The quality of a case history study begins with the quality of the interviewing by which the data have been obtained. If, in lieu of direct observation and experiment, it is necessary to depend upon verbally transmitted records obtained from participants in the activities that are being studied, then it is imperative that one become a master of every scientific device and of all the arts by which any man has ever persuaded any other man into exposing his activities and his innermost thoughts. Failing to win that much from the subject, no statistical accumulation, however large, can adequately portray what the human animal is doing. However satisfactory the standard deviations may be, no statistical treatment can put validity into generalizations which are based on data that were not reasonably accurate and complete to begin with. It is unfortunate that academic departments so often offer courses on the statistical manipulation of human material to students who have little understanding of the problems involved in securing the original data. Learning how to meet people of all ranks and levels, establishing rapport, sympathetically comprehending the significances of things as others view them, learning to accept their attitudes and activities without moral, social, or esthetic evaluation, being interested in people as they are and not as someone else would have them, learning to see the reasonable bases of what at first glance may appear to be most unreasonable behavior, developing a capacity to like all kinds of people and thus to win their esteem and cooperation—these are the elements to be mastered by one who would gather human statistics. When training in these things replaces or at least precedes some of the college courses on the mathematical treatment of data, we shall come nearer to having a science of human behavior.
Problems of interviewing have been particularly important in the present study because of the long-standing taboos which make it bad form and, for most people, socially or legally dangerous to discuss one’s sexual activities in public or even in the presence of one’s most intimate friends. It is astounding that anyone should agree to expose himself by contributing his sex history to an interviewer whom he has never before met, and to a research project whose full significance he, in most instances, cannot begin to understand. Still more remarkable is the fact that many of the histories in the present study have come from subjects who agreed to give histories within the first few minutes after they first met the interviewer. We are not sure that we completely comprehend why people have been willing to talk to us; but there may be some value in discussing the bases on which we have appealed for histories, and in describing some of the devices that we have employed to establish the quality of the record.
Any study which depends upon obtaining data from large numbers of people must have an appeal which is sufficient to win the whole-hearted cooperation of persons of every sort. In the present instance, the chief appeal has been altruistic—an invitation to contribute to basic scientific research, an opportunity to help others by sharing one’s experience. The appeal to professionally trained and other educated groups has involved a technical exposition of the scientific problems involved, and of the social significance of securing data which clinicians may utilize in their practice. The academic groups in psychology, biology, and sociology cooperated as soon as they saw broad, basic principles emerging from the study. Religious groups saw a need for information on the early training of children, and have shown an outstanding willingness to cooperate in any study which might contribute to an understanding of problems which affect the stability of the home and of marriage. More poorly educated and mentally dull individuals have responded to the simple and brief explanation that “The doctors need to know more about these things. They need your help, so they can help other people.” The underworld requires only a gesture of honest friendship before it is ready to admit one as a friend, and to give histories “because you are my friend.” For each group the mode of the appeal is different, but in each case it is based on the measure of altruism that is to be found—if one knows how to find it—in nearly all men.
In answer to our request for her history, the little, gray-haired woman at the cabin door, out on the Western plain, epitomized what we have heard now from hundreds of people: “Of all things—! In all my years I have never had such a question put to me! But—if my experience will help, I’ll give it to you.” This, in many forms, some of them simple, some of them sophisticated as scientists and scholars like them, some of them crude, incisive, and abrupt as the underworld makes them, is the expression of the altruistic bent (however philosophers and scientists may analyze it) which has been the chief motive leading people to cooperate in this study. We shall always be indebted “to the twelve thousand persons who have contributed to these data, and to the eighty-eight thousand more who, some day, will help complete this study.” However involved the reader may become in the statistics, the fine points of the argument, and the grand intricacies of the minute details, he will never understand this study until he comprehends the human drama that has been involved in securing the data.
In an honest way, we have tried to make those who have contributed aware of our amazement at their willingness to help, and of our esteem for them because they have helped. This appreciation has, undoubtedly, been a factor in winning cooperation. Evident appreciation may, therefore, belong in the list of devices which may be employed to secure histories; but appreciation must be sincere, else it will not work.
More selfish interests have animated many of those who have contributed. This is understandable, too. Many of the subjects have welcomed the opportunity to obtain information about some item affecting their personal lives, their marriages, their families, friends, or social relations. The more frequent questions have concerned:
Possibly harmful effects from “excessive” sexual activity
Physical harm resulting from masturbation
Incidences of masturbation, pre-marital intercourse, extra-marital intercourse, mouth-genital contacts, homosexual relations, animal contacts
Comparisons of the individual’s activities with averages for the group to which he belongs
“Am I normal?”
The physical and social significances of petting
The relation of pre-marital experience to subsequent adjustment in marriage
Items to consider in choosing a mate for marriage
Differences between male and female responsiveness
Techniques conducive to mutuality of response in marital intercourse
Medical aspects of contraception
Data on the sexual development and education of children
Problems arising from homosexual activity
Information about available medical, psychiatric, or other clinics to which persons with special problems may be referred
Impotency, heredity of physical defects, worries over genital characters, venereal disease, pregnancy (but these items only occasionally)
As scientists, the authors of this volume have given information when it was available and scientifically established, while refusing to advise on any choice of behavior. Nevertheless, many persons have felt that the information obtained was sufficient repayment for their own contributions to the study.
In a number of communities, public knowledge of this source of help has brought many histories. This does not mean that an undue number, of neurotic or psychotic individuals has contributed. On the contrary, items of the sort listed above are the everyday sexual problems of the average individual; and the greatly disturbed type of person who goes to psychiatric clinics has been relatively rare in our sample. We have refused to take histories from recognizable psychotics who were handicapped with poor memories, hallucinations, or fantasies that distorted the fact.
The psychoanalyst will incline to the view that most of those who have given histories have obtained some inflation of their egos by doing so. This is undoubtedly true, whether the record was one of unusual prowess, of conformance with the norm, or of low rates of activity which were the result of some incapacity for which the individual wanted pity. Most clinicians find that people like to talk about themselves. On the other hand, there is no evidence that this human quality has distorted the record, and the exaltation of one’s self has not seemed as significant as the altruistic motives which have animated most of the subjects—unless altruism is, of course, merely another means of self gratification.
There are some who have contributed histories in order to satisfy their curiosity as to the nature of the questions asked, and to learn how such an interview is conducted. Several hundred psychoanalysts, psychiatrists, physicians, clinical psychologists, social workers, and other professional persons have had an especial interest in observing the interviewing techniques. In communities where we have worked for periods of time, persons of every social level, even including the lowest, have volunteered in order to find out what sort of thing their friends were experiencing when they contributed histories.
In many instances, cooperation with the study may be made a group activity. To accomplish this, an interviewer must utilize the principles of mass psychology, mix them well with common sense, and add the skills of a patent medicine vendor and a Fuller brush man—while, withal, maintaining the community’s esteem for the dignity of a science which has nothing to sell. Members of a college fraternity, a sorority, a church organization, a parent-teacher group, a service club, all of the inmates of a penal institution, the patients of a particular physician, all of the persons in some section of a city, all of the population in some rural community, may be persuaded to contribute as a matter of loyalty to an activity which is officially or tacitly supported by the group. In this way many persons have been reached who, as lone individuals, would have had little interest in the research. Loyalty to the group may also lead an individual to exercise more than usual care in providing a detailed and accurate record of his activity.
