series, and branches of the same transnational banks or giant corporations. International pop music is heard wherever we go, and the young people universally wear the same jeans. All this, however, is but a thin and recent veneer.

In essence, this new, single epidermis of world civilization merely covers or conceals the immense variety of cultures, of peoples, of religious worlds, of historical traditions and historically formed attitudes, all of which in a sense lie "beneath" it.

The problem is that the media is portraying a system of ideas that doesn’t correspond with reality. But knowing its vast and powerful impact, we have to be aware of the dangers arising from the manipulation of truth.

2. What are the characteristics of the postmodern mentality?

If we are not aware of this "big lie," we slowly fall prey to the manipulation and become superficial, or "light," like the low-calorie products we consume.

The mentality of the "light" man of our multicultural society can be summarized in five aspects:

1. Materialism: The real value is money. You are valued by what you have and not by what you are.

2. Hedonism: Having a good time is the new code of behavior. Everyone wants to feel good at the expense of ideals and meaning.

3. Permissiveness: Everything goes at the expense of the real concept of morality.

4. Relativism: Everything is relative; there is an absolutization of the relative. Subjectivity sets the rules. The only absolute is selfishness.

5. Consumerism: This is the postmodern formula of freedom.

A man orphan of humanity, without firm convictions, with aseptic commitments, with a sui genens indifference made of curiosity and relativism: his ideology is pragmatism; his rule of behavior, the current style; his code of ethics is based on statistics as substitute of conscience; his morals, full of neutrality, lack of compromise, and subjectivity; his religion, skepticism, absence of belief. He has deserted the transcendental values, and for this he becomes vulnerable and easy prey for manipulation.

The "light" man doesn’t have any interest in truth and changes the meaning of words to his own profit. To the "enslavement of his passions" he gives the name of "freedom"; to "sex" without compromise he gives the word "love"; to his "wealth, comfort, and well-being" he gives the name of "happiness"; and "joy" is confused with "pleasure." In this culture of nihilism, this man has no ties; he only lives for himself and for his pleasures without restrictions.

Also, this individualistic mentality allows for the use of terms like "gender," "reproductive health," "homophobe," "safe sex," "pro-choice," which are part of an agenda promoted by certain groups that are part of the "big lie."

As your president, Vaclav Havel, has said in different speeches:

We live in the postmodern world, where everything is possible and almost nothing certain.

"Apres nous le deluge" is the principle of a man who is related to no order but that of his own benefit. It is a nihilistic principle of a man who has forgotten that he is only part of the world, not his owner, of a man who feels no relation to eternity and styles himself master of space and time.

The relativization of all moral norms, the crisis of authority, the reduction of life to the pursuit of immediate material gain without regard for its general consequences . . . originates in that which modern man has lost: his transcendental anchor, and along with it the only genuine source of his responsibility and self-respect.

This fall of supreme values is one of the dramas of the actual man, and because human beings need transcendence, he creates other substitutes to fill the vacuum, such as sex, consumerism, drugs. The man without meaning falls into the classic triad, described by the Viennese psychiatrist Viktor Frankl, of depression, aggression, or addiction.

3. How this postmodern mentality affects the way human sexuality is considered.

The two conflicting views of the "frozen lake" could be seen in the two different approaches to human sexuality nowadays.

The first, most pervasive of all—and the most heavily portrayed in the media—is the permissive approach. Its origin can be traced to Freud and his disciples, specifically W. Reich. Sex is all there is, and in this context everything is allowed. Sexuality is reduced to selfish sex based in pleasure, hedonism, and permissiveness. Sexual relations become transient, anonymous, promiscuous, orgiastic—ones in which the individuals can be interchanged; they don’t have value in themselves besides the satisfaction of their own sexual desires. The subject becomes only an object of pleasure.

In this context, contraception is a must, because children are not wanted and may be seen as intruders or troublesome. This mentality that worships contraception is already prepared to accept abortion as a natural consequence.

There is another branch in this approach that some consider separately as the naturalistic approach, in which sexuality is presented as a physiological function that has to be satisfied biologically as a "natural" need. There is no mention of love, affection, fidelity, or ethics. It is based in the now outdated Kinsey report and in the Master and Johnson books. Kinsey studied the sexual behavior of a sample of volunteers who he recruited or who came to him. Unscientifically he drew general conclusions that were presented as norms of sexual conduct, even though this sample was not at all representative of the population. But he got the press, and he really had an audience.

