Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus.

The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.

Circuits regulating pleasure and happiness - focus on potential biomarkers for circuitry including the habenuloid complex.

INTRODUCTION: The multiplicity and complexity of the neuronal connections in the central nervous system make it difficult to disentangle circuits that play an essential role in the development or treatment of (neuro)psychiatric disorders. By choosing the evolutionary development of the forebrain as a starting point, a certain order in the connections can be created. The dorsal diencephalic connection (DDC) system can be applied for the development of biomarkers that can predict treatment response. MATERIALS AND METHODS: After providing a brief introduction to the theory, we examined neuroanatomical publications on the connectivity of the DDC system. We then searched for neurochemical components that are specific for the habenula. RESULTS AND DISCUSSION: The best strategy to find biomarkers that reflect the function of the habenular connection is to use genetic variants of receptors, transporters or enzymes specific to this complex. By activating these with probes and measuring the response in people with different functional genotypes, the usefulness of biomarkers can be assessed. CONCLUSIONS: The most promising biomarkers in this respect are those linked to activation or inhibition of the nicotine receptor, dopamine D4 receptor, µ-opioid receptor and also those of the functioning of habenular glia cells (astrocytes and microglia).

Mapping a Danger Zone of the Dorsal Nerve of the Clitoris: Implications in Female Cosmetic Genital Surgery.

BACKGROUND: The literature regarding the route of the dorsal nerve of the clitoris is sparse and lacks surgical focus. With an increasing number of procedures being performed on the labia, it is important to elucidate the route and note any variation from normal of the nerve. METHODS: Fifty-one cadavers were dissected to yield 97 dorsal nerve of the clitoris samples. Measurements were taken from (1) the dorsal nerve of the clitoris penetration point of the perineal membrane to the urethra, (2) the nerve's penetration point of the perineal membrane to the pubic bone, (3) the angle of the clitoris to the branch point of the dorsal nerve of the clitoris, and (4) the branch point of the nerve to the distalmost point of the glans clitoris. Any anomalous branching patterns of the dorsal nerve of the clitoris were recorded and classified. RESULTS: The means and standard deviations of each measurement were used to create a surgical danger zone. The mean of each measurement was (1) 34.63 mm, (2) 5.74 mm, (3) -3.07 mm, and (4) 30.40 mm, respectively. In addition, six distinct branching patterns were observed, organized, and classified based on the location and number of branches observed. CONCLUSIONS: The dorsal nerve of the clitoris has multiple branching patterns and typically travels along the same course in most women. Further investigation of the course and three-dimensional position of the dorsal nerve of the clitoris is warranted to preserve sexual sensation as the frequency of procedures involving the female pudendum increases.

Analysis of facial expressions in response to basic taste stimuli using artificial intelligence to predict perceived hedonic ratings.

Taste stimuli can induce a variety of physiological reactions depending on the quality and/or hedonics (overall pleasure) of tastants, for which objective methods have long been desired. In this study, we used artificial intelligence (AI) technology to analyze facial expressions with the aim of assessing its utility as an objective method for the evaluation of food and beverage hedonics compared with conventional subjective (perceived) evaluation methods. The face of each participant (10 females; age range, 21-22 years) was photographed using a smartphone camera a few seconds after drinking 10 different solutions containing five basic tastes with different hedonic tones. Each image was then uploaded to an AI application to achieve outcomes for eight emotions (surprise, happiness, fear, neutral, disgust, sadness, anger, and embarrassment), with scores ranging from 0 to 100. For perceived evaluations, each participant also rated the hedonics of each solution from -10 (extremely unpleasant) to +10 (extremely pleasant). Based on these, we then conducted a multiple linear regression analysis to obtain a formula to predict perceived hedonic ratings. The applicability of the formula was examined by combining the emotion scores with another 11 taste solutions obtained from another 12 participants of both genders (age range, 22-59 years). The predicted hedonic ratings showed good correlation and concordance with the perceived ratings. To our knowledge, this is the first study to demonstrate a model that enables the prediction of hedonic ratings based on emotional facial expressions to food and beverage stimuli.

Socio-ecological predictors of non-organized physical activity participation and decline between childhood and adolescence.