Lectures to college, professional, church, and other community groups have most frequently provided the entree to the better educated portions of the population. Hundreds of such lectures have been given. Perhaps 50,000 persons have heard about the research through lectures, and perhaps half of the histories now in hand have come in consequence of such contacts.
Practically all of the contacts at lower levels, and many of those at other levels, have depended upon introductions made by persons who had previously contributed their own histories. One who has not already given a history is not usually effective as a “contact man.” Contact men and women have often spent considerable time and have gone to considerable pains to interest their friends and acquaintances. Many hundreds of such persons have helped, but a- short list of those who have helped most will show something of the diversity of the backgrounds which have been represented:
Bootleggers
Clergymen
Clerks
Clinical psychologists
College professors
College students
Corporation officials
Editors
Farmers
Female prostitutes
Gamblers
Headmasters of private schools
Housewives
Lawyers
Male prostitutes
Marriage counselors
Ne’er-do-wells
Persons in the Social Register
Physicians
Pimps
Police court officials
Prison inmates
Prison officials
Professional women
Psychiatrists
Public school teachers
Social workers
Thieves and hold-up men
Y.M.C.A. secretaries
Y.W.C.A. secretaries
Welfare workers
Women’s Club leaders
In securing histories through personal introductions, it is initially most important to identify these key individuals, win their friendship, and develop their interest in the research. Days and weeks and even some years may be spent in acquiring the first acquaintances in a community. In a sober rural area, the most highly esteemed of the local clergymen may be the right person to sponsor the project. If it is a prison population, the oldest-timer, the leading wolf, the kingpin in the inmate commonwealth, or the girl who is the chief trouble-maker for the administration must be won before one can go very far in securing the histories of other inmates. If it is a good residential area in a large city, the quiet but steady young housewife with a host of friends who know they can count on her, or the sociable and reasonably successful middle-aged business man who is active in service clubs and civic projects, is the person most likely to put us across in that community. If it is the underworld, we may look for the man with the longest FBI record and the smallest number of convictions, and set out to win him. To get the initial introductions, it is necessary to become acquainted with someone who knows someone who knows the person we want to meet. Contacts may develop from the most unexpected sources. A rich man may provide the introduction to a leader in the underworld, a Salvation Army worker may serve as the contact for the Social Register. The number of persons who can provide introductions has continually spread until now, in the present study, we have a network of connections that could put us into almost any group with which we wished to work, anywhere in the country.
Having met these significant persons, and gotten their histories, we take time to become acquainted with them and with their communities. They must come to like us as individuals, and the whole community must know about us and about the research, if we expect to secure any large number of histories in the area. We go with them to dinner, to concerts, to night clubs, to the theater; we become acquainted with them at community dances, in poolrooms, in taverns, and in other places which they frequent. They in turn invite us to meet friends in their homes, at teas, at dinners, at other social events. For years we have maintained a considerable correspondence with persons who are likely sources of new contacts. In many cases we have developed friendships which are based upon mutual respect and upon our common interest in the success of this project. When, in the course of time, we turn to securing histories from the rest of the community, most of the people who then contribute do so because they are friends of our friends, because they accept the contact man’s evaluation of the research, and because of their confidence that he would not involve them in difficulties. Among more poorly educated groups, and among such minority groups as rural populations, Negroes, segregated Jewish populations, homosexual groups, penal institutional inmates, the underworld, etc., the community is particularly sensitive to the dangers of outside interference, and particularly dependent upon the advice of their leaders in deciding whether they should cooperate.
An element of competition may be introduced by working two groups simultaneously or in immediate succession. College A contributes because College B has also contributed. College B is persuaded to cooperate because College A has already contributed more histories than B. The principle works equally well for fraternity and sorority groups, for people living in different nouses on a city block, for the inmates of a penal institution, for the court judge and his staff, for groups of psychiatrists, and for many other groups.
There may be a certain amount of pressure employed in securing histories from the last persons in any group which is contributing a hundred percent to the study. Sometimes the pressure has originated from the investigators, more often it has been the group interest which has swayed the individual. There has been some constraint upon professional people, especially upon those who are involved in giving sexual advice in clinics, to contribute to a research project which will serve them in their professional activities. Some of the histories obtained from inmates in institutions probably would not have been obtained except for the institutional tradition of conformance to the administration’s program, or to the group activity in which all the other inmates were cooperating. Where such indirect or more direct pressure is employed it becomes particularly important to establish a satisfactory rapport with each subject after he has actually come into conference for a history.
Payment for histories has been confined to the economically poorer elements m the population, to persons who are professionally involved in sexual activities (as prostitutes, pimps, exhibitionists, etc.) or to others who have turned from their regular occupation and spent considerable time in helping make contacts. The payment has never been large, rarely amounting to more than a dollar or two for the couple of hours involved in contributing; and equivalent amounts may be paid to persons who have helped make the contacts. There is no evidence that such payments have distorted the quality of the record, although the prospect of securing double payment leads an occasional individual to try to duplicate his contribution. In the latter case, it has been necessary to keep accurate records and require identification; but this has presented only a minor problem. On the whole, payment has worked well, for it has undoubtedly made it possible to secure many histories which otherwise would not have been obtainable; and it should be realized that even in the groups which are paid, men and women have contributed primarily because they respect us, because they appreciate our interest in them, and because they are willing to contribute for the sake of helping others. Certain it is that the remarkable body of confidential information that has been secured from some of these lower level and underworld groups would not have been available if there had been no other bases than money to interest them. Twelve thousand people have helped in this research primarily because they have faith in scientific research projects.
There are, after all, only two reasons why anyone should hesitate to contribute his sex history to a scientific project. He may hesitate because he fears that the interviewer will object to something in his history, and he may fear a loss of social prestige, or legal penalties, if his history were to become a matter of public knowledge. An occasional individual has hesitated, in addition, because he did not want to stir up memories of old fears, old hurts, or old losses that were associated with his or her sexual life; occasionally a psychotic—or simply a contrary individual—has blocked at cooperating; but most persons who have hesitated have done so because they feared embarrassment before the interviewer, or feared public disclosure of their activities.
It is imperative, therefore, that the investigator be able to convince the subject:
1. That he, as a scientist, offers no objection to any type of sexual behavior in which the subject could possibly have been involved.
2. That the confidences of the record will be kept without question.
A scientist studying sex should be able to accept any type of sexual behavior objectively, listen to the record without adverse reaction, and record without social or moral evaluation. That much is expected of the student measuring the lengths of insect wings, recording the chemical changes that occur in a test tube, or observing the colors of the stars. It is not too much to expect similar objectivity of the student of human behavior.
But something more than cold objectivity is needed in dealing with human subjects. One is not likely to win the sort of rapport which brings a full and frank confession from a human subject unless he can convince the subject that he is desperately anxious to comprehend what his experience has meant to him. Sexual histories often involve a record of things that have hurt, of frustrations, of pain, of unsatisfied longings, of disappointments, of desperately tragic situations, and of complete catastrophe. The subject feels that the investigator who asks merely routine questions has no right to know about such things in another’s history. The interviewer who senses what these things can mean, who at least momentarily shares something of the satisfaction, pain, or bewilderment which was the subject’s, who shares something of the subject’s hope that things will, somehow, work out right, is more effective, though he may not be altogether neutral.