As an example of the "big lie" concerning human sexuality, I will like to quote a study published in 1994 by a team of researchers at the University of Chicago that is based on scientifically accurate survey data. The researchers relied on a random sample of 3,432 selected respondents rather than on an unrepresentative group of volunteers.

The impression of "anyone who watches a movie, reads a magazine, or turns on the television is that almost everyone but you is having endless, fascinating, varied sex." But as the authors of the study have found, "the public image of sex bears virtually no relationship to the truth."survey." Little Brown and Co. Boston. 1994. p. 1.

We don’t find this approach only in the media, but also in the books that teach sexual education in some schools of the world. These books concentrate only on the physical components of sex, providing detailed information on contraception and abortion. These programs push children to physical sex, but of course "safe sex," which as we know in many instances just means "more sex."

Here again the "big lie," or a partial truth, is presented to the public with all the amplifiers of the media and promoted by certain school programs.

The other view of sexuality is the personalistic approach, where sexuality is not only a function of genital organs or an imperative of the instincts, but it is seen as a manifestation of the person as a whole. Here all the aspects that constitute human sexuality are taken into consideration. The cognitive, the affective, the spiritual, the moral, the social, and the physiological are involved. "Sexuality becomes personal and truly human when it is integrated into the relationship of one person to another, in the complete and mutual lifelong gift of a man and a woman." Words like love, tenderness, affection, communication, commitment, solidarity, and parenthood have a real meaning.

4. The different ingredients of human sexuality.

There are five ingredients of human sexuality:

1. Cognitive or intellectual. This is the need to communicate with the other to share our life, to live a dual, which becomes one biographical project, where the union and communion between persons is possible. This ingredient of human sexuality has to overcome many of the pressures of the present world, including:

a. The pressure of time—the sheer pressure of daily life—which has been talked about already. Couples simply do not have time for each other today. They work; they watch TV together; they take the kids to school, to piano, to karate; they exercise. However, they do not have time for each other to talk about their feelings, their hopes, their hurts, their children.

b. The pressure of consumerism, which pushes us in the pursuit of more money and more goods. Consumerism takes time and often competes with the family for time. Consumerism also attacks family relationships at the level of values: What matters most to you? Relationships or possessions?

c. The pressure of TV and noise. Silence is needed to permit communication, and TV maintains the necessary noise to distract ourselves from talking and sharing.

2. Affective/emotional. Sexual life, in order to be truly human, needs to be immersed in an affective and emotional world—in love. Sexuality without love is not human; it can be infrahuman. But love demands self-giving; it involves a commitment that draws the person out of solitude and isolation and sets his or her life on a course of concern for others—wishing them well, desiring what is "good" for them—which, according to St. Thomas, is the very essence of love. "Only in this sincere self-giving do men and women find their own fulfillment, self-realization, and happiness," as Dr. Falcovitz told us yesterday.

In this context we have to overcome the pressures of the "me" generation, of selfishness, and of hedonism and comfort. The "big lie" presents to us "love" as "sex," or as "feeling." Romantic love is a beginning, but love is something more. Genuine love is a movement of the will towards the other. Love is work and courage—work to overcome selfishness and laziness, and courage to overcome the fear of suffering.

A newborn child’s mother, who wakes up in the middle of the night, extremely tired, and goes to see her crying infant—without any "feeling"of love at that moment—just accepts the tiredness, overcoming selfishness and laziness. And she discovers that as she accepts the suffering, her heart suddenly grows. The nurturing of the other produces nurturing of her own heart. She is now more capable of love. She is more mature. Even her face changes. She is more placid and fulfilled. That is another reason to promote breast feeding: for the growth and well-being of the family.

3. Physical. This should always be an expression of mutual love and never just one of unilateral or shared self-gratification.

4. Moral. Human sexuality is free and undetermined, not fixed by instinct. And as with any act of freedom, it entails certain rules and values. Morality in this context of sexuality also tells us about transcendence, because the carnal relation should be a sign and a symbol of something beyond the simple relation, something deeper that transcends temporality and belongs to the infinite. The moral of sexuality is the moral of lore. The moral of love is the moral of the relation, and the moral of the relation is the moral of permanence, stability, fidelity. In this area we have to overcome the pressures of permissiveness and relativism.

5. Social. Human sexuality is not only a relation between persons, but it also socializes and creates kinship, family, ties, community. The union of two normally grows into a specially united three, four, or more. By becoming a family, a marriage is more personalized, because more persons are involved in the enriching challenge of donation acceptance.

