Lesbian Bed Death Meaning and History

Lesbian Bed Death Meaning

In 1983, when Pepper Schwartz and Phillip Blumstein revealed to the world that lesbians were the least sexual couple of all couple pairings, a vision of lesbians as non-sexual started to emerge in our culture. This research led to more research (Loulan 1984) which further confirmed that not only were lesbians having less sex than other couples, but they were also experiencing a more rapid and dramatic drop in frequency as their relationships continued. Ultimately, a powerfully descriptive and derogatory three-letter phrase emerged to describe the lower frequency and rapid decline of sexual frequency among lesbian couples. The phrase used to describe this phenomenon was lesbian bed death (LBD).

Where did the phrase lesbian bed death come from?

Once the phrase, Lesbian bed death, grabbed the attention of the media, researchers, and comedians in the 80’s, it wasn’t long before this phrase became regularly associated with the sex lives of lesbians. The origin of this phrase has been attributed to three different women. In researching the etiology of LBD, it became apparent to this researcher that no one had investigated the roots of this term. The three women most commonly cited for coining the phrase are the author of the book Lesbian Sex Joann Loulan; famous lesbian comedian Kate Clinton; and researcher and co-author of the book American Couples, Pepper Schwartz.

Pepper Schwartz, co-author of American Couples

In a search for the original creator of the phrase lesbian bed death, I reached out to all three credited sources. First, I contacted Dr. Pepper Schwartz, co-author of American Couples. American Couples is a book written in 1983 that summarizes research she and her co-author Phillip Blumstein conducted with 12,000 couples, including four couple pairings: married, co-habitating (heterosexuals), gay males and lesbian couples. In this book, lesbians were identified as the couple pairing with the lowest rates of sexual frequency. Her research is often credited as the source from which this phrase evolved. Pepper Schwartz responded to my inquiry about this by  saying, “It is attributed to me—people I know say I said it—but I never wrote it. Sadly, I have no memory about it—so I can’t deny or confirm!”  Unsatisfied, I moved on to the next most commonly  -quoted source, Joann Loulan.

Joann Loulan, Author of Lesbian Sex

I reached out to Joann Loulan, author of Lesbian Sex (which was published in 1984, and used copies are still available on amazon).  Lesbian Sex was the first most comprehensive book written by a lesbian, and for lesbians, on the topic of lesbian sex. Frankly, few books have been written since. Loulan shared with me, “I did not coin the phrase Lesbian Bed Death.” She admitted, “I used it frequently, but of course my life was (and is) trying to make that change within the lesbian community and make sex sexy again.” Strike two. No confirmation that this term was developed by her. 

Kate Clinton, Lesbian Comedian

Finally, this researcher contacted Kate Clinton, who also denied coining the term. Always the comedian, she shared a phrase that she used in her comedy, and she expressed much pride in it. Rather than a same-sex relationship, Clinton jokes that lesbians have a “some sex relationship.” Clinton suggested contacting Sue Hyde, the Director of the National Gay and Lesbian Task Force Creating Change Conference. Clinton recalled that Hyde’s partner, Jade McGleughlin, may have been responsible for the phrase lesbian bed death (LBD).

In an email response to this researcher’s inquiry, Sue Hyde wrote, “Jade McGleughlin coined the phrase ‘lesbian bed death’ in about 1985 or so. She will need to relate to you the particulars of how her brilliant mind compressed into a three-word unforgettable phrase the entire phenomenon of decreasing lesbian sex activity in long term couples.” She stated, “I believe she used the term in a paper she wrote while at Smith School of Social Work, where she was proceeding towards her LICSW” (Hyde 2011).

In a phone conversation, Jade McGleughlin stated that she did not know exactly how LBD came into being, but she thought that it “coalesced spontaneously among a group of lesbians for whom it captured an experience particular to that moment.” McGleughlin said that she and the other lesbians in her community, whom she described as sex-positive feminist queers, “wanted the sexiness of talking about sex and to have butch-femme power be translated into hot sex” (McGleughlin 2012). McGleughlin reported that the term does not have concrete, traceable roots. Rather, it is something best credited to a group of women at a specific point in history. While she denied credit for coining the phrase, McGleughlin identified herself as the messenger.