The sympathetic interviewer records his reactions in ways that may not involve spoken words but which are, nonetheless, readily comprehended by most people. A minute change of a facial expression, a slight tensing of a muscle, the flick of an eye, a trace of a change in one’s voice, a slight inflection or change in emphasis, slight changes in one’s rate of speaking, slight hesitancies in putting a question or in following up with the next question, one’s choice of words, one’s spontaneity in inquiring about items that are off the usual routine, or any of a dozen and one other involuntary reactions betray the interviewer’s emotions, and most subjects quickly understand them. Unlettered persons and persons of mentally lower levels are often particularly keen in sensing the true nature of another person’s reactions.
If the interviewer’s manner spells surprise, disapproval, condemnation, or even cold disinterest, he will not get the whole of the record. If his reactions add up right, then the subject is willing to tell his story. The interview has become an opportunity for him to develop his own thinking, to express to himself his own disappointments and hopes, to bring into the open things that he has previously been afraid to admit to himself, to work out solutions to his difficulties. He quickly comes to realize that a full and complete confession will serve his own interests. It becomes unthinkable that he should cover up, deny, or fail to relate anything that has happened.
These are the things that can be done in a person-to-person, guided interview that represents a communion between two deeply human individuals, the subject and the interviewer (McNemar 1946). These are the things that can never be done through a written questionnaire, or even through a directed interview in which the questions are formalized and the confines of the investigation strictly limited. In the present study, the number of persons who have admitted involvement in every type of sexual activity, and particularly in socially taboo types of activity, is much greater than has ever been disclosed in any questionnaire study; and comparisons of the data in this and in previously published studies should provide some measure of the possibilities of personal interviewing as a technique in case history studies.
It has been asked how it is possible for an interviewer to know whether people are telling the truth, when they are boasting, when they are covering up, or when they are otherwise distorting the record. As well ask a horse trader how he knows when to close a bargain! The experienced interviewer knows when he has established a sufficient rapport to obtain an honest record, in the same way that the subject knows that he can give that honest record to the interviewer. Learning to recognize these indicators, intangible as they may be, is the most important thing in controlling the accuracy of an interview. Beyond that there are cross-checks among the questions, inconsistencies to watch for, questions which demand proof, and other devices for testing the validity of the data (all of which are discussed in the last section of the present chapter).
At the beginning of an interview the subject must be assured that he can tell all, but it is not always possible to win complete rapport at the very start. The subject will need to be reassured many times in the course of the interview, and continually convinced by the evident sympathy of the interviewer. Often the subject begins by admitting only a small part of his activity, and adds more only gradually as he becomes more certain that he can do so without disapproval.—“Yes, I have been approached for such relations, but I did not pay attention.”—“Yes, there were physical contacts, but they did not interest me.”—“Yes, there were complete contacts— when I was asleep.”—“Yes, there was one affair in which I responded, in a mild way.”—“Yes, I liked it well enough, but I didn’t think I wanted any more of it.”—“Well, yes, I did try it again.”—“Yes, since then I have become interested, and I have had a good deal of it lately.”—So the history builds up. At each step the subject intended to stop with the minimum of information, and would have stopped completely if there had been any indication that the interviewer was surprised, was offended, or disapproved. After each essay, the additional bit of information was added because the subject discovered that he could tell more. If, at any point, the interviewer had failed, the story would have stopped there.
Sometimes the capacity of the investigator is severely tested. Whatever his sexual background, each person reaches the limit of things he can understand because of his own previous experience, the limit of things he can appear to understand because he has wanted them and would have had them if it had been socially expedient, and the limit of things he can sympathetically admit because he has glimpsed what they have meant to some other people. Beyond that there are always things which seem esthetically repulsive, provokingly petty, foolish, unprofitable, senseless, unintelligent, dishonorable, contemptible, or socially destructive. Gradually one learns to forego judgments on these things, and to accept them merely as facts for the record. If one fails in his acceptance, he will know of it by the sudden confusion or sudden tenseness of his subject, and the quick conclusion of the story. If the interviewer masters his own confusion, the subject may tell him about it, and congratulate him to boot for being able and willing to “take it.”
The many persons who have contributed to this study have done so voluntarily and with a full understanding of what we were trying to learn through our questioning. To have used any sort of devious device would have ruined the subject’s confidence in everything we were doing. It has repeatedly been suggested that we try narcosynthesis, lie detectors, or other such means for testing the reliability of at least some of the answers of some of the subjects; but if we had coerced a single person by any such means, we would have lost our capacity to win things from anyone else. In any study which needs to secure quantities of data from human subjects, there is no way except to win their voluntary cooperation through the establishment of that intangible thing known as rapport.
Our laws and customs are so far removed from the actual behavior of the human animal that there are few persons who can afford to let their full histories be known to the courts or even to their neighbors and their best friends; and persons who are expected to disclose their sex histories must be assured that the record will never become known in connection with them as individuals. Each subject in this study has contributed only because he has been thus assured by a friend whom he trusts, or by the investigator at the beginning of the interview. It is important to note, however, that assuring one of the confidence of the record can be effective only when that assurance is honest in its intent and never, under any circumstance, betrayed in its execution. If there were ever a single failure to maintain such confidence, then others would learn of it and refuse to contribute histories. The care with which confidences have been guarded in the present study has probably never been surpassed in any other project dealing with human material.
Keeping confidence in this study has involved the development of a cryptic code in which all of the data have been recorded (Chapter 3, Figure 2). The code is never translated into words at any stage in the analyses of the data. Each interviewer has memorized the code, and there is no key to the code in existence. Only the six persons who have actually taken histories have ever known any part of the code, and only four persons are, at the present writing, acquainted with the whole code. None of the other persons who have helped in the technical work in our laboratory knows the code. A few routine tabulations of non-sexual items have been made by the technical assistants; but practically all of the handling of the data, including the punching of the Hollerith cards and their manipulation in the IBM statistical machines, has been done by those of us who have taken the histories. Never in the nine years of this research has any other person had access to the information available on the histories of particular individuals.
It has been necessary to preserve the identity of each history in order to make subsequent additions, in order to compare re-takes of histories (Chapter 4), and in order to coordinate data coming from two or more persons involved in the same sexual activities (as spouses in a marriage or heterosexual or homosexual companions in common sexual activities). This identification has been accomplished by the use of a coded set of symbols for which, again, there is no key in existence. The code was developed with the help of an experienced cryptographer and involves, simultaneously, the use of several devices designed to complicate possible decoding. It is the judgment of the cryptographer who tried to break the final form that decoding would be impossible unless one had access to all of the histories and all of the files for a considerable period of time; and that after identification the data would be practically unintelligible because of the difficulty of deciphering such a position code as the one used here. It should be added that the histories are kept behind locked doors and in fireproof files with locks that are unique for this project.
