Sexual dysfunction includes arousal disorders, response disorders, as well as the presence of disturbing, erotically necessary fantasies about fetishes, children, or other non-consenting persons. Sexual dysfunction also includes risky masochistic and/or sadistic behaviors, cross-dressing, fetishism, and voyeurism that are linked to arousal and which have grown out of control and feel frightening.
Since the sexual response cycle is comprised of three phases: desire, excitement, and orgasm, it makes sense that some of the dysfunctions may also be organized roughly in conjunction with these phases. We can, therefore, speak about Hypoactive Sexual Desire and Sexual Aversion Disorder. We can speak about Inhibited Female Orgasm, Retarded Ejaculation and Premature Ejaculation. We can speak about Vaginismus and erectile dysfunction disorder.
Good sex therapy will usually correct most problems, provided other causes are ruled out. The challenge of good sex therapy is two-fold: (1) to teach and monitor the fairly simple behavioral modifications that have proven so effective in reducing sexual dysfunction, and (2) to skillfully handle the deeper issues that are often at the heart of certain dysfunctions. Good sex therapy will also manage the anxieties and resistances that crop up during the treatment process. For example, when the prematurely ejaculating man begins to gain ejaculatory control, his partner will frequently grow anxious about continuing treatment for fear that success will result in her being left for “a more attractive” partner. Thus, because sex is so closely linked with intimacy and relationship, these areas can also be made a part of the therapy.
However, it is not necessary to have a sexual partner in order to seek and receive successful treatment for a sexual disorder. Self-stimulation exercises and assignments have been developed in the treatment strategies for the single patient. And, in respectful recognition of certain Orthodox Jewish and devout Catholic prohibitions against masturbation and “spilling seed,” modifications are made in order to remain within the bounds of a couple’s religious beliefs.
Sex therapy, or therapy that includes sexual issues is not surrogacy. Sex therapy is limited to verbal exchanges. A good therapist maintains an empathic, non-judgmental environment where it is safe for both individual and couple to discuss and resolve difficult issues. |