Chapter 1: Attitudes about Public Nudity in Society

April

“Daan, do I hear Arie fussing?”

“He is; I’m on it, Kim. Don’t stop your work,” Arie’s dad, Daan Janssen, called to his wife Kimberly. “I’ll check him. Must have a messy diaper.”

“Thanks, dear. I’m almost done reviewing anyway. Damn, I’ll be glad when I get these boards finished.”

Daan’s wife, Kimberly Arno, was preparing for Step 2 of the U.S. Medical Licensing Examination, commonly known as the medical boards, the final step in allowing her to become a licensed physician. Her specialty field was psychiatry. She had previously completed a PhD degree in neuroscience from Boston University, and would receive her MD degree this spring. She and Daan wanted to stay in the Boston area so she had applied for the medical school’s affiliated residency program at the Boston Medical Center, BMC. This wasn’t a typical step; new physicians usually did their residency at a different clinical location from their medical school, but Kimberly had chosen to study altered states of consciousness in her PhD program and had previously published two important papers on the dissociative state, articles based on her dissertation research. The BMC had a highly regarded psychiatry department and its head, the chief of psychiatry, wanted Kimberly to join their staff, so she had been selected for their residency program.

Daan walked into his infant son’s room to be greeted by the sight of four tiny limbs waving in the air above a squirming, dark-haired baby boy. The sounds Arie was making sounded insistent and plaintive. The odor that reached Daan’s nose told the rest of the story.

“Yeah, Arie’s diaper is full,” Daan groaned. “Maybe we need to ease up on his beef meals,” he muttered. “This kid’s poop can get really stinky.”

Arie was eight months old, having been born the past July. As Daan was taping up the sides of his son’s fresh diaper, Kimberly joined him.

“Thanks for doing that, honey. I was just reviewing the last part of the practice exam, and my head is swimming. One of the practice questions in the final set I worked on was on psychiatry and was a doozy. The patient reported dreaming about being naked and seeing naked people everywhere and found it distracting and disturbing, to the extent that it was interfering with his life. The question asked to offer some possible diagnoses, recommend a course of treatment, and give the rationale for that reasoning.”

“Jeez, sweetie, that’s a strange question,” Daan mused. “Why would they focus on nudity?”

“Nudity in dreams is common, sweetie; you know that. And of course, public nudity is much more common these days than just a few years ago, but that question? Dream nudity doesn’t really intrude into waking life normally. Jeez. Such a general question, there were so many answer possibilities. Is his problem caused by shame or guilt, or is it related to anxiety? Other possibilities are obsessive and compulsive disorder or gymnophobia. The cause could be from a prior trauma like a sexual assault, or body dysmorphia, or even a general anxiety about sexuality. It could be anxiety from a fear that his nudity is body shaming or that he is somehow exposed and unprotected. Another possible fear is that he believes that he’s physically inferior in some way, like having a micropenis. So there was no clear answer and my response was to list a few possibilities and I wrote that an actual diagnosis and treatment plan required further discussion with the patient.”

“So what was the answer?” Daan asked.

“I had listed all the more common diagnosis possibilities that the answer required, plus several additional ones, and that the case required further therapy sessions, so, yay, I was correct,” Kimberly smiled. “Damn, after tomorrow, no more exams until I have to take Part 3 of the boards. That’s when I finish my first residency year.”

The two parents kissed Arie, who looked very sleepy, and Daan put him down in his crib. They checked the baby monitor, turned the night light on and the main light off, and tiptoed out of the room.

When they were out of the room, Daan said, “Say, honey, I saw in the TV program guide that there’s that monthly news documentary program on tomorrow night and there’s a special about the changed social attitudes toward public nudity. It caught my eye ‘cause one of the guests is to be Eleanor Garner.”

“Oh, really? Jeez, I need to watch that show for sure,” Kimberly told him.

“Do you keep in touch with her?”

“Yeah, I do, but not as much now as when I was working on my doctorate. She was my external committee member and a collaborator on one of my projects, you’ll recall.”

Daan knew that in many universities, the doctoral candidate’s faculty dissertation committee includes a member who is not affiliated with that university.

“I wonder why the network show asked her to appear,” Daan remarked.

