WHAT IS SEX THERAPY?

Sex therapy is a form of psychological treatment designed to both ameliorate sexual dysfunction and enhance sexual fulfillment. By combining psychological counseling, sex education, relationship counseling with behavioral approaches designed specifically for enhancing sexual functioning, individuals can learn to achieve a higher degree of sexual satisfaction.

Sex therapy can be helpful for individuals and couples depending on the issue being addressed. Some issues can be dealt with on an individual basis, while others are best treated in the context of a couple relationship.

The most common sexual dysfunctions are:

Erectile dysfunction (primary and secondary impotence): Often men experience difficulty obtaining or maintaining an erection sufficient for penetration. Sometimes there is an organic basis for this dysfunction; a urologist should be consulted prior to contacting a sex therapist. Most often, however, the dysfunction has a psychological basis. Primary impotence refers to a man who has never been able to maintain an erection for purposes of intercourse either with a female or a male, vaginally or rectally. In secondary impotence a man cannot maintain or perhaps even get an erection, but has succeeded at having either vaginal or rectal intercourse at least one time in his life. The occasional failure to get an erection is not to be confused with secondary impotence. Familial, societal, and intrapsychic factors contribute to primary impotence. Some of the more common influences are (1) performance anxiety, (2) a seductive relationship with a mother, (3) religious beliefs in sex as a sin, (4) traumatic initial failure, (5) anger toward women, and (6) fear of impregnating a woman.

Rapid ejaculation: Rapid ejaculation is the most common dysfunction and it is the easiest to treat. Masters and Johnson define premature ejaculation as the inability to delay ejaculation long enough for the woman to orgasm fifty percent of the time. (If the woman is not able to have an orgasm for reasons other than the rapid ejaculation of her partner, this definition does not apply.) Other therapists define premature ejaculation as the inability to delay ejaculation for thirty seconds to a minute after the penis enters the vagina.

Retarded ejaculation (ejaculatory incompetence): Ejaculatory incompetence is the opposite of premature ejaculation and refers to the inability to ejaculate inside the vagina. Men with this difficulty may be able to maintain an erection for 30 minutes to an hour, but because of psychological concerns about ejaculating inside a woman, are not able to achieve orgasm. One of the reasons this dysfunction goes undetected is because the male's partner is satisfied and indeed often is able to achieve several orgasms. Most of these men can readily achieve orgasm through masturbation or in some cases through felatio. Many factors contribute to this condition, some of which are religious restrictions, fear of impregnating, and lack of physical interest or active dislike for the female partner. In addition such psychological factors as ambivalence toward one's partner, suppressed anger, fear of abandonment, or obsessional preoccupation also play a significant role in developing retarded ejaculation.

Vaginismus: This relatively rare sexual disorder is characterized by a conditioned spasm of the vaginal entrance. The vagina involuntarily closes down tight whenever entry is attempted, precluding sexual intercourse. Otherwise, vaginismic women are often sexually responsive and orgastic with clitoral stimulation. Similar attitudes to those found in impotent males are often found in these women. Religious taboos, physical assault, repressed or controlled anger, and a history of painful intercourse all contribute to this dysfunction.
Anorgasmia: The most common sexual complaint of women involves the specific inhibition of orgasm. Orgastic dysfunction refers solely to the impairment of the orgastic component of the female sexual response and not arousal in general. Nonorgastic women can become sexually aroused and in fact enjoy most other aspects of sexual arousal. Inhibition and guilt about masturbation, discomfort with one's body, and difficulty giving up control, contribute to orgastic dysfunction. With a combination of education and practice most women can be taught to achieve orgasm.

Inhibited sexual desire: Inhibited sexual desire or response refers to the lack of desire for erotic sexual contact. In almost all cases when there is a lack of sexual desire the underlying causes are psychological in nature. Avoidance of sexual contact because of fears of rejection, failure, criticism, feelings of embarrassment or awkwardness, body image concerns, performance anxiety, anger towards a partner or women in general, lack of attraction towards a partner, all play a part in reducing or eliminating the sexual response. Many people are too uncomfortable to talk to their partner or anyone else about these issues preferring to simply avoid sex or attribute their lack of sexual appetite to stress, worries, etc. Some of these men and women have a very active fantasy life and prefer the solitude of masturbation to the intimacy of sexual relations.

Sex Therapy
What is Sex Therapy?
Impotence
Premature Ejaculation
Low Sexual Desire
Erectile Dysfunction
Sexuality and Sex Therapy, an article by Dr. Dreyfus

Click here to sign up for Psychotherapy Update,
a newsletter full of articles and information

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.