The pressures in this area are of two kinds:

a. The contraceptive mentality, which sees the child as an intruder, as something to be protected from.

b. This pressure of isolating the needs and tragedies that some families support: "This is only us; this is our problem." The great challenge for us today is to break the isolation and communicate, to share, and to help other families that feel our same pressures and concerns.

When we analyze these ingredients of human sexuality and the anti-family pressures of the "big lie" presented by the media, we need "courage and strength to dismiss them as the destructive distortions that they are." In this fight we have to get together with other families and live the solidarity that our world and our families need. Congresses like this help in this process.

We should embrace positively and openly the personal approach to sexuality, in which all these aspects are taken into consideration. It is the only truly human approach—the one that can bring us closer to the truth and love and their fulfillment: happiness. In this way we will be capable of assuming our responsibilities and react against the reductionistic postures that see sexuality only as a function of genital organs or an imperative of the instincts and thus help the future generations.

(Before Freud there was man and no sex. After Freud there is sex without man.)

5. How should we teach our future generations in this aspect?

The real education on the mystery of life and its transmission cannot be given only through information on sexual techniques. It requires education of the affectivity, the formation of character and conscience, the encouragement of the virtue of chastity, the discovery of the meaning of existence. It should be given in the framework of friendship, affection, and understanding; it should follow the criteria of truth, adequacy, progressiveness, and opportunity. This task can best be accomplished in the family where parents can give it personally, answering the needs of the child at each stage of development with delicacy, naturalness, and serenity, and within the context of love, purpose, and finality.

At this point I will like to add another "T" to the five Dr. Whitfield mentioned yesterday. He talked about time, touch, talents, tenderness, and toughness. I would like to add temperment, because it has been found that children are born with a particular temperament that does not change throughout life.

Cervantes wrote in his Don Quijote, "Genio y figura hasta la sepultura," meaning "temperament and shape or figure until death,"

We as pediatricians can tell parents five or 10 minutes after the birth of a child, or as soon as we see the baby, some of the features of his temperament and thus allow the parents to start seeing the child as a person with a peculiar temperament, from which they can learn. This will help parents in the process of education. We can tell the parents if they are facing an easy child, a spirited "Pepsi" child (Pepsi = Persistent, Energetic, Perceptive, Sensitive, Intense), or a "mother killer."

I have found this to be very helpful to the parents because they start the adventure of education with an important step. In any human relation, if you want to improve the other, first you need to know the person, both his positive aspects and his negative ones. Then you need to accept these aspects, and this is a difficult part. Only after doing these are you able to help your child by "pulling," with your right hand; insisting on the best; setting goals; "pushing" with your left hand, helping in a gentle manner; and encouraging.

When we know the child or try to learn the way he or she is, we are more capable of helping the child build character.

Sexual education starts in the womb before a child is born; it begins when the mother and the father start talking to the child. From the very beginning of life, love, affection, and human values taught by the parents are part of this formation. All this is given throughout life, and parents should be comfortable with their task of promoting virtues like love, self-discipline, compassion, generosity, service, self-sacrifice, trust, loyalty. Through the setting of rules and limits, parents are giving the building blocks of a mature personality to their children to help them give and receive love.

One of the places where these values can be taught more easily is in the large families, where sharing, generosity, and service are learned in a natural way.

Some years ago while talking to Dr. Zang De Wei, the health representative of the Chinese government in Shanghai, I ask her about something that worried me about the Chinese policy of one child per couple. The question was about how those children were capable of understanding the concept of fraternity, of sharing with one’s siblings, of that sentiment that one can quarrel with one’s brother or sister at home but cannot accept anybody outside the family saying anything bad about this same sibling, of that special bond of loyalty that can be further translated with loyalty to one’s own country.

She answered that it was a real problem that they were facing, and they even had characterized a syndrome called the 4-2-1 syndrome: four grandparents, two parents, and one obnoxious child who is extremely selfish, egotistic, and impossible at school, where he feels he should be treated like a king, because he is at home.

But you don’t need to go to China to see this. I find it every day in my practice. How difficult it is for parents to discipline an only child, how easy to spoil them, and how hard to teach them self-giving, generosity and sharing, because they are never satisfied; they are selfish and tyrannical. These children want everything now; they cannot delay gratification. How many feeding and sleeping problems I see in these children who use manipulative behavior.