To a very large degree, analyzing this material has involved additions of data, summations of the numbers of persons engaged in particular activities, tabulations of ages, tabulations of frequencies, totals of other data, and correlations of facts and factors; and, as taxonomists interested in the behavior of whole segments of the population, we do not foresee that we will ever be concerned with the publication of the particular histories of particular individuals. It has, therefore, been possible to guarantee that no history will ever be published in a form which would identify it as an individual history. It has been possible to explain the safety of this mode of publication even to uneducated and mentally duller individuals, and thus to persuade them that they can safely contribute histories.
Individual histories in this project have been discussed only among the research associates on this staff. They have not been discussed even with professional friends outside of the staff. Particular histories have not been used as illustrations in public lectures or in group conversation, although examples have sometimes been synthesized from real cases. They have not been discussed even when the individuals involved were geographically so remote as to seem unidentifiable; for people travel about over the country, and one often meets persons who are acquainted with one’s subjects in some distant town.
Few professional people seem to know what it means to preserve the absolute confidence of a record. Professional confidence too often refers to the discussion of individual cases with anyone in the professional fraternity. Such discussions, often in the hearing of secretaries or nurses, soon spread the information abroad, whence it returns to confound the subject who gave his history only after he was guaranteed strict confidence. Professional people connected with courts too often obtain confessions by promising the confidence of the record, which they promptly betray by carrying the data to the court. Academic persons doing research on human case histories regularly turn them over to graduate students to be studied, and on occasion exhibit them, with names attached, to whole classes of students for examination. Few clinical records are ever in code, and in very few cases is there any attempt to separate the name of the subject from the plainly written record. In many a social welfare agency there are more non-professional persons who see the confidential records than there are professional people in the organization. In penal institutions there are always inmates who are employed in clerical positions, where they have access to the “confidential” records; and information spreads through them to the whole of the inmate body. In some institutions the inmate population is better acquainted with the content of some of these records than the officials themselves. Persons who have been betrayed through such sources become, naturally enough, skeptical about contributing further data to any professional person, and it has often been difficult to convince them that our own records would be kept inviolate.
We have been pressed by many people for information about particular persons who have contributed histories. Husbands and wives often want data about their spouses, and in many cases such information would help them make better marital adjustments; but if such information were ever given, other husbands and wives would not be willing to give their histories. Parents ask about their children, and partners in common sexual activities often want advice which cannot be given without drawing upon the confidential record. While it has disappointed many persons not to secure such information, their esteem for the integrity of the records has inevitably increased and, in consequence, they are then willing to contribute their own histories, and to interest their friends in the project.
In penal and other institutions, we have maintained an invariable rule that no confidence given by an inmate would ever be passed on to the administration of the institution. We have worked only in institutions which have accepted us on these terms. No administration has ever asked us to break the rule. In a few cases where we have felt that some inmate would find it to his advantage to have the administration know more of his history, we have advised the subject to that effect and, if he has agreed, we have helped make such contacts—but only when he has voluntarily agreed to such a procedure.
There is probably no legal right for anyone to preserve the confidence of any information which has been given him. By custom the courts ordinarily recognize the rights of a priest or of a physician to preserve confidences obtained in the performance of their professional duties, but there is no statute law establishing such a right. If we were brought before a court we would have to hope that such precedents would be extended to scientists involved in the investigation of such a subject as human sex behavior. If the courts of all levels were to refuse to recognize such a privilege, there would be no alternative but to destroy our complete body of records and accept the consequences of such defiance of the courts. If law enforcement officials, students of law, and persons interested in social problems want scientific assistance in understanding such problems, they will have to recognize a scientist’s right to maintain the absolute confidence of his records; for without that it would be impossible to persuade persons to contribute to this sort of study.
The skillful interviewer will develop particular techniques which work for him, though they may not serve another investigator so well. But even though there are these differences in the applicability of particular methods, it may be of value to other persons who are interested in interviewing to know something of the technical devices that have proved effective in the present research.
1. Putting the subject at ease. Many of the persons who contribute to a sex study manifest some uneasiness at the beginning of an interview, and from the start particular attention needs to be given to putting the subject at ease. Interviews are held in places that are as attractive and comfortable as the subject’s social background may demand. Many persons are considerably helped if they can smoke during the interview. Conversation is initiated as casually as possible, first about everyday affairs that may be remote from anything that is sexual. If the subject knows someone whom we have previously known, or has recreational interests which are in any way connected with our own, that provides a basis for conversation. One does the sort of things that a thoughtful host would do to make his guests comfortable, but always easily so that the subject is not aware that they are designed to put him at ease.
2. Assuring privacy. Places where the interviews are held should be reasonably soundproof, and there should be no unexpected interruptions from other persons entering the room.* From the very set-up of the interview, the subject must be reassured of confidence.
3. Establishing rapport. The subject should be treated as a friend or a guest in one’s own home. The tottering old man who is a victim of his first penal conviction, appreciates the interviewer’s solicitation about his health and his interest in seeing that he is provided with tobacco, candy, or the other things that the institution allows one who has sufficient funds. The inmate in a woman’s penal institution particularly appreciates those courtesies which a male would extend to a woman of his own social rank, in his own home. The interviewer should be as interested in the subject as he is in recording the subject’s history. It is important to look the subject squarely in the eye, while giving only a minimum of attention to the record that is being made. People understand each other when they look directly at each other.
4. Sequence of topics. Since, as already indicated, it is often necessary to build up rapport after an interview has actually started, it is advisable to begin a conference with the items that are non-sexual and least likely to disturb the subject, and to follow with a sequence which leads gradually into things that the subject may consider more difficult to discuss. Those things on which one may expect the maximum cover-up and blockage should be left until the end of the interview. By then the subject has acquired confidence, and it is possible to secure a record of things that could never have been secured at the beginning of the interview. In the present study we usually begin with a discussion of the subject’s age, place of birth, educational history, recreational interests, physical health, parental background, brothers, sisters, and other non-sexual data. The first sexual items are those for which the subject is least responsible, namely the sources of his sex education. The record of overt sexual activities begins with the things that are most remote, such as the pre adolescent sex play. From there on the sequence of topics is varied in accordance with the subject’s social background, his age, and his educational level. For unmarried college males the sequence is nocturnal emissions, masturbation, pre-marital petting, pre-marital intercourse with companions, intercourse with prostitutes, animal contacts, and the homosexual. For males who have never gone beyond the tenth grade in school, pre-marital intercourse can be discussed much earlier in the interview, because it is generally accepted at that social level; but masturbation needs to be approached more carefully if one is to get the truth from that group. At that level, petting is secondary to intercourse in interest and in acceptance, and it is brought into an interview only after the discussion of intercourse.
With many females it is simpler to get a record of the homosexual than a record of masturbatory activity. For the older generation of males of every social level it is simpler to get a record of pre-marital intercourse than to get a record of masturbation. With persons who have publicly known homosexual histories, extensive masochistic or sadistic experience, histories as prostitutes, or other special sorts of sex experience, we get better cooperation when we take the record of the special experience before trying to get details on the more usual activities. It is often easier to get the professional record from a female prostitute than it is to get the record of her personal sex life with her boy friend or with her husband. In dealing with an uneducated and timid older woman from a remote farm area or mountain country, the sequence has to become most desultory, including only the simplest questions about each type of sexual experience, with no details on any point until the whole of the history has been covered in a preliminary way. By then the subject should have become more confident, and it will be possible to ask her such details about each type of activity as would have shocked her at the beginning of the interview. A good interviewer becomes very sensitive to the reactions of his subjects, immediately drops any line of inquiry which causes embarrassment, and stays with simpler matters until the subject is ready to talk in more detail. This technique, more than anything else, probably accounts for the fact that among the 12,000 persons who have been interviewed in the present study, all but three or four have completed their histories; and those few would not have been lost if we had known as much at the beginning of this study as we now know about a good sequence of questions in an interview.
