lecture 13 Flashcards
Linear model of sexual response (4 phases):
(masters and johnsons)
1)excitement
2)plateau
3)orgasm
4)resolution
Kaplan’s triphasic model (1970’s)
1)sexual desire
2)excitement
3)orgasm
takeaway of masters and johnsons and kaplan
Takeway: Kaplan actually included sexual desire as its own phase, whereas masters and johnsons only included excitement which focused more on the physiological component rather than psychological component noted in kaplan’s model
Dual control model (Bancroft and janssen, 2000s)
Propensities to award sexual excitation and sexual inhibition vary widely from one person to the next
Excitation is the accelerator pedal and inhibition is the brake pedal
Some people have more sensitive accelerators and some people have more sensitive brakes
Most people fall into the moderate section
What is best is for people to have a balance between sexual excitation and sexual inhibition
There can be many factors contributing to inhibition and excitement including physiological and organic issues, psychosocial, cultural and behavioral issues
Sexual tipping point, at some point the scales weigh heavier on one point than the other (either excitement or inhibition) and that can affect sexual decision making
Sexual problem categories
Desire
~Not enough desire
Excitement
Something interfering with arousal
Orgasm
~Difficulty with ejaculation
Pain
~Some kind of pain with sexual activity
New View Critique
group of sex therapists that specialize in the treatment of women’s problem, this group of feminists came together to create the New View
New view States 3 critiques of DSM:
1)diagnostic categories treat male and female sexuality as equivalent when they differ in important ways
2)they ignore the relationship context of sexuality and desire for emotional intimacy
3)they ignore differences among women and naturally occurring variations in women’s sexuality
New View Proposed Categories
1)sexual problems due to socio-cultural, political, or economic factors
Sexual problems coming from inadequate sex education, lack of access to sex services, family work obligations
2)sexual problems relating to partner and relationship
Sexual inhibition due to abuse from partner
Partner sexual problems
3)sexual problems due to psychological factors
Sexual aversion due to past experience of abuse
Personality problems
Fear of sex due to pain, sti’s
4)sexual problems due to medical factors
Negative effects from having an STI or using medication
Fear of Pregnancy, neurological disorders
Biopsychosocial approach to understanding health
Multi aspects that go into understanding why someone has a sexual concern
Steps taken when people come in for sex therapy:
1)Look at Biological causes to sexual health issues
2)Psychological factors
psychological factors
Understand myths and misinformation that the patient has
Ie: “i believe herpes means i can never have a good sex life”
This is not true
Treatment: psychoeducation (telling the patient their beliefs are not true)
Negative attitudes
Negative beliefs about partners, sexual activities
Treatment:psychoeducation, CBT
Relationship distress
Person may be feeling disconnected from partner
Treatment: couples therapy
Lifestyle
Ie:work schedule
Treatment:problem solving, scheduling
Psychological distress
Depression and anxiety
Treatment: individual therapy
Techniques and communication
For many people, they are not getting the correct stimulation which can be fixed by effective communication
Treatment: psychoeducation, couples therapy
Spectatoring
feeling like you are observing yourself performing and judging yourself
associated with anxiety when having sex
treatment:CBT
Most effective to look at what issues are contributing to the issue to come up with a treatment plan
Format of sex therapy
Assessment
Assessing the causes of the sexual function issue
Frequency of sessions
Variable, but often there are exercises that clients are asked to do
Session format
Starts with a check in with homework, and assigning other homework
Ground rules
Discussion with the client to what to expect with the sessions and homework
Sensate focus
1)self exploration
2)self pleasuring
3)mutual pleasuring
4)intercourse/end goal
PLISSIT Model:
P: giving a person permission to talk about a topic, or to get medical assistance
LI:limited information: giving person more information to a person
SS:specific suggestions: sex therapist gives patient specific treatments for their issue
IT: intensive therapy: sex specialist giving high level of intervention/treatment