On the other hand, how different it is in a large family, where children learn in a natural way to share, to give and receive love, to care for the others, to serve, and to delay gratification. Here manipulative behaviors are limited because there is no receptor available to keep alive the manipulation. I imagine that you have often reflected on the colossal impact on a boy or a girl from a one- or two-child family when he or she comes in contact with a family where there are four or six or ten kids. He or she learns so many things that cannot really be learned in manuals: that people can get along, that they can be very united without being the same, that fights are to be made up, that few people can have their own way, that not to forgive or make up leaves you more and more alone. When you explain to your children the need to learn to get along in family life, don’t be afraid to point out the enormous disadvantages of their friends from single-child families, here children probably have more things but have little opportunity to learn to share life.

Of course, as in any generalization, things don’t always work this way. We all know one-child families that educate mature people and large families where manipulative behaviors abound. The key factor here is awareness of the situation by the parents and clarity of the goals. This should be implemented with love and fortitude through rules that will model desired behaviors and will build virtues adequate to the age and stage of the child.

But, unfortunately, in the last few decades "the family’s moral training comes down to inculcating the bare minimal social behavior, not lying or stealing." Says the author of The Closing of the American Mind:

The family requires a certain authority and wisdom about the ways of the heavens and of men. It has to be a sacred unity believing in the permanence of what it teaches if its ritual and ceremony are to express and transmit the wonder of the moral law. When this belief disappears, as it has, the family has, at best a transitory togetherness. People sup together, play together, travel together, but they do not think together. TV marks the high tide for family intellectual life.

And earlier he states: "Nietzsche said the newspaper had replaced the prayer in the life of the modern bourgeois, meaning that the busy, the cheap, the ephemeral had usurped all that remained of the eternal in his daily life. Now television has replaced the newspaper."

I know and hope that your families are different, that you are concerned about this, that you try to enrich your family by devoting your time and putting the necessary effort to promote communication and transmit values and traditions, otherwise you wouldn’t be here.

But at the same time, we receive constant influences from the exterior world. As you know, in some countries the sex education classes are an obligatory part of the curricula. In cases like this we have to get involved with the schools in order to change the orientation those classes have. We cannot accept the reductionistic sex instruction that the majority of these curricula have. We should promote human development in which sexuality is just one part. The subjects given in the classes should teach virtues and values adapted to each age of the child. We should work to instill in the school the formation of willpower that has been left out in the educational system, where only the cognitive faculty is stressed. Human beings have intelligence and willpower, and we have to promote both aspects at home and in the school.

My country, Venezuela, has a law in Congress that obliges the schools to give sexual education. The books available were all from the permissive approach, where only genital instructions and techniques are given and the only human quality is genitalia. To counteract these books and to provide schools with materials that could foster a more humane outlook, we started a project with a big goal: promote human development in the context of family values. We wanted to show a normal family, with all its endeavors, that could serve as a model of behavior for children, who, in some cases, did not have an ideal family of their own. (In my country, as in many Latin-American countries, the father is out of the picture.) As the main actor we chose a boy, Carlos, because one of our goals was to develop responsibility in males to become good fathers.

The premise, which has been proven in other contexts, was that the children could interject the examples and have a pattern to copy in their future. Says William Bennett: "The stories speak to morality and virtues not as something to be possessed, but as the central part of human nature, not as something to have but as something to be, the most important thing to be . . . that will enable them to make sense of what they see in life and help them live it well."

The books use the method of tales, stories, and anecdotes that were specially created for the texts or extracted from local or world literature. These stories and anecdotes describe the undertakings of a regular family in order to foster the formation of virtues and moral examples that shape human character, as well as instill an importance of the rules of hygiene and health habits and the preservation of the environment.

We realize that this has been always the task of the family, and we promote the involvement of parents in this education. As a matter of fact, at each level there is a book for children, a book for the teacher, and also work for the parents to do.

At each stage we concentrate on certain virtues that some authors have indicated as "critical" for certain ages. For example, during the preschool years we stress sharing, generosity, obedience, respect, and order; in the first and second years of primary school: laboriousness, gratefulness, sincerity, and justice; and in the adolescent period: friendship, modesty, sobriety, temperance, loyalty, service, cooperation, and responsibility.

In the book for the teacher, we provide a background to help them in their task and to increase their awareness in these aspects of building virtues, which they can also translate into other areas of their teaching. We have received a very good response from the teachers in this aspect.

In this way, we used the excuse of a law for sexual education to provide learning in the framework of virtues, values, and the shaping of will power—and sexuality is just one aspect of this integrated whole.

With this work we help not only in the building of the intellectual quotient, but also in the building of the so-called emotional intelligence and its five different aspects described by Yale psychologist Peter Salovey of self-conscience, self-control, self-motivation, empathy, and assertiveness.

Thank you very much for your attention.