She thought she popularized the phrase during the 1987 March on Washington, where she gave a speech during the Sex and Politics Forum, and she also wrote about LBD in her master’s thesis around the same time. Confirming this was Sue Moir, another lesbian whose name surfaced during the search for the roots of lesbian bed death. Moir was a friend of McGleughlin’s, and also a part of the group of women discussing this topic. Moir explained to this researcher that she heard this phrase lesbian bed death “at a dyke gabfest in Newton,” and that McGleughlin got it from her. What Moir reported is consistent with what McGleughlin recalled. McGleughlin does not take ownership for creating the phrase, and she speculated that the phrase surfaced within lesbian group discussions. Thus, two separate people, neither of whom claims credit for the phrase, corroborate that the idea of LBD evolved through lesbian group conversations.

Moir also stated that she was present when McGleughlin first used the phrase publicly, saying, “I can tell you it was the first time that the audience had heard it” (Moir 2011). McGleughlin stated there was a synergistic effect between the talk of sex within a community of feminist women, and the positive influence this talk had on the sex lives of lesbians engaged in these conversations. McGleughlin’s perception was that LBD included more than the diminishing sex in a lesbian’s personal relationship at the time. She felt it also captured the larger loss of a sexual community where women had grown accustomed to having a public space for sexual discussions and the excitement of the sexually charged women’s movement.

Lesbian bed death was about more than sex. McGleughlin recalled that at the tail end of the sex wars, the whole experience “seemed to collapse into this phrase—kind of like a screen memory.” There was a real phenomenon of waning sex within lesbian relationships, and lesbians further lost connection to the sexual community once the sex wars ended. McGleughlin stated a few times, “sex couldn’t keep pace with rhetoric—but the rhetoric was dying and rhetoric in part produced sex.” This was something of a dialectic, she said, “The theory and the practice were held in tension and constructing and deconstructing each other” (McGleughlin 2012).

Jade McGleughlin stated that LBD “captured a historical moment” during the waning of the sex wars. By giving a name to this moment, she sparked a notion that eventually spread across the United States like wildfire. The message traveled far and wide and it stuck.

The timing of McGleughlin’s speech also coincided with the lesbian sexuality research (Schwartz and Blumstein 1983, Loulan 1984, 1987) at the time, which became an accelerant for the spread of the LBD message. Ultimately, Lesbian Bed Death took on a new and unintended meaning that gave shape to lesbian sexuality as inferior, and in some way doomed. McGleughlin expressed regret about the impact of this phrase. In her opinion, the phrase collapsed the complexity of lesbian sexuality, and what might otherwise have been a historical phenomenon became a “condensation” and “condemnation” of lesbian sexuality (McGleughlin 2012).

How did the Narrative of Lesbian Bed Death Impact Lesbian Sexuality?

The search for understanding about how Lesbian Bed Death influenced lesbian sexuality over the last three decades left this researcher with more questions than answers. There is great curiosity about how the topic of lesbian sex, and the phrase lesbian bed death, was carried from the east coast to the west coast so swiftly and effectively during an era when the internet was not available to spread information at viral rates. Though it is interesting to uncover the roots of this phrase, the ultimate goal of this research is to gain a better understanding of how this phrase assumed enough power in our culture to influence the perceptions of lesbians as sexually inferior. How did this message spread so quickly, and then remain so active in the cultural consciousness?

The label of Lesbian Bed Death devalues lesbian relationships by suggesting that lesbians are inadequate, or worse yet, sexually broken. When the measurement is frequency, lesbians lose the race against heterosexual or gay pairings when it comes to sex.

Who benefits if lesbian sex is viewed as inadequate, or inferior to the sex had by heterosexuals?

One theory is that lesbians pose a threat to social order. Historically, men have held the power in our culture, and women have been raised to depend on them, primarily financially, for survival. This pattern has broken down over the years, thanks to the women’s liberation movement and the increase of women in the workforce. However, women still struggle to find equal footing with men in most areas of life. In South Africa, raping a lesbian can make a man a township hero. “Attackers boast publicly of their crimes and declare to their victims: ‘We’ll show you-you’re a woman,’ the report said. Such attacks are often referred to as ‘corrective rapes’ in South Africa” (Guardian 2011, 1). A woman without a man in South Africa is not considered a woman at all. As archaic as this perspective seems in 21^st century America, it is not unreasonable to think that we are a culture that is not yet finished moving slowly out of one view (women are defined by men) and into a new perspective (women are defined by themselves). As we have learned from many other oppressed groups, such as Blacks in America, cultural change is slow, regardless of what is true and right.