Physical activity (PA) tends to decline during late childhood and adolescence. In Australia, this decline has been shown to particularly occur non-organized PA (e.g., active play, informal sport). This study aimed to explore predictors of non-organized PA at 13y; and decline between 11y and 13y. Data were sourced from the Longitudinal Study of Australian Children. Non-organized PA was measured using time-use diaries. Analyses included Cragg hurdle and binary logistic regressions. The likelihood of non-organized PA at 13y was predicted by PA enjoyment (OR = 1.36, p = 0.007), number of siblings (OR = 1.11, p < 0.001), sex (females) (OR = 0.66, p < 0.001) and home computer use at 11y (OR = 0.98, p = 0.002) (n = 3,193). Females also engaged in less non-organized PA at 13y (ß = -77.77, p = 0.048) (n = 3,193). Significant predictors of decline in non-organized PA were socioeconomic position (OR = 0.92, p = 0.047) and sugary drink consumption at 11y (OR = 1.06, p = 0.033) (n = 3,222). Strategies to promote non-organized PA may include targeting females and those of lower socioeconomic position, and focusing on types of PA that may replace the perceived benefits of computer use.

Intracranial self-stimulation-reward or immobilization-aversion had different effects on neurite extension and the ERK pathway in neurotransmitter-sensitive mutant PC12 cells.

Various actions trigger pleasure (reward) or aversion (punishment) as emotional responses. Emotional factors that negatively affect brain neural control processes for long periods of time might cause various mental diseases by inducing neuronal changes. In the present study, newly developed PC12m12 cells which are　highly sensitivity to neurotransmitters such as acetylcholine (ACh), were used. Exposing the cells to plasma from rats that had been subjected to intracranial self-stimulation (ICSS) markedly upregulated neurite outgrowth. In addition, voluntary running in a wheel or forced on a rotating rod was used to induce behavioral excitation in rats, and examinations of their plasma confirmed that the ICSS-induced neurite outgrowth was not associated with the ICSS behavior itself. Furthermore, immunoblotting and treatment with U0126, an ERK (extracellular signal-regulated kinase) antagonist, showed that the ICSS-induced neurite outgrowth was related to neuronal ERK activity. Exposing the same cells to plasma from rats that had been subjected to immobilization (IMM) also increased neurite outgrowth. Although the degree of enhancement was not as great as that seen after the ICSS rat plasma treatment, it was less than that observed after treatment with ACh as a positive control. These results indicate that ICSS or IMM lead to varying degrees of morphological changes, such as enhanced neurite outgrowth, in PC12m12 cells, but the neuronal signal transduction pathways underlying these effects differ; i.e.,the former morphological change might involve the activation of the ERK pathway, whereas the latter changes might not. Using PC12m12 cells which exhibit sensitivity to neurotransmitters, it might be possible to clarify the pathogeneses of mental diseases at the neuronal level and search for therapeutic drugs.

Continuous walking and time- and intensity-matched interval walking: Cardiometabolic demand and post-exercise enjoyment in insufficiently active, healthy adults.

We compared cardiometabolic demand and post-exercise enjoyment between continuous walking (CW) and time- and intensity-matched interval walking (IW) in insufficiently active adults. Sixteen individuals (13 females and three males, age 25.3 ± 11.1 years) completed one CW and one IW session lasting 30 min in a randomised-counterbalanced design. For CW, participants walked at a mean intensity of 65-70% predicted maximum heart rate (HRmax). For IW, participants alternated between 3 min at 80% HRmax and 2 min at 50% HRmax. Expired gas was measured throughout each protocol. Participants rated post-exercise enjoyment following each protocol. Mean HR and V˙O2 showed small positive differences in IW vs. CW (2, 95%CL 0, 4 beat.min-1; d = 0.23, 95%CL 0.06, 0.41 and 1.4, 95%CL 1.2 ml.kg-1.min-1, d = 0.36, 95%CL 0.05, 0.65, respectively). There was a medium positive difference in overall kcal expenditure in IW vs. CW (25, 95%CL 7 kcal, d = 0.58, 95%CL 0.33, 0.82). Post-exercise enjoyment was moderately greater following IW vs. CW (9.1, 95%CL 1.4, 16.8 AU, d = 0.62, 95%CL 0.06, 0.90), with 75% of participants reporting IW as more enjoyable. Interval walking elicits meaningfully greater energy expenditure and is more enjoyable than CW in insufficiently active, healthy adults.

