Transcript Human Sexuality - myteachingspace.com

Human Sexuality
Sexual Function Difficulties,
Dissatisfaction, Enhancement, and
Therapy
Sexual Desire and Activity

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“ebb and flow”- natural to have highs
and lows in sexual desire and activity
Most report occasional sexual difficulties
(McCarthy & McCarthy, 2003)
Defining Sexual Function
Difficulties

What constitutes a sexual “problem”

Discourses on normality/abnormality
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Cultural scripts
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DSM-IV
Difficulties and Dissatisfaction
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Difficulties: problems/issues with
sexual functioning
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Inability to participate in sexual
relationships as we wish
Dissatisfaction: subjective response
to sexual difficulties
Sexual Dysfunctions

Disturbance in sexual desire and in the
physiological sexual response

Causes “distress”
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“persistent or recurrent”
Female Sexual Dysfunction
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Critique: often based on physical criteria

How should we measure female sexual
dysfunction?
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Less research on female sexual problems

Role of psychological and contextual factors
Female Sexual Dysfunction

Need for greater focus on
2004):
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(Basson, 2003;
Subjective sexual arousal
Female sexuality as distinctive/different
from male sexuality
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Role of attachment, personal history, etc.
Female Sexual Dysfunction
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Contextual/relational factors
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Socio-cultural factors;
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Cultural norms and ideals;
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Inadequate information about female
sexuality
Survey Findings
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National Health and Social Life Survey
1,749 women; 1,410 men
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Women: 43% reported sexual difficulties
Men: 31% reported sexual difficulties
Survey Findings
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Sexual dysfunction/difficulties are more
common in men and women who have
been sexually victimized
Both physical and psychosocial factors
were implicated
Sexual Desire Disorders
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Lack of fantasies and desire for sexual
activity
Causes distress and interpersonal
difficulty
Sexual Desire Disorders:
HSD

Hypoactive sexual desire: lack of sexual
desire

Causes more stress in marriages than any
other sexual problem (McCarthy &
McCarthy, 2003)
Sexual Desire Disorders
HSD
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
Often transitory
May be associated with depression, stress,
and interpersonal difficulties

**high sex drive is not a disorder in the DSM**
Sexual Desire Disorders
Sexual Aversion
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Sexual Aversion Disorder: aversion
to and avoidance of genital contact
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Anxiety, fear, or disgust toward sex
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Actions are taken to avoid sexual situations
Sexual Desire Disorder:
Sexual Aversion
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Sexual Aversion Disorder
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panic attacks and physical symptoms
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past sexual trauma
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negative parental reactions to sexuality
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sexual pressure from a partner
Sexual Arousal Disorders
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Female Sexual Arousal Disorder: lack of
physiological sexual response
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Male Erectile Disorder: erectile
dysfunction;
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associated with sexual/performance
anxiety, low excitement, potential medical
issues
Sexual Arousal Disorders

The disorder may have physical or
psychological roots
Orgasmic Disorders


2nd most common sexual problem, after
low sexual desire
Female Orgasmic Disorder; may be
related to negative/guilty attitudes
about sex, relationship problems
Orgasmic Disorder
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Male Orgasmic Disorder: delay or
absence in orgasm; inhibited or delayed
ejaculation
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Premature ejaculation
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Often related to sexual anxiety
Sexual Pain Disorders
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Sexual Pain Disorders: Genital pain
associated with intercourse;
psychological origins
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Inadequate sex education, sexual trauma,
sexual guilt, relationship problems
Physical Causes of Sexual
Dysfunction: Men
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Alcoholism, smoking, drug use
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Diseases of the heart/circulatory system
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Other physical illnesses

A side effect to certain medications
1994)
(Vine,
Physical Causes of Sexual
Dysfunction: Women
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Diseases/chronic illnesses
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Stress and fatigue
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Hormonal changes
Sexual Dysfunction: Treatment
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Accurate information about sexuality
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Communication skills
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Fostering positive sexual attitudes
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“homework”
Treatment
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Cognitive therapies:
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Looking at sexual attitudes/beliefs
Addressing erroneous/unhealthy sexual
attitudes
Treatment
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Behavioral components:
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Addressing concrete behaviors
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“homework”- sexual exploration
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Partner exploration
Taking away sexual pressures
Couples therapy
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Treating sexual dysfunction as a
relationship issue
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Taking away blame
“Neutrality and mutuality”
Treatment
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Addressing fear/anxiety associated with
sexuality
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The client’s personal history
Performance anxiety
Sexual Addiction
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Not in the DSM-IV
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Does sexual addition exist?
What is it?
How is it treated?
Sexual Addiction
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Sexual addiction/compulsive sexual
behavior
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A form of impulse control disorder? (Barth
& Kinder, 1987)
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Approximately 2 million sexual addicts in
the U.S. (Delmonico & Carnes, 1999)
Sexual Addiction
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Continuing to participate in sexual behaviors
despite negative consequences (Bird, 2006)
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Damaging to oneself and others
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More likely to engage in risky sexual behaviors
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Often report feelings of shame/isolation
Sexual Addiction
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The Internet:
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New arena for sexual addicts (Griffiths,
2001)
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Pushing mild addicts into deeper addictions?
Affordable/anonymity (Cooper, 1998)
Sexual Addiction: Women
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Female sexual addicts:
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Relationship-oriented online sexual
behavior
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often leading to real life sexual encounters
(Schneider, 2000)
Sexual Addiction: Women
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Women report experiencing greater
shame than men
Women are less likely to engage in
group counseling/12 step programs
Sexual Addiction: Men
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More prevalent in men
Gay/bisexual men are slightly more
likely to report sexual addiction (Cooper,
2000)
Sexual Addiction
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Research suggests sexual addiction
often occurs with other psychological
disorders
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Co-morbidity
Sexual Addiction
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Sexual addicts: significantly more likely
to experience clinical depression (Weiss,
2004)
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Tentative link: sexual addiction and
untreated ADHD (Schwartz, 2003)
Sexual Addiction
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Link between loneliness and
pornography usage (Yoder, 2005)
Sexual Addiction
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Sexual addiction and OCD

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Individuals with both conditions experience
greater fear and avoidance regarding
thoughts
Less pleasure related to performing sexual
compulsions (Schwartz & Abramowitz, 2003)
Treatment of Sexual Addiction
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Couples/family therapy
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Medication (SSRIs)
Treatment of Sexual Addiction
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Cognitive restructuring
Confrontation
Defining “sexual sobriety” and sexual
boundaries
Empathy/grief counseling