Another curiosity that surfaced during this research is about the momentum required to get the message of LBD off the ground. Groups of women were reportedly having regular chats about sex, which served to enhance their own sex lives, and simultaneously fulfilled an important need for a sense of belonging. These participants of these chats percolated the unifying concept of lesbian bed death. From these chats what rose to the surface was the message of lesbian bed death. If McGleughlin’s perception of this phrase is true, it expresses a dual message about the loss of sex and loss of community. In that case, the message itself has somehow changed over time, losing the emphasis once placed on the “death” of the community of lesbians who talk about sex.

An alternate theory about the spread of this message is the possibility that it was simply true, and lesbians themselves were seeking personal validation for their own experience. It is possible that the continued discussions, which also kept LBD alive and spreading, provided an outlet for lesbians to validate their experience. Although there has not been much research about lesbian sexuality over the last three decades, the existing research consistently reported low rates of sexual activity for lesbians, with few exceptions (Alicia Mathews et al 2003, Lelita Peplau et al 1997). Research has also consistently shown a quick decline in frequency over the course of lesbian relationships. The reality seems to be that lesbians had, and still have, less sex. This researcher keeps returning to one question. Who cared, and why was this a problem?

Is lower sexual frequency a problem for lesbians?

Coming out in the 70s and 80s was avant-garde behavior. Lesbians were not previously visible to the general public. The best way to establish a sense of belonging is to identify the ways in which you are similar to those with whom you wish to join. If research revealed that lesbians are sexually inadequate during the same time that lesbians were seeking approval for their identity, it seems possible that lesbians themselves would have difficulty accepting this information.

Instead of embracing what is, advocates of lesbians sought, and seem to still be seeking, to disprove the amount of sexual activity that occurs between women, as if to say, “We are like you.” Presumably, the assumption is that being like heterosexuals will allow lesbians to be seen as “normal.” This researcher believes that the greatest power is sourced from the truth. It is not important how much sex lesbians are having, or how often lesbians are having sex. What is important is whether or not lesbians are satisfied with their intimate relationships and whether or not they feel empowered to create these relationships according to their own truth, and not a social standard randomly transferred from other couple pairings.

Gay men are reportedly the most sexual of all pairings. If the frequency or amount of sex determines health, then why are gay men not considered the healthiest of all couples? What would have happened if Schwartz and Blumstein discovered that heterosexuals were having the least amount of sex and that their sexual activity declined more rapidly than the other couple pairs? It is likely that this paper would be evaluating the concern with sexually overactive lesbians, even if their sexual behaviors were exactly as they are now.

Another question that evolved from this research is; How far did the phrase lesbian bed death travel? This researcher decided to briefly explore perceptions of lesbian sexuality in other countries. A cursory look for information about sexual frequency among lesbians in other countries did not reveal much. There was one report on lesbians in The Netherlands/Holland by Karin Van Rosmalen-Nooijens, et al which was conducted in 2008. This study indicated that seventy-six percent of lesbians of all ages experienced a decline in sexual activity.  It appears that the phrase lesbian bed death did not spread far beyond the borders of the United States, but perhaps the phenomena of lower sexual frequency is a shared experience regardless of the country in question.

What does appear consistent is that how lesbians are viewed within a culture is rooted in how women are viewed within that culture. The attitude towards lesbian behavior is directly affected by the role a woman is expected to play in her culture. For example, in Asia, a woman’s role is primarily concerned with reproduction. The concept of sexual orientation is irrelevant because sex for women is not about sex, it is about having babies. In Asia, any sexual behavior that doesn’t have the goal of procreation is considered an aberration. Thus, homosexuality is not acceptable behavior because it is by its very nature about pleasure.

Lesbian bed death stereotyped the sex lives of lesbians as defective, inadequate, and inferior to others. This label added another layer of oppression very similarly to the way “sexual inverts” did in the early 20^th century. It is useful to consider the history of the term sexual invert, and the influence this term had on cultural perceptions of lesbians. From the mid-1920s to the mid-1970s, lesbians were considered “sick,” “disturbed,” and “deviant.” It took a half-century to transcend the damaging perceptions of lesbians as mentally ill.