Affective responses to high-intensity interval training with continuous and respite music.

Music has been shown to enhance affective responses to continuous exercise, but the most effective application of music during interval exercise is poorly understood. This study examined two contrasting applications of music designed to assuage the decline in pleasure often experienced during high-intensity interval training (HIIT). In a repeated measures crossover design, 18 recreationally active participants (10 men and 8 women; M age = 25.1 ± 5.1 years; M BMI = 23.08 ± 2.01 kg/m 2; M VO2max = 38.82 ± 10.73 ml/kg/min) completed three HIIT sessions (10 x 60 s efforts at 100% Wmax, separated by 75 s recovery) on a cycle ergometer. Participants completed two experimental conditions: respite music (applied only during the recovery periods), continuous music (applied throughout the entire HIIT session); and a no-music control condition. Results indicated that music did not influence affective valence during the work bouts or recovery periods of the HIIT sessions (ps >.05), but that listening to music continuously elicited greater post-task enjoyment (p =.032, d = 0.66) and remembered pleasure (p =.044, d = 0.5). This study is the first to investigate the application of music during a practical HIIT protocol and to compare the effects of respite versus continuous music during interval exercise.

Reducing sugar use in coffee while maintaining enjoyment: A randomized controlled trial.

Consuming coffee without (or with less) sugar may help people lower their daily calorie intake without restrictive dieting. We tested two theory-based interventions to help people do so. One involved gradually reducing sugar over time, and the other was based on mindfulness theory. These interventions were compared to a repeated exposure (to sugar-free coffee) group. Participants in all conditions had significant increases in consumption of sugar-free coffee that lasted 6 months. The mindfulness group had a larger increase than the others. Unexpectedly, the gradual reduction intervention led to a decrease in liking for sugar-free coffee and was the least effective.

Emotion recognition in objects in patients with neurological disease.

OBJECTIVE: Considerable research indicates that individuals with dementia have deficits in the ability to recognize emotion in other people. The present study examined ability to detect emotional qualities of objects. METHOD: Fifty-two patients with frontotemporal dementia (FTD), 20 patients with Alzheimer's disease (AD), 18 patients awaiting surgery for intractable epilepsy, and 159 healthy controls completed a newly developed test of ability to recognize emotional qualities of art (music and paintings), and pleasantness in simple sensory stimuli (tactile, olfactory, auditory), and to make aesthetic judgments (geometric shapes, room décor). A subset of participants also completed a test of ability to recognize emotions in other people. RESULTS: Patients with FTD showed a marked deficit in ability to recognize the emotions conveyed in art, compared with both healthy individuals and patients with AD (relative to controls, deficits in patients with AD only approached significance). This deficit remained robust after controlling for FTD patients' ability to recognize pleasantness in simple sensory stimuli, make aesthetic judgments, identify odors, and identify emotions in other people. Neither FTD nor AD patients showed deficits in recognizing pleasant sensory stimuli or making aesthetic judgments. Exploratory analysis of patients with epilepsy revealed no deficits in any of these domains. CONCLUSION: Patients with FTD (but not AD) showed a significant, specific deficit in ability to interpret emotional messages in art, echoing FTD-related deficits in recognizing emotions in other people. This finding adds to our understanding of the impact these diseases have on the lives of patients and their caregivers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Single-response appetitive Pavlovian to instrumental transfer is suppressed by aversive counter-conditioning.