5. Recognizing the subject’s mental status. One should not attempt to take a history from a subject who is mentally incapacitated, whether permanently or temporarily so. Persons who are badly intoxicated cannot give reliable histories; and while it is impossible to rule out all who have been drinking, since that would rule out a high proportion of all persons in certain social groups, one must learn to identify the level of intoxication of his subjects and avoid taking a record that is below standard. Some individuals, of course, are more cooperative when they have had a small amount of alcohol. Persons who are under the immediate influence of drugs, particularly of some narcotic that induces sleep, are impossible as subjects. A person who is heavily intoxicated with marihuana (which is not a drug) is similarly unreliable. Benzedrine and some other drugs are not so likely to interfere with the individual’s capacity to give an accurate record. Persons who are physically exhausted or mentally fatigued are difficult, and some older persons who are badly senile are hopeless.
Feeble-minded individuals vary considerably in their capacities to remember things. There are some whose memories are accurate on details, and this is also true of many uneducated persons who are not feebleminded. Consequently, the interviewer must learn to identify a feebleminded case and must preface the interview with such ordinary, everyday conversation as will allow him to determine the capacities of such an individual. It is possible to get a fair record from most feeble-minded individuals whose IQ’s are not below 50, although interviewing any person with a rating below 70 becomes a slow process in which each idea must be given plenty of time to penetrate, with endless repetition, and with a vocabulary which is confined to the simplest of words, both in the sexual vernacular and in the references to commonplace activities.
6. Recording at time of interview. In the literature on interviewing, it is customary to advise that records should not be made in the presence of a subject, but that they should be made after the subject has left at the close of an interview. This is the commonest procedure among many psychiatrists, clinical psychologists, and among social workers. It is supposed that a subject is embarrassed at seeing his statements put on paper, and that he will talk more freely if he feels that he can say some things that are not recorded. It has been said that there is a loss of rapport when the interviewer records during the interview. For these reasons we attempted to follow standard practice early in this study and found that it introduced a tremendous error into the records. Much of the specific quotation which appears in psychiatric literature evidently represents the interviewer’s notion of how the subject talked rather than a record of what the subject actually said. After the first few months of this study, we began to record all of the data directly in the presence of the subject, and there has been no indication that this has been responsible for any loss of rapport or interference with the subject’s free exposure of confidences. We have become convinced that any loss of rapport which comes when data are recorded directly has been consequent upon the longhand method of writing out answers while the subject sits in silence waiting for the next question. This is the thing that is destructive to rapport. By using a code for recording, it has been possible in the present study to record as rapidly as one can carry on a conversation, without loss of rapport or blockage on the subject’s part.
7. Systematic coverage. On each history in the present study there has been a systematic coverage of a basic minimum of about 300 items. This minimum is expanded for persons who have extended experience in premarital or extra-marital intercourse, who have extended homosexual histories, who have had experience as prostitutes or pimps, or who have had multiple marriages. The maximum history covers 521 items. One of the most fundamental aspects of the present survey is its systematic coverage of a uniform list of items on each history. Such coverage is not possible in a free association procedure where the subject records things as they happen to come to his mind and where, in consequence, each person may provide information on some items that are not covered by the next persons in the study, and where, in consequence, it is impossible to add together and secure incidence or frequency figures that would be applicable even to the sample population as a whole. The use of a standard form in coding the data (Figure 2) makes it possible to look over the history sheet at the end of an interview, and to make sure that every block in which there should be some record has been satisfactorily accounted for.
8. Supplementary exploration. While there may be a basic minimum of material that is covered on each history, the interviewer should not hesitate to secure additional data on special situations that are outside of the routine. For instance, about twenty questions are routinely asked about masturbation, but there are males who have developed elaborate techniques about which scores of additional questions should be put. Concerning the average individual’s relations with his parents, the routine questions may give all the necessary information on most individuals, but an occasional individual may have had some complex relation with his parents which makes it valuable to get the record in more detail. In taking the histories of identical twins, especial inquiry is made about their emotional relations to each other, the extent to which they share common social activities, and other items which are not touched in the usual history. A highly intelligent individual who has had considerable experience in a socially taboo type of behavior may help analyze the situation in such detail as is never investigated in the average history. In the routine, there are only minor questions on masochism and sadism, but if there is any indication that a subject has been consciously and deliberately involved in such behavior, he should be questioned on scores of items which are not in the basic interview. Persons who are blind, deaf, crippled, or otherwise handicapped, persons who have lived in foreign countries, persons who have had experience in military groups or who have lived in other special situations, similarly become sources of special information. As scientific explorers, we, in the present study, have been unlimited in our search to find out what people do sexually. These, again, are the things that can be done in a guided interview and which cannot be touched in a questionnaire study or even in a directed interview.
9. Standardizing the point of the question. In the present study, the questions asked in the interviews have never been standardized in form, but the points which they cover have been strictly defined. When the subject is asked about his relations to his parents, there is a strict definition of the period to which the information should apply. When the question concerns the subject’s experience in petting, petting is precisely defined so there is no confusion about the sort of experience which may be included under that head. When the subject’s relations with prostitutes are the issue, a clear distinction is made between a prostitute and a girl who is merely promiscuous. Data about the health of an individual are designed to catch those illnesses which interfere with an individual’s social adjustment. Each other question has had its point precisely defined, in order that the data secured from the many different subjects and by the several interviewers may fairly be added together. It is unfortunate that the limitations of space make it impossible to give the whole list of questions, with their precise definitions, anywhere in the present volume, although a list of items covered in each interview is shown in Chapter 3.
10. Adapting the form of the question. While the point of each question has been standardized, the form of each question has varied for the various social levels and for the various types of persons with whom the study has dealt. Standardized questions do not bring standardized answers, for the same question means different things to different people. In order to have questions mean the same thing to different people, they must be modified to fit the vocabulary, the educational background, and the comprehension of each subject. It is especially important to use a vocabulary with which the subject will feel at home, and which he will understand. The college-bred interviewer needs to go to considerable pains to limit his vocabulary to the relatively few words that are employed by persons in lower educational levels. Everyday terms, as well as sexual vernaculars, are involved: a lower level individual, for instance, is never ill or injured, though he may be sick or hurt. He does not wish to do a thing, though he wants to do it. He does not perceive, though he sees. He is not acquainted with a person, though he may know him. One needs a certain sensitivity to adapt his vocabulary to the limited usages of such subjects. Except among college graduates, there is little knowledge of the clinical terms that concern sex, and sexual vernaculars must be used in interviewing lower level individuals. Such vernaculars vary considerably among different groups.