History, it is said, often repeats itself. Given this, it is possible, or even likely, that lesbian bed death, much like sexual inversion, will cycle out of the collective consciousness and be replaced by a new, improved perception of lesbians. If lesbian bed death is a concept that evolved in the mid-1980s, history would indicate that by the year 2030, LBD should be nearly erased from the collective consciousness. This does not, of course, mean that lesbians will be having more sex, but the absence of the label will clarify cultural perceptions about lesbian sexuality, and how those perceptions play out in the sex lives of lesbians.

What makes the most sense to this researcher when assessing the history and influence of the phrase lesbian bed death, is that there was a melting pot of motivations, which led to a conversion of agendas that served multiple purposes simultaneously. Whether it was used as a form of oppression, a way to keep women in their place in society, or whether it was simply because it is true and lesbians needed validation for their truth, the side-effects of this phrase on the sex lives of lesbians have proved unhelpful.

This researcher has concluded that lesbian bed death is a disparaging phrase used to criticize the sexual realities of lesbians in comparison to heterosexuals. It is not the behavior of lesbians that is the problem, it is the grossly inaccurate and irresponsible categorization of these behaviors as inadequate or dysfunctional that is the problem. Debating lesbian bed death validates its merit. This researcher’s conclusion is that lesbians have a bed (a sex life) and it is different than other couple pairs. That difference does not make it dead, it simply makes it different.

To defend lesbian bed death suggests that there is something legitimate to argue against. This researcher does not believe in the legitimacy of LBD. It is a misunderstood concept that filled a void of understanding during a time that lesbians were stepping out and exploring the uncharted territory of a visible life among the heterosexual population. The mistake, it seems, was to agree that a lesbian relationship should mirror that of a heterosexual relationship in order to be successful.

As it turns out, in the limited research conducted about the difference between gay and heterosexual relationships, authors such as John Gottman have concluded that gays and lesbians are more inclined to fight fairly, are not as belligerent with one another as heterosexuals are, and are less domineering and not as fearful with each other. He also discovered that lesbians and gay men make better use of humor when they argue than do their heterosexual counterparts (John Gottman, et al 2003). Is frequent sex more important to a relationship than fair fighting and being kind?

Sexual Frequency of Lesbians

What is the current sexual frequency of lesbians? Question number eight in the Frequency vs. Satisfaction survey asked, “In the last six months, how many times have you had sex (intimate contact intended to create sexual pleasure) with your partner?” Respondents were prompted to fill in the number of times they had sex in the last six months. Four separate categories of frequency were created to quantify the amount of sex that lesbians were having. Women who reported having sex zero to nine times were placed in the category labeled “once monthly or less.” Women who reported having sex between ten and twenty-one times in the last six months were assigned to the category of “two to three times per month.” Women who reported having sex twenty-two to eighty-three times in the last six months were categorized as having sex “one to three times a week.” The final category of “four or more times per week” included women who reported eighty-four or more episodes of sexual activity in the last six months.

The reported sexual frequencies were then rounded to the nearest category. For example, if a woman reported she had sex nine times in the last six months she would be assigned to the category of “once monthly or less.” Nine times in the last six months is obviously more than once monthly, however, it is closer to this category than it is to the next category of “two to three times a month,” and thus the best fit.

Question eight was completed by 416 women. Twelve percent (50 lesbians) of the sample reported having no sex in the last six months. Thirty-seven percent (154 lesbians) of the sample reported having sex once monthly or less. Combined, these groups represent almost half of the sample population, suggesting that the majority of lesbians are having sex once monthly or less. Twenty percent of lesbians reported having sex two to three times a month. Twenty-seven percent of lesbians reported having sex one to three times weekly. Only five percent reported having sex five or more times weekly.

Few studies have been conducted on the sexual frequency of lesbians. One of the most recent studies was published in 2003 by Matthews, Tartaro, and Hughes. In a comparative study of lesbian and heterosexual women in committed relationships, Alicia Matthews, et al found that sixty-nine percent of lesbians and seventy-six percent of heterosexual women reported having sex at least once weekly. These findings are significantly higher than those of this study. Only thirty-four percent of the women in the Frequency vs. Satisfaction sample reported having sex at least weekly, as seen in figure seven. It is important to note, however, that the sample size for the Alicia Matthews, et al. study was based on thirty-six lesbians. The small sample size raises questions about the validity of these findings, and the authors acknowledge that the small sample limits their ability to make any generalizations about lesbian sexuality.