Environmental stimuli, when paired with reward, can influence behaviour in maladaptive ways, for example, by encouraging overeating or addiction. Such behaviour can be sensitive to reward value manipulations, under circumscribed conditions, but whether reward-seeking is also sensitive to stimulus value manipulations remains unclear. Thus, the current experiment investigated whether reducing the hedonic value of a reward-paired stimulus would reduce reward-seeking behaviour. In total, 36 participants successfully completed a single-response Pavlovian-instrumental transfer (PIT) task with a counter-conditioning procedure. The Pavlovian phase associated three conditioned stimuli (CSs) with money at 100%, 50%, or 0% contingency. Counter-conditioning then followed for the experimental group, who saw the 100% CS paired with unpleasant pictures, while the control group saw only neutral images. Instrumental training required participants to learn a button-pressing response to win money. The transfer phase contrasted instrumental responding during baseline and CS presentation. Both experimental and control groups liked the 100% CS more than the other CSs after Pavlovian training, but counter-conditioning reduced this 100% CS liking. In transfer, the experimental group showed an abolition of appetitive PIT, while the control group showed maintenance of appetitive PIT. However, this group difference was only evident in response vigour, not response initiation. In summary, CS hedonic value influences cue-potentiated instrumental responding. More specifically, hedonic value of a reward-paired cue influences the vigour of instrumental responses, but not the decision to initiate a response. These data may have relevance to smoking cessation policies, where the introduction of health warnings may be viewed as a real-world example of counter conditioning.

Psychological responses, muscle damage, inflammation, and delayed onset muscle soreness to high-intensity interval and moderate-intensity continuous exercise in overweight men.

We compared in-task affect to HIIE and MICE, and its relationship with time spent at different metabolic domains, perceived exertion (RPE), self-efficacy, enjoyment, and future intention of exercise in overweight inactive men. Muscle damage and soreness, and inflammation were assessed post-exercise. Fifteen participants (28.9 ±â€¯5.0 yr; 29.2 ±â€¯3.8 kg/m2) completed a HIIE (10 × 1 min at 100% Vmax, 1 min recovery) and MICE (20 min at 55-59% VO2reserve) session. Affect, alertness, RPE, and self-efficacy were assessed in-task, and enjoyment and future intention post-task. At baseline, 24 and 48 h, creatine kinase, lactate dehydrogenase, interleukin-6 and -10, tumor necrosis factor alpha, and muscle soreness were assessed. Affect (-3.1 ±â€¯1.8 vs. 0.8 ±â€¯1.8, P < .001) and self-efficacy (70 ±â€¯15 vs. 90 ±â€¯15%, P < .001) were lower, while RPE and alertness were higher in HIIE compared to MICE (Ps ≤ .02). Affect was negatively correlated with RPE in HIIE (r = -0.90) and MICE (r = -0.72), and time spent above respiratory compensation point in HIIE (r = -0.59). Affect was positively correlated with self-efficacy in MICE (r = 0.74). Enjoyment, future intention, muscle damage and soreness, and inflammation were similar between HIIE and MICE post-exercise. Therefore, in-task HIIE was experienced as unpleasant compared to MICE, but the psychological and physiological responses post-task were similar in overweight inactive men.

Evaluation of Pleasure-Displeasure Induced by Use of Lipsticks with Near-Infrared Spectroscopy (NIRS): Usefulness of 2-Channel NIRS in Neuromarketing.

In order to examine whether near-infrared spectroscopy (NIRS) would be a useful neuromarketing tool, we employed NIRS to evaluate the difference of pleasure-displeasure in women, induced by the use of different types of lipsticks. The subjects used lipsticks A and B; A is softer than B. Concentration changes of oxy-Hb were measured in the bilateral prefrontal cortex (PFC) during use of lipsticks A and B. We evaluated the right and left dominancy of PFC activity by calculating the Laterality Index (LI) (LI = leftΔoxy-Hb - rightΔoxy-Hb); positive LI indicates left-dominant activity while negative LI indicate right-dominant activity. We found a significant interaction between the use of lipsticks A and B, using a two-way factorial analysis of variance [F(1,13) = 9.63, p < 0.01]; Δoxy-Hb in the left PFC was larger than that in the right PFC during the use of lipstick A, while Δoxy-Hb in the right PFC tended to be larger than that in the left PFC during the use of lipstick B (p < 0.1). The LI of lipstick A was larger than that of lipstick B (paired T-test, p = 0.0083). We suggest that lipstick A caused a more positive emotional response than lipstick B, since greater left than right frontal cortical activity is associated with positive affect. These results suggest that 2-channel NIRS may be a useful neuromarketing tool, since it allows objective assessment of pleasure-unpleasure.

Intermittent and daily smokers' subjective responses to smoking.