One must know and use the vernacular terms with a fine sense of their proprieties and their exact meanings in each group. Their awkward use may damage instead of building rapport. Sexual vernaculars differ considerably in different sections of the country. One should take considerable pains to determine the precise meanings of the variant terms as soon as he starts work in a community. Negro and white groups differ in their usages even in the same city. There are differences between the vocabularies of older and younger generations in any social level. A volume could be written on the vernaculars that should be known by anyone attempting to deal with people outside of his own social level, and the training of interviewers for the present study has involved a considerable amount of work on that point. Everywhere questions must be varied so they will bring replies that pertain to exactly the same thing. In many instances, questions must be freely expanded in order to make their meanings clear to the subject. This again is the sort of thing which cannot be done with a questionnaire or with a directed interview in which the questions are standardized as to form.
11. Avoiding bias. In a study in which the forms of the questions are not standardized, there is a considerable responsibility on the interviewer to see to it that his spontaneous questions are not so phrased as to bias the subject’s reply (McNemar 1946). In his tone of voice and in his choice of words, the interviewer must avoid giving the subject any clue as to the answers he expects. For instance, when the subject is at a loss to know how to estimate the frequencies with which he has engaged in a particular sort of activity, the interviewer can explain what sorts of frequencies are possible, provided he is careful not to give any idea what frequencies are common in the population, or what frequencies he, the subject, might be expected to have. What is actually done is to suggest to the subject that his activity might average once a week, three or four times a week, once a month, every day, or more often, or less often. The interviewer avoids suggesting an answer by avoiding any sequence in the illustrative list which he gives, and is careful not to attach particular importance to the last item in the list, which is the one that many persons will accept as their answer if the interviewer is not on his guard. Feeble-minded individuals and occasionally some other persons are highly suggestible, and then it becomes particularly important to avoid suggesting answers and important to test all answers for consistency.
12. Direct questions. When one is dealing with such a socially involved question as sex it becomes particularly important to ask direct questions, without hesitancy and without apology. If the interviewer shows any uncertainty or embarrassment, it is not to be expected that the subject will do better in his answers. Euphemisms should not be used as substitutes for franker terms. In some of the previous studies, many sexual terms are avoided: masturbation becomes “touching yourself”; a climax in masturbation becomes “securing a thrill through touching yourself”; and sexual intercourse becomes “relations with other persons,” or “sex delinquency” (Ackerson 1931, 1942). With such questions the subject cannot help but sense the fact that the interviewer is not sure that sex is an honorable thing, and a thing that can be frankly talked about. Evasive terms invite dishonest answers. In one of the previous studies there was a long list of questions concerning the homosexual, but the approach was so indirect that a person who had had an abundance of such experience could have answered every one of the questions honestly, and still never have admitted that he had ever had an overt experience.
13. Placing the burden of denial on the subject. The interviewer should not make it easy for a subject to deny his participation in any form of sexual activity. It is too easy to say no if he is simply asked whether he has ever engaged in a particular activity. We always assume that everyone has engaged in every type of activity. Consequently we always begin by asking when they first engaged in such activity. This places a heavier burden on the individual who is inclined to deny his experience; and since it becomes apparent from the form of our question that we would not be surprised if he had had such experience, there seems to be less reason for denying it. It might be thought that this approach would bias the answer, but there is no indication that we get false admissions of participation in forms of sexual behavior in which the subject was not actually involved. Other techniques of modifying questions, particularly if they concern socially taboo behavior, may bring a considerable increase in the number of positive answers.
14. Avoiding multiple questions. Anyone experienced in teaching should have learned to avoid multiple questions. Multiple questions usually bring replies that are ambiguous, and their avoidance in a sex study is particularly important because they provide an opportunity for the subject to dodge one of the questions by giving his attention entirely to the other. For instance, the interviewer who asks the subject if he is erotically aroused “by seeing nude males or females,” may get as an answer that he is always aroused by seeing females. Thereby the subject manages to evade the fact that he is to some degree aroused by seeing males.
15. Rapid-fire questioning. In order to cover the maximum amount of material in a single interview, it is necessary to ask questions as rapidly as the subject can possibly comprehend and reply. This method has the further advantage of forcing the subject to answer spontaneously without too much premeditation. Such a rapid fire of questions provides one of the most effective checks on fabrication, as detectives and other law-enforcement officials well know. It would be practically impossible for a person who was deliberately falsifying to answer the many questions that are asked concerning the details of his activity, when the questions come as rapidly as they do in our interviewing. Looking an individual squarely in the eye, and firing questions at him with maximum speed, are two of the best guarantees against exaggeration.
16. Cross-checks on accuracy. Cover-up is more easily accomplished than exaggeration in giving a history. The best protection against cover-up lies in the use of a considerable list of interlocking questions which provide cross-checks throughout the history, and particularly in regard to socially taboo items. There are, for instance, twelve questions concerning homosexual experience that appear in each interview before direct questions on that point are ever asked. The significance of some of these preliminary questions would not be recognized by anyone except a skilled psychiatrist. It would be difficult for most persons who had had anything more than incidental homosexual experience to deny that fact after they had answered the questions which provide the cross-checks on this point. There are similar cross-checks on various other aspects of a history. Such devices should be confined, however, to honest inquiries concerning items which are an integral part of the individual’s history; and one should avoid setting traps that put the subject on the defensive because they are obvious devices for forcing him into an admission.
Probably the most effective system of cross-checks has been the use of vocabularies that are peculiar to persons with particular sorts of experience, and which are quite unknown to persons without such experience. For instance, when one asks a female subject “how many years she has been in the life,” she must betray an honest confusion and inability to understand, or else she identifies herself as a prostitute. There are special argots for practically all of the socially taboo activities; and they may provide checks on many of the persons who must be included in a human case history study. Nevertheless, in spite of all that may be done, a certain amount of deliberate cover-up may slip by, and the investigator must find some means of measuring the extent of that cover-up in each part of his data.
17. Proving the answer. If it becomes apparent that the subject’s first answer is not correct or sufficient, one should ask for additional information, and re-phrase the original question in a way that will make him prove his answer or expose the falsity of his reply. In a rapid fire of additional questions, it is difficult for a dishonest subject to be consistent. With uneducated persons, and particularly with feeble-minded individuals, it is sometimes effective to pretend that one has misunderstood the negative replies and ask additional questions, just as though the original answers were affirmatives; whereupon the subject may then expose the truth by answering as though he had never given a negative reply. “Yes, I know you have never done that, but how old were you the first time that you did it?” is a question which, amazingly enough, may break down the cover-up of a feeble-minded individual. With such a technique, on the other hand, it is especially important to make sure that the subject’s final admissions are not fictions which the interviewer has suggested to him.
If the subject corrects his original answers, it should be made easy for him by ignoring the contradictions and receiving the new information as easily as though it were his first reply to the question. On a few occasions we have taken a complete history after we were convinced that it was a fraud, then laid it aside and suggested to the subject that he “now give it to us straight.” If the interviewer is sure enough of his interpretation of the situation, the protests of the subject can be quickly silenced and he will proceed to give a full and correct history. These falsified histories, in conjunction with the corrected records, are especially valuable documents because of the insight they give into an individual’s public acknowledgments, in contrast to his actual behavior.
