Various psychological treatments for the correction of sexual dysfunction which cannot be identified by a biological inadequacy.
Changing attitudes towards sex
Sex therapy, the treatment of sexual disorders, has evolved from early studies on sexual behavior made over 50 years ago. During these 50 years, the approach to sex therapy has changed immensely. When William Masters and Virginia Johnson published Human Sexual Inadequacy in 1970, the sexual revolution, born in the 1960s, was not yet in full force. Due in part to the development of the oral contraceptive known as "the pill" and the rise in the politics of feminism, society began to take a different, more open view of sexuality . For many, the sexual morals of the Victorian age and strict religious backgrounds had lingered even into the years after World War II. Traditionally, women were afraid to admit an interest in or even pleasure from sex. Men were permitted even less freedom to discuss sexual problems such as impotence. The rise in sex therapy addressed those issues as they had never been addressed before, in the privacy of a doctor's office.
In addition to shifting attitudes about sex, developments in medicine allowed more people to experience a satisfying sex life. By the 1990s, medications were developed that addressed the biological nature of sexual dysfunctions. Before these developments, if a man or a woman had trouble functioning sexually, the cause was often considered merely "psychological" and not a medical matter. Such medical treatments as penile implants, the prescription drug Viagra, and surgery or hormone replacement therapy for women can now be used to solve sexual disorders. If medical treatment does not solve a patient's disorder, sexual pleasure becomes a key issue for therapists.
Masters and Johnson out, postmoderns in
Masters and Johnson were pioneers in sex therapy. Their research focused on three basic ideas: first, on encouraging couples to engage in completely new experiences; second, on persuading couples to perform in a previously prohibitive way that would hopefully dissolve their sexual conflicts; and third, on allowing couples to openly discuss such taboo subjects as premature ejaculation. By the 1990s, however, other researchers began noting that this form of therapy was not as useful with the coming of what is termed the "postmodern" age. In this new era, a different approach to sex therapy was deemed necessary.
Love and intimacy in the postmodern era affords the luxury of modern medicine and biology. Once medical factors are ruled out, a more ominous issue arises, that of desire disorders. Postmodern sex therapies consider many complex problems when approaching sexual dysfunction . According to current research, sexual disorders might have a host of underlying causes. These causes might even make sexual dysfunction desirable to the person suffering from such problems. For example, if a couple is having problems with intimacy, trust, or control in their relationship, creating sexual problems might be a way of avoiding dealing directly with the real issues. Low self-esteem , unresolved family or parental conflicts, or using energy for performance at work instead of for sex are all examples of problems that a couple must address before any promising sex therapy can begin.
If medical issues have been ruled out, once a person resolves whatever problem is causing a difficulty with intimacy, loving sexual relationships will be able to proceed. In an age of mobility with computers and email replacing interpersonal contact, avoiding intimacy is rather easy. Such technological "advances" as relying on automatic teller machines to hand out money, using computer keyboards to order products and services, and even machines to check out groceries all eliminate the opportunity for conversation or to release tension through personal contact. When people are allowed, or even expected, to become self-absorbed, sexual desire becomes even less necessary. In this age of over-achievers and cyberspace millionaires, living a life of all work and no play is considered a virtue. With so many issues at hand, a qualified sex therapist is often needed to help a person reach to the core of his or her problems. Most experts agree, sex therapies that address people and their personal histories, and not only problems that are manifested at the time of therapy, are those that have the best chance for success.
Gochros, Harvey L. Sexual Distress. The Encyclopedia of Social Work, 19th edition. Edwards, Richard L., Ed.-in-Chief. Washington, D.C.: NASW Press, 1995.
Hight, T. L. Sex Therapy. The Baker Encyclopedia of Psychology. Grand Rapids, MI: Baker Books, 1999.
Packer, Jennifer. Get Rid of the Fears That Keep You from True Intimacy. Knight Ridder/Tribune, The Dallas Morning News, June 6, 2000.
American Psychological Association. 750 First Street, N.E., Washington, D.C., USA. 20002-4242, 202-336-5500, 800-374-2721.