RATIONALE: One third of US smokers are intermittent smokers (ITS) who do not smoke daily. Unlike daily smokers (DS), whose smoking is negatively reinforced by withdrawal relief, ITS may be motivated by immediate positive reinforcement. In contrast, incentive salience theory posits hypothesis that "liking" of drug effects fades in established users, such as DS. OBJECTIVE: This study aims to compare ITS' and DS' hedonic responses to smoking. METHODS: Participants were 109 ITS (smoking 4-27 days/month) and 52 DS (smoking daily 5-25 cigarettes/day), aged ≥21, smoking ≥3 years, and not quitting smoking. For 3 weeks, participants engaged in ecological momentary assessment, carrying an electronic diary that asked them to rate their most recent smoking experience on 0-100 visual analog scales (satisfaction, enjoyment [averaged as "pleasure"], feeling sick, feeling a "rush," enjoying upper respiratory sensations, and immediate craving relief). Hierarchical random effect regression analyzed 4476 ratings. RESULTS: ITS found smoking pleasurable (mean = 69.7 ± 1.7 [SE]) but significantly less so than DS did (77.6 ± 2.3; p < 0.006). ITS also reported more aversive response (ITS 18.2 ± 1.4, DS 11.6 ± 2.0; p < 0.007). Even though ITS are more likely to smoke at bars/restaurants, when drinking alcohol, or when others were present, they did not report more pleasure in these settings (compared to DS). More extensive smoking experience was unrelated to craving or smoking effects among DS, but predicted greater craving, greater pleasure, and less aversion among ITS. CONCLUSIONS: The findings were largely inconsistent with incentive-salience models of drug use.

Surgically Induced Changes in Gut Microbiome and Hedonic Eating as Related to Weight Loss: Preliminary Findings in Obese Women Undergoing Bariatric Surgery.

OBJECTIVE: Weight loss surgery results in significant changes in the anatomy, function, and intraluminal environment of the gastrointestinal tract affecting the gut microbiome. Although bariatric surgery results in sustained weight loss, decreased appetite, and hedonic eating, it is unknown whether the surgery-induced alterations in gut microbiota play a role in the observed changes in hedonic eating. We explored the following hypotheses: (1) laparoscopic sleeve gastrectomy (LSG) results in changes in gut microbial composition; (2) alterations in gut microbiota are related to weight loss; (3) alterations in gut microbiome are associated with changes in appetite and hedonic eating. METHODS: Eight obese women underwent LSG. Their body mass index, body fat mass, food intake, hunger, hedonic eating scores, and stool samples were obtained at baseline and 1-month postsurgery. 16S ribosomal RNA gene sequencing was performed on stool samples. DESeq2 changes in microbial abundance. Multilevel-sparse partial least squares discriminant analysis was applied to genus-level abundance for discriminative microbial signatures. RESULTS: LSG resulted in significant reductions in body mass index, food intake, and hedonic eating. A microbial signature composed of five bacterial genera discriminated between pre- and postsurgery status. Several bacterial genera were significantly associated with weight loss (Bilophila, q = 3E-05; Faecalibacterium q = 4E-05), lower appetite (Enterococcus, q = 3E-05), and reduced hedonic eating (Akkermansia, q = .037) after surgery. CONCLUSIONS: In this preliminary analysis, changes in gut microbial abundance discriminated between pre- and postoperative status. Alterations in gut microbiome were significantly associated with weight loss and with reduced hedonic eating after surgery; however, a larger sample is needed to confirm these findings.

How the Brain Wants What the Body Needs: The Neural Basis of Positive Alliesthesia.

Discontinuing unhealthy behaviors, such as overeating or drug use, depends upon an individual's ability to overcome the influence of environmental reward cues. The strength of that influence, however, varies greatly depending upon the internal state of the body. Characterizing the relationship between interoceptive signaling and shifting drug cue valuation provides an opportunity for understanding the neural bases of how changing internal states alter reward processing more generally. A total of 17 cigarette smokers rated the pleasantness of cigarette pictures when they were nicotine sated or nicotine abstinent. On both occasions, smokers also underwent functional magnetic resonance imaging (fMRI) scanning while performing a visceral interoceptive attention task and a resting-state functional connectivity scan. Hemodynamic, physiological, and behavioral parameters were compared between sated and abstinent scans. The relationships between changes in these parameters across scan sessions were also examined. Smokers rated cigarette pictures as significantly more pleasant while nicotine abstinent than while nicotine sated. Comparing abstinent with sated scans, smokers also exhibited significantly decreased mid-insula, amygdala, and orbitofrontal activity while attending to interoceptive signals from the body. Change in interoceptive activity within the left mid-insula predicted the increase in smoker's pleasantness ratings of cigarette cues. This increase in pleasantness ratings was also correlated with an increase in resting-state functional connectivity between the mid-insula and the ventral striatum and ventral pallidum. These findings support a model wherein interoceptive processing in the mid-insula of withdrawal signals from the body potentiates the motivational salience of reward cues through the recruitment of hedonic 'hot spots' within the brain's reward circuitry.