18. Forcing a subject. There are some persons who offer to contribute histories in order to satisfy their curiosity, although they have no intentions of giving an honest record of their sexual activities. As soon as one recognizes such a case, he should denounce the subject with considerable severity, and the interviewer should refuse to proceed with the interview. Such an attack on a dishonest subject is quite contrary to the usual rules for interviewing, and a procedure which we at first hesitated to employ in the present study. We have, however, decided that it is a necessary technique in dealing with some individuals, particularly some older teen-age males and some females in underworld groups. Failure to command the situation in these cases would lower the community’s respect for the investigator and make it impossible for him to secure honest histories from others in the group. It must be understood by all concerned that giving a history is a voluntary matter, but that as soon as an individual agrees to contribute he assumes the responsibility of serving scientific accuracy. If the falsification is not recognized until after the interview, and if the individual is of importance in his community, the interviewer may well return to him and demand that he correct the record. The list of persons who have been forced in this fashion, in the present study, has included individuals in the underworld, feeble-minded subjects, prison inmates, and one clergyman. No history has ever been lost as a result of such action, and the study has won a number of staunch friends because of our insistence on scientific honesty.
19. Limits of the interview. In spite of the long list of items included in the present study (Chapter 3) and in spite of the fact that each history has covered five times as much material as in any previous study, numerous students have suggested, and undoubtedly will continue to suggest after the publication of the present volume, that we should have secured more data in the fields of their special interests. Specifically it has been suggested that the following matters should have had more thorough investigation:
Anthropology: Racial ancestry for several generations. A companion study on some culture other than American. The correlation of somatotypes and behavior
Endocrinology: Hormonal assays of at least some series of homosexual cases
Gynecology: Physical examinations of the genitalia of each female subject
Marriage Counseling: Non-sexual factors in marital adjustment
Medicine: More complete histories of health and disease, and genital examinations of all male subjects
Psychoanalysis: More data on early childhood, parental relations, etc.
Psychology: More data on motivations and attitudes, and complete personality, intelligence, and masculinity-femininity tests
Sociology: More detailed studies of cultural and community backgrounds; a precise economic rating
Urology: Sperm counts, more detailed genital measurements and records of defects
We are quite conscious of the limitations of the data which we have secured, and would like to see intensive studies of all of the above subjects in their relations to sex. It is, however, physically impossible to undertake all collateral investigations while making a preliminary survey in any field. This is a taxonomic survey of the sexual behavior of a whole great section of mankind, and it has been necessary to limit the immediate study to those things which can be covered in the twenty-eight years assigned to the project. Specialists in psychoanalysis, in mental measurements, in gynecology, and in various other fields, are the ones best equipped to undertake intensive studies; but when we have made such suggestions, they properly enough respond that their techniques take too long, and that they are in consequence in no position to cover the tens of thousands of cases that we are handling in the present survey.
Early in the study it became apparent that it was highly desirable to cover each history in a single interview of limited duration. If an interview is interrupted, there is a considerable loss of rapport, and much time is wasted in trying to re-establish relations with a subject at a second meeting. If the interview extends beyond an hour and a half or two hours, the subject becomes fatigued and the quality of the record drops. If the average interview is to be kept within these limits, nothing can be added to the present schedule unless a corresponding number of other items is dropped out. The extension of each interview by even ten minutes would lower the quality of the intake and materially reduce the number of histories that could be secured in a year. To add such a thing as a good test of economic status, or a masculinity-femininity test, would nearly double the length of time needed for each individual.
20. Avoiding personal identifications. The subject will be considerably relieved if he does not have to name the other persons involved in his socio-sexual contacts; and it is well to go out of one’s way to assure him that there is no desire to have such names. If the subject spontaneously includes them, make it apparent that they are not recorded on the history. We have secured thousands of confidences that could not have been obtained if we had insisted on having names of the other persons involved. Even then it is sometimes difficult to avoid identifications, and this is a prime reason why it is difficult to get histories from some married persons, from persons who have had sexual relations with relatives or with persons who are prominent in a community, and from persons involved in deeply emotional love affairs.
21. Avoiding controversial issues. The interviewer who makes moral appraisals of any type of sexual behavior is immediately forestalled from securing an honest record, and as scientists we have, of course, renounced our right to make such evaluations. The same principle applies to discussions of racial, religious, political, and economic issues, particularly among lower level, rural, and minority groups. It is not even possible to agree with the subject’s attitudes or the attitudes of his community, for the limits of the interviewer’s agreements are finally reached, and his silence on other issues names the things with which he disagrees. There is no way except to abstain from the discussion of all controversial social issues when one is making a scientific study of a human population.
22. Overt activities versus attitudes. To a large degree the present study has been confined to securing a record of the individual’s overt sexual experience. This has been because we feel that there is no better evidence of one’s attitudes on sex. Specific questions have been asked about each subject’s attitudes toward his parents, toward masturbation, premarital intercourse, sexual relations with prostitutes, and homosexual experience; but we do not have much confidence in verbalizations of attitudes which each subject thinks are his own, when they are, in actuality, little more than reflections of the attitudes which prevail in the particular culture in which he was raised. Often the expressed attitudes are in striking contradiction to the actual behavior, and then they are significant because they indicate the existence of psychic conflict and they throw light on the extent to which community attitudes may influence an individual.
23. Interviewing young children. For children who are twelve or older, it is usually feasible to adapt the regular interview to their vocabulary and experience, securing quite satisfactory answers. For younger children, especially for those under eight years of age, it is necessary to use a totally different approach. An interview then becomes a social session involving participation in the child’s ordinary activities. One of the parents has been present in all of our interviews with these younger children. The technique is one in which the interviewer looks at dolls, at toys of other sorts, joins in games, builds picture puzzles, romps and does acrobatics with the vigorous small boy, tells stories, reads stories, gets the child to tell stories, draws pictures, gets the child to draw pictures, shares candies and cookies, and withal makes himself an agreeable guest. Tucked into these activities are questions that give information on the child’s sexual background. If the picture book shows kittens putting on nightgowns for bed, the child may be asked whether she wears nightgowns when she goes to bed. When the interviewer tussles with the four-year old boy, he may ask him whether he similarly tussles with the other boys in the neighborhood, and rapidly follows up with questions concerning tussling with the girls, whether he plays with any girls, whether he likes girls, whether he kisses girls.
There is no sequence of questions and one depends upon opportunities that the play activities create for leading off into particular questions. The child’s drawings are highly significant, as psychologists will understand. Many a small child who cannot possibly describe the anatomical differences between males and females will draw pictures of boys and girls which make the distinction. An interview with a young child becomes an information test rather than an examination of the child’s overt activity; and the reactions of the child to the questions are more important than the specific information which he supplies. The above-mentioned four-year old boy may talk freely and spontaneously about the other boys that he plays with. He may or may not so freely admit that there are girls in the neighborhood with whom he also plays, and his embarrassment, his hesitancy, his disturbed giggling, or his calm acceptance of the fact are the most important things for the student of sexual behavior to note. Many of the adult attitudes toward various items of sex are already discernible in the three-or four-year old’s history, and often the differences in attitudes of different social levels are already reflected in the reactions of these young children. A later volume will cover this aspect of the study.