“So, at the Horning Institute, her research specialty is on the physiological symptoms and signs of stress from negative emotion causes such as fright, shame, and humiliation. Nudity, when it’s unexpectedly encountered or a person is forced to strip—like a lot of high schools are doing now with that new naked P.E. class initiative that’s started—will evoke those reactions, so that could be why. My PhD research covered the related area: what happens to the human psyche when it’s highly overloaded with stress—as a reaction to extreme fright or even terror—and I made some important progress in understanding the dissociative state.”

“Yeah, the mind kind of shuts down somehow and the person seems like a robot in a way,” Daan observed. “Like an out-of-body experience, OBE, but more severe. We studied about that state a fair amount in my graduate psychology program.”

“So there’s always been this argument about dissociation, whether it’s a pathological response akin to a neurosis or even a psychosis like a schizoid reaction, or whether it’s a protective mechanism that the brain takes to absorb the shock and allow the person’s psyche to slowly recover. In my research, you’ll recall that I told you about my findings about changes in the brain’s pyramidal tracts and the PAG—the periaqueductal gray—in the dissociative patients I was able to work with. Those findings allowed me to go further in seeking proof that the dissociative state can be a built-in protective neuro-psychological response to overwhelming stress, since in lower animals, those brain areas are associated with the animals’ protective freezing responses when faced with a threat, where any tiny motion will attract a predator’s attention.

“In fact, some people can voluntarily enter such a state—called volitional dissociation—in order to intentionally separate themselves from terribly unpleasant experiences. In my research, I found that the same brain mechanisms, from the most severe forms of dissociation with depersonalization and derealization, to volitional dissociation, exist on a continuum and that a person’s predisposition to have such responses can vary greatly between individuals.”

“So Eleanor’s research and yours kind of complemented each other’s, right?”

“Exactly. Listen, I’m tired and need to sleep now. The exam starts at 7:00 a.m. tomorrow; it’s more than eight hours long. They only allow a total of sixty minutes of rest or break time, which includes lunch break, and I want to be fresh.”

“Sure, darling. Don’t worry about Arie. I’ll do the overnight feeding and diaper detail if he wakes. He’s almost at eight hours sleep now, and since it’s almost 10 p.m., he should sleep till maybe 6 a.m. You go get some rest.”

Just after 4:30 p.m. on the following day, Daan was in his school office going through several folders. He leaned back, rubbed his eyes, and looked out the window where the late afternoon sunlight was streaming through the glass, bathing the room in its red-tinted golden light. Spring was just around the corner and he couldn’t wait for the warmer days. His phone rang; it was Kimberly.

“It’s me, honey ... Just leaving the exam room. That was exhausting; my poor eyes are all worn out.”

“Wow, sweetie, so how do you think you did?” he asked her.

“I’m sure I nailed it. I actually studied about half of the questions that were on the exam, and I knew the other stuff cold. They grade by AI—you know, computer, so I’ll get my results in about ten days. Say, should I get Arie from day care?”

“No, you just go home and kick back. You’ve had a lot of stress the past month with both studying and your clinical duties. I had a light day and my swimming coaching is pretty much over for the season; just tidying up the paperwork. My last class ended two hours ago, but I had a bunch of administrative AD jobs to finish up. Say, I’ve got some interesting but mostly concerning news about some instructional changes at my school that I’ll tell you. Let me finish up here and I’ll be able to leave in ten minutes and I’ll pick Arie up.”

Daan actually had several jobs; in addition to his being the school’s assistant athletic director (AD), he was a health and physical education teacher at Newton Charter High School; this was a new school in the district and had opened only three years ago, drawing its students from the other two local high schools. Also, with his master’s degrees in psychology and clinical social work, he served not only as the school’s head counselor, he also was the school district’s unofficial psychologist. Finally, he was the swimming team coach. Daan was an NCAA collegiate recordholder; his record time in the 400-meter individual medley event earned in his competing for his alma mater, the University of Virginia, was yet unbroken.

In the state, each high schools’ head swimming coach led both the boys’ and girls’ swimming programs, which had been essentially gender-merged in all of the Massachusetts schools several years ago and typically, each high school had a single head swimming coach. That coach was usually supported by an opposite-sex assistant coach who would deal with the issues of their own sex when needed. Since Daan’s school had a selective admission policy—it maintained an enrollment of about 800 students—those multiple jobs were doable for one person.

When he arrived home with Arie, Kimberly had already begun to prepare dinner, so Daan set Arie in his playpen and went to help her.