High-intensity interval training programme for obese youth (HIP4YOUTH): A pilot feasibility study.

Recently, there has been growing interest in high-intensity interval training (HIT) as a strategy to improve health. In this pilot study, we examined the feasibility of a 4-week low-volume HIT and its effects on cardiorespiratory fitness (CRF), blood pressure (BP) and enjoyment in overweight and obese youth. Twelve adolescents (body mass index (BMI): 34.8 ± 3.9 kg · m‒2, 14.9 ± 1.5 years) participated in 12 sessions of HIT (10 × 60 s cycling bouts eliciting ~90% maximal heart rate, interspersed with 90 s recovery, 30 min/session, 3 sessions/week) over ~4 weeks. All the participants completed the study and exercise attendance averaged 92%. Despite no changes in body weight and total fat, HIT resulted in significant (P < 0.01) increases in CRF (pre: 20.1 versus post: 22.2 ml · kg‒1 · min‒1) and exercise time (pre: 425 versus post: 509 s) during peak oxygen uptake test, and a reduction in resting systolic BP (pre: 115.8 versus post: 107.6 mmHg). The majority of study participants (83%) enjoyed HIT and more than half of the participants (58%) reported that HIT is a more enjoyable form of exercise compared to other types of exercises. Low-volume HIT is a useful strategy to promote exercise participation and improve cardiovascular health in overweight and obese youth.

When a woman is mother: feminine jouissance in motherhood

From the clinical listening of women concerning the strains of motherhood, this article intends to discuss the indications of Sigmund Freud and Jacques Lacan regarding the comings and goings of the feminine and the maternal positions. This article proposes that Lacan's writings on the matter of jouissance make it possible to discuss the relation between feminine and maternal through a path other than that of complementarity but neither one of exclusion, insofar as that relation may be taken within the condition of supplementarity.

Quando uma mulher é mãe: o gozo feminino na maternidade. A partir da escuta clínica de mulheres acerca dos impasses da maternidade, este artigo pretende problematizar as indicações de Sigmund Freud e Jacques Lacan com relação aos encontros e desencontros das posições feminina e materna. Este artigo propõe que o trabalho de Lacan sobre o campo do gozo torna possível problematizar a relação entre o feminino e o materno por uma via que não seja a da complementaridade ou tampouco a da exclusão, na medida em que tal relação possa ser tomada na condição de suplementaridade.

From the sexual difference to sexuation

The author revisits a route in Lacan's production that is located between the work "The Signification of the Phallus" and the seminar "Encore", to demonstrate the shift that occurs in the field of psychoanalysis, in regard to the location and function of marking the sexual difference in the structural web of the subject's constitution. As the operator of this twist, the author refers to the notion of jouissance and to the sexuation mathemes developed by Lacan, which led to a consideration of sexuatinno longer distinguished solely by the phallus and the "ideal types" of each sex, but by the field of jouissance, there included the feminine jouissance.

Da diferença sexual à sexuação. O autor revisita um percurso na obra de Lacan que se localiza entre o escrito "A Significação do Falo" e o seminário "Encore", para demonstrar o deslocamento que ocorre no campo da psicanálise, no que tange a localização e a função de balizamento da diferença sexual na trama estrutural da constituição do sujeito. Como operador desta torção o autor se refere a noção de gozo e aos matemas da sexuação desenvolvidos por Lacan, que determinaram uma consideração da sexuação não mais unicamente abalizado pelo falo e pelos "tipos ideais" de cada sexo, mas pelo campo do gozo, onde inclui-se ai, o gozo feminino.