Sexuality And Sex Therapy
Edward A. Dreyfus, Ph.D.

CAUSES OF SEXUAL DYSFUNCTION

Most sexual dysfunction occurs because of faulty beliefs and attitudes about sexuality, poor habits, ignorance, and early experiences. There are some sexual dysfunctions that are precipitated by physiological, biological, or chemical factors. However, all physiological dysfunctions have a psychological component. When men are unable to obtain or maintain an erection, whether from physiological or psychological causes, they feel inferior, less manly. When a woman is unable to reach orgasm she feels less feminine. Therefore, in all cases of sexual dysfunction it is necessary to attend to the psychological aspects of the difficulty and what it means to the individual.

Physiological factors. Some of the more common nonpsychological precipitants of sexual dysfunction include hormonal imbalance, medications, neurological impairment, physiological disorders, and even vitamin deficiency. Certain illnesses and medications can have side effects that affect sexual functioning including impotence and increased or decreased libido.

Many people prefer to think of only a medical approach to sexual dysfunction since it is more acceptable to one’s self image to believe that there is an organic basis for the dysfunction. Even in those instances when there is a recognizable medical condition affecting sexual functioning, the psychological component cannot be overlooked. We all have varying psychological reactions to physical illness or impairment. This psychological reaction can exacerbate the physical problem. This is especially true for infertility problems. Most people who have difficulty conceiving a child choose to investigate the medical aspects to the exclusion of the psychological aspects. Yet we all know of many cases where a couple after years of frequenting the fertility clinics to no avail, finally decide to adopt a child only to conceive a few months afterward. Clearly this would suggest that psychological factors were at play.

Psychological factors. Most sexual dysfunctions have a psychosocial etiology. Dr. Helen Singer Kaplan states, “In a general sense we see the immediate causes of the sexual dysfunctions as arising from an antierotic environment created by the couple which is destructive to the sexuality of one or both. An ambiance of openness and trust allows the partners to abandon themselves fully to the erotic experience.” She lists four specific sources of anxiety and defenses against full sexual enjoyment: 1) Avoidance of or failure to engage in sexual behavior which is exciting and stimulating to both partners. 2) Fear of failure, exacerbated by pressure to perform, and overconcern about pleasing one’s partner rooted in fears of rejection. 3) A tendency to erect defenses against erotic pleasure. 4) Failure to communicate openly and without guilt and defensiveness about feelings, wishes and responses.

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For forty years Dr. Dreyfus has been practicing as a clinical psychologist and life coach in Santa Monica, California where he specializes in individual psychotherapy, relationship counseling, and sex therapy. He has recently published two books,
Someone Right for You: 21st Century Strategies for Finding Your Special Someone
and
Keeping Your Sanity (In an Insane World)
released by Xlibris and can be found at
www.SomeoneRightForYou.com
and
www.KeepingYourSanity.com.

For further information or consultation regarding psychological issues, or life coaching, you may contact Dr. Dreyfus by letter, phone, email, or fax.

You can e-mail him or call (310) 208-5700.