Another study was done in 1997 by Letitia Peplau, et al also revealed higher rates of sexual frequency among lesbians. This particular study focused on the sexual behaviors of 398 Black lesbians (Letitia Peplau, et al 1997). The findings showed that eleven percent of Black lesbians reported having sex more than three times a week. This is slightly higher than the eight-percent in the Frequency vs. Satisfaction study. Forty-seven percent of lesbians in Letitia Peplau, et al’s study reported having sex one to three times per week, which is significantly higher than the twenty-nine percent in the Frequency vs. Satisfaction Survey. Forty-one percent of the Black lesbians reported having sex less than once a week, which is significantly lower than the sixty-five percent in the Frequency vs. Satisfaction Survey.

Letitia Peplau, et al acknowledge that the sample is non-representative; however, it does offer insight to the variability of lesbian sexuality. What accounts for the higher rate of sexual frequency among Black women? This is valuable information, given that most of the studies conducted on lesbian sexuality are based on the histories of Caucasian women, including the Frequency vs. Satisfaction sample. While this question is outside the scope of this paper, it is none-the-less a valuable question to note.

The most commonly cited source about lesbian sexual frequency is still Schwartz and Blumstein (1983). The frequency of lesbian sex is presented in the context of length of relationship and the rating of one’s quality of sex life. For the American Couples study, it appears these statistics were based on a total of 768 lesbians. Of these lesbians, 195 reports having sex once a month or less, which equals twenty-five percent of the sample. This is significantly lower than the findings in the Frequency vs. Satisfaction Survey which suggest that forty-eight percent of all lesbians in the sample (44% of lesbian couples) are having sex once monthly or less.

The same calculation process reveals that twenty-seven percent of the American Couples sample have “sex between once a month and once a week” This compares to sixty-eight percent of the women in the Frequency vs. Satisfaction sample who have sex between once a month and once a week. The third category offered is “sex between one and three times a week.” This includes 274 lesbians or thirty-six percent of the American Couple’s sample. This finding does not differ much from the Frequency vs. Satisfaction Survey, which indicated that twenty-nine percent of lesbians are having sex one to three times per week. The final category of frequency, “Sex three times a week or more,” comprised nineteen percent of the sample. The Frequency vs. Satisfaction Survey reported eight percent of women at this level of sexual frequency, which is less than half of the findings by Schwartz and Blumstein (Schwartz and Blumstein 1983, 27).

Loulan’s 1987 study revealed remarkably similar findings to the Frequency vs. Satisfaction Survey. Twelve percent of women in both samples report having no sex. Loulan categorized sexual frequency as “once or fewer times” (presumably per month) and “two to five times a month,” which compare closely to the fifty-three percent of lesbians in the Frequency vs. Satisfaction Survey who reported having sex up to one or two times per month (Figure 7). Twenty percent of lesbians reported having sex six to ten times a month in Loulan’s survey, compared to twenty-six percent of lesbians in the Frequency vs. Satisfaction study who reported having sex one to two times weekly. Those reporting sexual activity three or more times a week in the Frequency vs. Satisfaction Survey comprise eight percent of the sample, and for Loulan’s study, fourteen percent reported having sex “eleven or more times in a month.” The similarity in these findings is striking.

Figure 6.  General Overview of Lesbian Sexual Frequency

Figure 7.  Detailed Lesbian Sexual Frequency

Women aged twenty-one to thirty are the most sexually active of the lesbians in the Frequency vs. Satisfaction study, with forty-eight percent having sex once weekly or more (Table 9). A noticeable drop in sexual frequency does not begin until after age fifty. At fifty-one, there is a ten percent drop in weekly sexual frequency. Thirty-one percent of forty-one to fifty-year-olds report having weekly sex. This drops to twenty-one percent at age fifty-one and to fourteen percent at age sixty-one. According to the National Institute on Aging, the average age of menopause is fifty-one, which seems to be the strongest explanation for this drop. One of the common side effects reported about menopause is a decrease in libido. The Frequency vs. Satisfaction findings is also similar to the findings of Loulan (1987), where she reports a general decline in sexual frequency as women age, with the most notable drop in frequency occurring between the age group forty to forty-nine, and fifty to fifty-nine.

