Copyright, Corey E. Miller, 2002, 2003 1 Chapter Fourteen: Sexual Enhancement and Therapy

Copyright, Corey E. Miller, 2002, 2003

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Chapter Fourteen: Sexual Enhancement and

Therapy


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Sexual Enhancement

• Sexual enhancement - improvement of the quality of one’s sexual relationship

• Intensifying erotic pleasure– Sexual arousal– Alternatives to intercourse


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Zilbergeld (1992): Six Requirements for Great Sex

1. Accurate information about sexuality2. Orientation toward sex based on pleasure,

such as arousal, fun, love, and lust, rather than performance and orgasm

3. Relationship allows each partner’s sexuality to flourish

4. Communication about sex, feelings, and relationships (verbally & nonverbally)

5. Being equally assertive about your own needs and those of your partner

6. Accepting, understanding, and appreciating differences between partners


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Common Conditions for Great Sex• Self-awareness - critical to enhancing

your sexuality1. Feeling Intimate2. Feeling Sexually Capable3. Feeling Trust4. Feeling Aroused5. Feeling Physically & Mentally Alert6. Feeling Positive about Environment &

Situation


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Sexual Disorders and Dysfunctions• Sexual dysfunction - a disturbance in sexual desire

and in the psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty

• Lifelong - • Acquired – after period of normal functioning• Generalized – all situations• Situational – specific situations


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Females• Problems Decrease w/ age except

lubrication• Nonmarried Women 11/2 Times More

likely to have Orgasm difficulties• College Graduates half as likely to have

problems w/ Orgasm, Anxiety• African Americans more likely to have

Low sexual desire• African Americans more likely to find

Sexual NOT pleasurable


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Females Continued• Women with low sexual activity are at a higher

risk for low desire and arousal problems• Rates are the same for Women who report

same sex activity as those who do not• Sexual arousal problems more likely among

victims of sexual assault• Sexual Dysfunctions negatively correlated with

emotional satisfaction and happiness


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Males• Nonmarried men report higher rates for

dysfunctions• College graduates 2/3 as likely to report

early orgasm and ½ as likely to report nonpleasurable sex and sexual anxiety

• Low sexual activity is NOT related to low desire and arousal problems

• Those that report some same sex activity more than twice as likely to experience premature ejaculation and low sexual desire


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Males Continued• Problems much more likely among

victims as children• Assaulters 31/2 times more likely to have

erectile dysfunction• Men reporting erectile dysfunctions and

low sexual desire experience diminished quality of life

• Those with Premature ejaculation are not affected


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Disorders of Desire

• Hypoactive sexual desire - HSD; also known as inhibited sexual desire; low or absent sexual desire

• Sexual aversion - phobic response to sexual activities or the idea of such activities

• Causes:– Negative Parental Attitudes– Trauma and Victimization


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Sexual Arousal Disorders

• Female sexual arousal disorder - inability to maintain adequate vaginal lubrication;

once termed “frigid”

• Male erectile disorder - inability to maintain an adequate erection– once termed “impotence”


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Orgasmic Disorders• Female orgasmic disorder - absence or

delay of orgasm after normal sexual excitement~25% of women unable to achieve orgasm in

12 months w/ partner

• Male orgasmic disorder - absence or delay of ejaculation after normal sexual excitement– Inhibited ejaculation– Delayed ejaculation


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Sexual Pain Disorders

• Dyspareunia - genital pain associated with intercourse

• Vaginismus - involuntary spasmodic contractions of the vaginal muscles


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Other Disorders

• Peyronie’s disease - development of calcium deposits and fibrous tissue in the penis

• Priapism - prolonged and painful erection


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Physical Causes of Sexual Dysfunctions

• Men:• Diabetes• Alcoholism• Lumbar-disc disease• Atherosclerosis• Spinal cord injuries• Smoking

• Women:• Diabetes• Heart disease• Hormone deficiencies• Neurological

disorders• Alcoholism• Spinal cord injuries


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Psychological Causes of Sexual Dysfunctions

• Fatigue and Stress• Ineffective sexual behavior• Sexual anxieties• Excessive need to please a partner

– 2/3 of Women faked O– 1/3 of Men faked O

• Inner conflict– Upbringing– Internalized Homophobia

• Relationship problems


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Masters and Johnson• Cognitive-behavioral approach• Majority of Sexual Dysfunctions caused by

ignorance, faulty techniques, or relationship problems

• Sensate Focus – focus on giving and receiving pleasure – focus isn’t arousal

• Treatment of Premature Ejaculation - Squeeze Technique

• Treatment for Female Orgasmic Disorder – partner touches Vulva – she shows him what she likes

• Surrogate Partners


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Treating Sexual Problems• Helen Singer Kaplan - psychosexual

therapy– Point our resistance and unconscious root of

problem

• PLISSIT model of therapy– Permission –– Limited Information – focus on area of

difficulty– Specific Suggestions - homework– Intensive Therapy

Documents

Copyright, Corey E. Miller, 2002, 2003 1 Chapter Fourteen: Sexual Enhancement and Therapy