Beginning with the pioneering work of Masters and Johnson during the 1960’s, professional interest in the study and treatment of sexual dysfunctions has increased dramatically. It was not surprising that the early research into psychotherapy, couples therapy, relationship counseling and more found the human sexual response to be quite complicated. What was of some surprise however was the discovery that sexual problems are quite common in the general population.
Out of the understanding of how the sexual response “works,”and why it doesn’t, has come specific and effective treatment approaches for dealing with the wide range of male and female sexual dysfunctions.
Sex therapy, based on what is now a large body of research, is a specialized treatment focusing on the resolution of sexual concerns. It is a relatively brief therapy, if the problem is not complicated by medical factors and/or relationship issues. Naturally, the more complications, the longer the therapy. However, when the sexual concern can be addressed directly and the treatment is appropriate, progress is usually rapid.
Sex therapy often involves both partners and relationship counseling when there is a committed relationship. Homework assignments are frequently given, thus allowing the couple to work on the concern between therapy sessions. The use of homework speeds the progress and shortens the number of therapy sessions to solve the problem.
Sexual dysfunctions can be divided into a number of categories, each requiring a specific, individualized treatment approach. Some of the most common sexual problems include:
- Sexual Aversion: being fearful and avoidant of sex.
- Hypoactive Sexual Desire: having an absent or low sex drive.
- Arousal Disorders: male difficulty with getting and/or maintaining erections and female difficulties in becoming and/or staying aroused.
- Orgasmic Disorders: premature ejaculation or delayed ejaculation in males and the absence or difficulty with reaching orgasm in females.
- Sexual Addiction/Compulsion: excessive sexual thoughts and/or behaviors which cause significant impairment in functioning.
- Gender Identity Disorders: a persistent discomfort with one’s sex and a strong identification with the opposite sex.
Causes of Dysfunctions
Causes of sexual problems can stem from biogenic, psychogenic and/or interpersonal factors. Biogenic, often called Organic, means the origin is biological or in the body. Psychogenic means the origin is in the psyche or mind. Interpersonal causes relate to unhealthy relationship dynamics which negatively impact sexual functioning.
Most sexual dysfunctions are not caused exclusively by one factor. Many times the cause is found to be the combination of factors; hence, treatment is most effective when carried out through the cooperative team effort of both an appropriate physician and sex therapist.
Many sexual dysfunctions are the result of problems within the relationship, requiring relationship counselling. If the relationship is in trouble, the sexuality will likely suffer. The reverse is also true. The sexual problem might start first, and over time, have a negative impact on the relationship. When the relationship is the cause of, or is damaged by, the dysfunction, a combination of relationship and sex therapy is the treatment of choice.
Additional Psychogenic Causes
Other possible psychogenic causes of sexual problems include stress, anger, anxiety, guilt, depression, fear of “letting go,” fear of intimacy, a history of emotional, physical or sexual abuse, an exaggerated concern over sexual performance, a fear of sexual failure, distracting thoughts or memories, or simply a lack of sexual knowledge.
Biogenic Causes of Sexual Dysfunctions
Biogenic causes are most typically the result of conditions, diseases, or injuries that affect the nervous system, the circulatory system, or the endocrine system. In addition, many medications are known to have negative impact on sexual dysfunctioning. While these causes require medical evaluation and treatment, the sex therapist is a valuable resource for resolving any relationship problems created by the organic dysfunction, for exploring new forms of sexual expression, and for enhancing the physical intimacy and strengthening the emotional bonds.
Additionally, it is important to note that alcohol and drug abuse can have a destructive affect on sexual desire and performance. Treatment for chemical addiction is often necessary before addressing sexual concerns.