In general, it is difficult to explore effectively unless one has some understanding of the sort of thing that he is likely to find. One cannot intelligently push questions on sexual behavior if he does not comprehend what the possibilities of behavior may be. Inevitably these possibilities are beyond the personal experience that any interviewer is likely to have had, and consequently the prospective student of sexual behavior needs to learn a great deal from the very considerable literature on sex, and a great deal more from the experiences of the persons from whom he takes histories.
Specifically, one needs to comprehend the whole range of possible techniques in each possible type of sexual behavior, including masturbation, petting, intercourse, homosexual activities, animal contacts, relations with prostitutes, etc.; and one needs to understand the variety of psychic problems that may be involved and the considerable social complications that may develop in connection with each type of activity. There are hundreds of possible positions in intercourse, and although the original interview may be confined to questions concerning the six major possibilities, the interviewer should be prepared to investigate the full diversity of positions which an experimentally-inclined subject may use. There are scores of variant techniques in the homosexual which should be investigated when the opportunity comes to get such information. There are hundreds of things that need to be known about prostitution before one is ready to secure an adequate history from a prostitute. Lacking a knowledge of the possibilities, the interviewer will get only the most routine record from a person who in actuality could give a wealth of information.
Many of these variant and relatively rare situations provide most significant data on the backgrounds of human sexual behavior. In many instances variant types of behavior represent the basic mammalian patterns which have been so effectively suppressed by human culture that they persist and reappear only among those few individuals who ignore custom and deliberately follow their preferences in sexual techniques. In some instances sexual behavior which is outside the socially accepted pattern is the more natural behavior (Chapter 6) because it is less affected by social restraints. The clearest picture of learning in sexual behavior is to be found in the homosexual; and if the homosexual had been ignored in the present study, we should not have realized that similar learning processes are involved in the development of the heterosexual. Histories of extra-marital intercourse and the whole story of prostitution provide the best possible data on factors affecting orgasm in the female, and they are replete with striking instances of conditioning for particular situations. The interviewer who is satisfied with covering the routine, and who is not prepared to explore into the abundance of divergent fields, loses some of the scientifically richest material that can be obtained in a case history study.
The background of knowledge which the interviewer has is of great importance in establishing rapport with his subjects. The importance of this cannot be overemphasized. A subject is inevitably hesitant to discuss things which seem to be both outside of the experience of the interviewer, and beyond his knowledge. The narcissistic and masochistic male who has greatly elaborated his masturbatory techniques realizes that he is so unusual that he does not intend to admit anything beyond the simple fact of masturbation, when he first comes into the interview; but the experienced interviewer will discern that this is a special case when he asks the routine questions concerning the subject’s interest in looking at his own genitalia during masturbation, his interest in observing himself in a mirror, his custom of nibbling or biting a partner during a sexual relation, his reactions to being similarly bitten, his reactions to stories of torture, and his reactions to being hurt himself. Although these questions do not come in a block, but are spread throughout the length of the interview, the investigator should be capable of putting the answers together and understanding what they mean. Ninety per cent of all masturbation in the male is by a single technique, but for this case that is now before him, the interviewer should know enough about other possible techniques to be able to convince the subject that he is talking with a person who understands. The subject must feel that the situation is not so new or so strange that the interviewer will be startled at these things. He must be convinced that the interviewer can take them as he did the routine material. The interviewer’s background of knowledge is the key to obtaining a wealth of special material that a routine schedule of questions may completely miss.
It is particularly important that the interviewer understand socially taboo and illegal sexual activities, because these are the most difficult items on which to secure honest records. He needs to understand the sexual viewpoint of the culture to which each of his subjects belongs. For instance, it is impossible to get any number of histories from prostitutes, female or male, unless they realize that the interviewer understands both the sexual situations involved in prostitution, and the social organization of a prostitute’s life. A single phrase from an understanding interviewer is often sufficient to make the subject understand this, and such an interviewer wins a record where none would have been disclosed to the uneducated investigator. A specific illustration will make this more apparent.
This is the case of the older Negro male whose first answers were wary and evasive. When questioned concerning his occupation, he listed a variety of minor jobs which, taken in connection with his manner of response, seemed to spell underworld activities. We followed up our clue by immediately asking the subject whether he had ever been married. We were not satisfied with his denial of marriage, and followed with a question as to whether he had ever lived common law. The easy use of a vernacular term made him feel freer to talk, and when he admitted that he had so lived, we asked how old he was when he first lived common law. When he said that he was then fourteen, our first suspicion concerning his underworld activity was confirmed, and we immediately followed up by asking how old the woman was. At this, he smiled and admitted that she was thirty-five. Then we remarked, easily and without surprise: “She was a hustler, wasn’t she?” This was the final step necessary for winning complete confidence. The subject stopped short in his reply, opened his eyes wide, smiled in a friendly fashion, and said, “Well, sir, since you appear to know something about these things, I’ll tell you straight.” The extraordinary record that we then got of his history as a pimp could not have been obtained if the subject had not comprehended that we understood the world in which he lived.
Very often the interviewer’s capacity to secure an accurate history depends upon his knowledge of the correlations that usually exist between certain items, and his readiness to demand an explanation of any inconsistency that appears in a particular history. To illustrate again: one starts by asking the girl how old she was when she turned her first trick (but one does not ask how old she was when she was first paid as a prostitute). She is then asked how many of the tricks return after their first contacts with her. Considerably later in the interview there is a question concerning the frequency with which she rolls her tricks (robs her customers). The girl who reports that few of the men ever return, and who subsequently says that she never robs any of the men, needs to be caught up abruptly and assured that you know that it doesn’t work that way. If she doesn’t roll any of the men, why don’t they return to her? This question is likely to bring a smile from the girl and an admission that since you appear to know how these things work, she will tell you the whole story, which means that she robs every time there is any possibility of successfully doing so.
The development of an interviewer is a long and slow process. In the present study, for instance, it has involved a full year of training for each interviewer before he was ready to go very far in taking histories. The code had to be learned, and experience in its use was acquired by reading and by re-recording histories that were already in the file. Further experience was obtained by observing other interviewers in action and recording simultaneously while they did the questioning. Conversely, the trainee was given an opportunity to interview in the presence of the more experienced members of the staff. Then there was an opportunity to re-take histories which others had previously taken, and the trainee’s own subjects were given re-takes by a more experienced interviewer. When the new interviewer is able to secure a record that is practically a perfect duplicate of that obtained by the experienced person, he is in a position to take histories that can be added to those obtained by the older interviewers. Finally, each new interviewer has had to acquire a considerable knowledge of what people can do sexually and demonstrate that he can draw on that knowledge in the case of an unusual sort of history. After such a training program, one may, or may not, be ready to face the variety of situations that an investigator of human sexual behavior may meet.
The effectiveness of any interviewing technique is, in the last analysis, to be determined by the quality of the data that are obtained. We have described the techniques by means of which we have secured the data which are presented in the remainder of this volume. Whether the techniques which have been used in the present study would be equally effective with other persons engaged in studying other problems, is a question which must be answered empirically by each investigator in connection with his own special problems.
* In contrast, we have observed a psychiatrist interviewing a subject, who was under criminal indictment, in a small room in which a half dozen persons were continually moving about and listening to the whole of the conversation.