Table 9.  Sexual Frequency Based on Age of Lesbians

Percentages reflect sexual frequencies per age group

n=lesbians per age

To explore the desire for sex as thoroughly as possible, the Frequency vs. Satisfaction survey inquired with participants about the frequency of non-partner sex in the last six months. Question ten asks, “In the last six months, how many times did you have sex with someone other than your partner?” Of the 498 respondents, only forty-two (12%) reported having non-partner sex. The most non-partner sex occurs with couples who have been partnered between six and ten years, followed by women who are newly partnered for up to six months (21%).

Of the forty-two women who report non-partner sex, thirty-nine responded to the question about whether or not their relationship is open or closed to outside sex. Of these thirty-nine who reported having sex outside their relationship in the last six months, thirteen are not currently partnered. This might suggest that thirteen (3%) of women pursued another relationship or at least sex, and it may or may not have been the cause of their relationship break-up. Eight (2%) of the women who had non-partner sex report that they have agreements with their partner to engage in sex outside the relationship. Eighteen of the women (4%) reported no such agreement, so were likely engaged in acts of infidelity.

The incidence of non-partner sex with or without partner approval is nominal. These findings are lower than the incidence of non-partner sex found in 1983 by Schwartz and Blumstein. Ten percent of their sample of lesbians reported infidelity, compared to four percent of the Frequency vs. Satisfaction sample. Of those with an agreement about non-partner sex, twenty-five percent engaged in sex outside of their relationship.

There are two possibilities that may account for this decline in non-partner sex. One, the onset of AIDS occurred around the time Schwartz and Blumstein reported their findings, which would place participants of their survey at the tail end of the sexual liberation movement where sex was viewed less restrictively in our culture. This era put a damper on the sex lives of all couple pairs.

Another possibility is that during the 70s and 80s, lesbians were less visible than they are in today’s culture. With this visibility comes an increased level of validation and possibly accountability. A client who was in her prime dating years during the years of Schwartz and Blumstein’s study explained to this researcher that she had been unfaithful in every relationship from around age twenty to age forty. She stated that now that she is approaching sixty years old, she has come to see that she never valued her relationships, that she did not see lesbian relationships as important as heterosexual relationships. She shared that she had trouble conceiving that they would last in the same way that married couples believed their relationships would last. She explained that she feels differently now, that she has come to see her relationship as something that has meaning, and she experienced this only after coming out and having others (particularly heterosexuals) know about her relationship.

Once lesbians became more visible, it is possible they began to take their own relationships more seriously, which may have contributed to the decline in non-partner sex among those without agreements.

Figure 8.  Instances of Sex Outside the Relationship Among Lesbians

In summary, research largely supports the fact that lesbians are less sexual than other couple pairings. However, there is no evidence to support the belief that this translates into a deficiency, or that a lower frequency is in any way unhealthy. The assumption that heterosexuals are the healthy standard by which lesbians must be compared is a paradigm this researcher rejects. Some lesbians have a lot of sex. Some lesbians have none. Lesbians of all ages are sexual, and most are disinclined to stray sexually from their primary relationship. Lesbian sex does appear to continue at a rate similar to that found in 1987 by Loulan, though fewer lesbians appear to engage in non-partner sex than in previous years. Chapter Seven will shift attention to what is important to lesbians when it comes to their intimate relationships

Read Chapter Five

Read Chapter Seven

SEXUAL FREQUENCY AMONG LESBIANS

ABOUT THE AUTHOR

Michele O’Mara, LCSW, Ph.D. is an expert lesbian relationship coach and psychotherapist with a comfortable obsession with all things related to love and relationships between women. She is particularly fascinated by lesbian couples in blended families, issues of infidelity, lesbian sexuality, and recovery from lesbian breakups. She is the author of Just Ask: 1,000 Questions to Grow Your Relationship, which is available in paperback or Kindle on Amazon, as well as an app on Itunes /Google play. As a side-hobby, she operates a quirky site called “AskLesbians.com” where she randomly polls lesbians to satisfy the quirkiest of curiosities. Lastly, she and her wife Kristen host Lesbian Couples Retreats in various destinations, and you can learn more about those at lesbiancouples.co.

This article is an adaption of Chapter Six of a dissertation written by Michele O’Mara, PhD. Tap here t read the entire dissertation in a pdf format.