Draft:Dual control model

Request to note the Sexual Tipping Point model as an an alternative type of dual control developed specifically for clinical application

Disclosure: I am Dr. Michael A. Perelman, the originator of the Sexual Tipping Point® model. Following Wikipedia’s conflict of interest guidelines, I am submitting this for neutral review and editing. My biography appears here: https://en.wikipedia.org/wiki/Michael_Perelman_(psychologist), and I am a faculty member at Weill Cornell Medicine: https://vivo.weill.cornell.edu/display/cwid-map2014. I am also the recipient of the Lifetime Achievement Award from the Sexual Medicine Society of North America (SMSNA). I propose adding a brief historical note within the article:

Separately and contemporaneous with the first publication of the Dual Control Model by Janssen and Bancroft, a clinical model integrating excitatory and inhibitory factors had been introduced by Michael A. Perelman, Ph.D., through the Sexual Tipping Point® model (STP). The STP model was developed as a result of over two decades of collaboration between Helen S. Kaplan, MD, and Michael A. Perelman,Ph.D. In Kaplan’s final book (1995), she described a "psychosomatic" dual-control model of sexual motivation emphasizing “inhibition/excitation” processes. Kaplan’s concept was derivative of the work of Kupferman (1991) who wrote, “All examples of physiological motivational control seem to involve dual effects—inhibitory and excitatory—which function together to adjust the system” (p. 751). In response to that insight, Kaplan wrote, “Control of sexual motivation is no exception and also operates on such a “dual steering” principle… Once again, we can learn from the similarities between eating and sex” (Kaplan, 1995, p. 17). An artist by training, Kaplan had sketched a cartoon in that 1995 book that foreshadowed the current digital graphics developed for use in the Sexual Tipping Point® model. Kaplan’s description and illustration of the dual control elements underlying human sexual motivation and sexual desire dysregulation anticipated Bancroft and his Kinsey Institute colleagues, including Graham, Heiman, Janssen, Sanders, and others. They later provided continuing erudite articulation of dual-control theory, research and related psychometrics becoming the best known of these various dual control models (1999, 2000, 2005, 2009). Kaplan also foreshadowed the work of James Pfaus’ (2006) concepts of satiation of appetite being related to satiation of sexual desire as a theoretical mechanism to explain Hypoactive Sexual Desire Disorder. Perelman found inspiration from Kaplan’s sketch and refined his own mind/body ideas into the Sexual Tipping Point® model and emphasized its utility for clinical practice. The Sexual Tipping Point® model easily illuminates the mind-body concept that mental factors can “turn you on” as well as “turn you off”; the same is true of the physical factors. The Sexual Tipping Point or STP depicts a person’s moment to moment sexual response (or lack), as regulated by the interaction of their constitutional sexual capacity with biomedical, psychosocial and cultural determining factors. An individuals STP differs from one experience to another, based on the proportional impact of one factor dominating, as others recede in importance. Both inhibitory and excitatory processes can occur simultaneously (they maybe bidirectional) and the balance between these processes determines the overall sexual response. The STP model can illustrate both the intra and inter-individual variability characterizing sexual response and its disorders for both men and women. the Sexual Tipping Point® concept is particularly useful for modeling treatment and can easily be used to explain risks and benefits for patients across a spectrum of sexual disorders.

• Perelman, M.A. (2009). The sexual tipping point: A mind/body model for sexual medicine. Journal of Sexual Medicine, 6(3), 629–632. https://doi.org/10.1111/j.1743-6109.2008.01177.x
• Perelman, M.A. (2018). Sex coaching for non-sexologist physicians: How to use the Sexual Tipping Point model. Journal of Sexual Medicine, 15(12), 1667–1672. https://doi.org/10.1016/j.jsxm.2018.09.011
• Perelman, M.A. (2016). Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model. Translational Andrology and Urology, 5(4), 563–575. https://doi.org/10.21037/tau.2016.07.05
• Rullo, J.E., Faubion, S.S., Hartzell, R.M., et al. (2018). Biopsychosocial Management of Female Sexual Dysfunction: A Pilot Study of Patient Perceptions From 2 Multi-Disciplinary Clinics. Sexual Medicine, 6(1), 1–7. https://doi.org/10.1016/j.esxm.2018.04.003
• Pfaus, J.G. (2009). Pathways of sexual desire. The Journal of Sexual Medicine, 6(6), 1506–1533. https://doi.org/10.1111/j.1743-6109.2009.01309.x

Thank you for considering this contribution. I welcome any feedback or editorial refinements. Drpnyc (talk) 15:46, 10 May 2025 (UTC)

This request was added to multiple talk pages. To other editors: please see my response at one of the other talk pages (diff), where I raise some concerns about the request. Biogeographist (talk) 19:36, 10 May 2025 (UTC)