Final Flashcards
3 Categories of Sexual Dysfunction
- Dysfunction
- Dissatisfaction
- Deviation
4 Types of Sexual Dysfunction
- Disorders of Desire
- Arousal Dysfunction
- Orgasm Dysfunction
- Pain
Hypoactive sexual desire disorder
The persistent or recurrent deficiency (or absence) of sexual fantasies/thoughts and/or desire for or receptivity to sexual activity that causes personal distress
- Can be lifelong or acquired, generalized or situational, and have single or multiple etiologies
- Must cause PERSONAL stress for dx; partner distress does not warrant dx
Sexual arousal disorder
[Male erectile disorder, female sexual arousal disorder]
The persistent or recurrent inability to attain or maintain sufficient sexual excitement, causing personal distress
- It may be expressed as a lack of subjective excitement, genital response (lubrication/swelling), or other somatic responses
Orgasmic disorder
[male orgasmic disorder, premature ejaculation, female orgasmic disorder]
The persistent or recurrent difficulty, delay in, or absence of attaining orgasm/ejaculation following sufficient sexual stimulation and arousal, causing personal distress
Pain disorders
[Dyspareunia, Vaginismus]
Dyspareunia: Recurrent or persistent genital pain associated with sexual intercourse.
Vaginismus: Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration, again causing personal distress
5 Basic Conditions for Healthy Sex
C- Consent E - Equality R - Respect T - Trust S - Safety
Pros of Therapist Comfort
- Allows client to “normalize” when therapist conveys she is comfortable dealing with sexual issues
- Allows client to reveal fantasies, concerns
- Allows for greater creativity in the treatment room
Assessment
- Screen clients (may be first screening by a professional)
- Incorporate in ongoing practice in matter of fact manner
- Specific requests for sex therapy –> comprehensive sexual assessment
Screening Questions
- Are you sexually active?
- Men, women, or both?
- Are you satisfied with the quality and quantity of sexual activity in your life?
- Is this an area you would like more information on/ to fully explore?
Ways to incorporate in ongoing practice
- Quality/Quantity of sex, and level of satisfaction
- Meaning of sex
- Contraindicated in presence of severe marital distress - marital therapy to pave the way for future tx of sexual problem
Comprehensive Assessment
Medical
Psychosocial
Psychophysiological
Treatment for
Premature/Delayed Ejaculation
- Relaxation response
- SSRIs
- Mindfulness - Fantasy
- Relationship issues
- Squeeze technique
Treatment for
Erectile Dysfunction
- Focus on non-erotic stimuli
- Encourage positive reinforcement
- Decrease demands
- Encourage open, positive communication with partner
Treatment for
Dyspareunia/Vaginismus
- Physical examination critical
- Vaginal dilators
- Relaxation training
- Greater success with partner involvement
Treatment for
Orgasmic disorder
- Relaxation - sensate focus
- Mindfulness of sensual pleasure
- Appropriate use of erotica/fantasy
- Masturbation
- Increase positive self-image
- Pelvic floor exercises
Treatment for
Disorders of Desire
(Men & Women)
- Education
- Sensate focus - sensual awareness
- Appropriate exposure to erotica, sexual aids
- Explore relationship to sex/erotic mind
- Hormonal (testosterone)?
Medically speaking, sexual issues fall into 3 general categories:
- Nerve supply
- Blood flow
- Hormones
Questions to ask regarding meaning of sex
- What does sex mean to you?
- How is/was sex treated in your family?
- What are the important events that shaped your sexuality?
- What would you like to experience most with your partner sexually, and
- What are you most afraid of?
The Erotic Equation
Attraction + Obstacles = Excitement
*Eroticism resides where there is UNPREDICTABILITY, SPONTANEITY, and RISK.
Emotional Connectedness Can Dampen Desire
When closeness becomes an obligation
Threat to separateness = basis of all attractions
Encouraging Change
- Clarify goals and motivations
- Nurture self-worth
- Embrace uncertainty
- Acknowledge and mourn your losses
- Practice mindfulness using your senses
- Risk the unfamiliar
- Integrate your discoveries
Most important issues that influence women’s sexual well-being
- Self-image
- Relationships
- Psychological health
- Social connectedness
- Cultural expectations
