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Chapter 13

Chapter 13. Sexual Problems and Therapy. Individual Differences and Relationship Conflicts. Different Expectations Different Assumptions Differences in Desire. Difference is not necessarily a matter of who is right and who is wrong.

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Chapter 13

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  1. Chapter 13 Sexual Problems and Therapy

  2. Individual Differences and Relationship Conflicts Different Expectations Different Assumptions Differences in Desire

  3. Difference is not necessarily a matter of who is right and who is wrong. Many couples have had, or eventually will have, sexual problems at some time in their relationship.

  4. Personal Reflections What do you do when your partner desires sex and you are not in the mood? Have you ever pretended to be tired or feeling poorly in order to avoid sex with your partner? If so, why?

  5. Relationship Conflicts Conflicts Struggling over differences in preferred sexual behaviors Recognizing relationship problems often affect sexual problems Solutions • Working together and talking about differences • Choosing properly trained and certified Marriage and Family Therapist www.aamft.org

  6. Personal Reflections Are you able to comfortably communicate your sexual values and needs to your sexual partner or your potential partner? If not, what barriers are preventing you from doing so?

  7. Sexual Therapy

  8. The PLISSIT Model Each level represents a successively deeper level of therapy and is only explored if necessary. P = Permission LI = Limited information SS = Specific suggestions IT = Intensive therapy

  9. Sexual Therapy Techniques

  10. Sexual Therapy Techniques Specific suggestions: Systematic desensitization (reduce anxiety) Self-awareness and masturbation (know yourself) Sensate focus (non-demand mutual pleasuring) Specific exercises

  11. Sensate Focus

  12. Personal Reflections Stop and reflect on the physical interactions you have with your partner(s). Is your partner able to caress your arms, legs, neck and so on, without you quickly attempting to steer the behavior toward sexual play? Why or why not?

  13. Male Sexual ProblemsSexual Desire Disorders Hypoactive Sexual Desire (0 to 3% of men) Primary Secondary or acquired Causes Behavior and cognitive therapies Sexual Aversion Disorder More extreme

  14. Sexual Arousal Disorder: Erectile Disorder (Erectile Dysfunction) ErectileDysfunction: persistent or recurrent inability to get or maintain erection, and distress Kinds Causes Treatment and therapy

  15. Teasing Procedure Used After Success with Sensate Focus

  16. Personal Reflections Have you ever experienced performance anxiety during sexual relations (e.g., anxiety about pleasing your partner, maintaining an erection, reaching orgasm)? If so, what do you think is the cause of the anxiety?

  17. Male Orgasmic Disorders: Premature Ejaculation Premature ejaculation: absence of reasonable voluntary control of ejaculation, and distress Kinds Causes Treatment and therapy

  18. Male Orgasmic Disorder Male Orgasmic Disorder: delay or absence of orgasm following what is typically a normal sexual excitation phase Kinds Causes Treatment and therapy

  19. Male Sexual Pain Disorders

  20. Female Sexual ProblemsSexual Interest/Desire Disorders Hypoactive Sexual Desire and Sexual Aversion: persistent or recurrent deficiency of sexual fantasies/thoughts and/or desire for or receptivity to sexual activity which causes personal distress Kinds Causes Treatments and therapy

  21. Female Arousal Disorder Female Arousal Disorder: persistent or recurrent inability to attain or maintain sufficient sexual excitement, causing personal distress Kinds Causes Treatments and therapy

  22. Can you briefly explain why this training technique is used?

  23. Female Orgasmic Disorder Female Orgasmic Disorder: persistent or recurrent inability of a woman to have an orgasm (climax or sexual release) after adequate sexual arousal and sexual stimulation Kinds Causes Treatments and therapy

  24. Can you think of the reason therapists encourage the women-on-top position to help women with orgasm problems?

  25. Personal Reflections Are you able to “let go” totally during sex (i.e., no anxieties about nudity, sweat, odors, noises, facial expressions, etc.)? If not, why not?

  26. Female Sexual Pain Disorders

  27. Hypersexuality: Compulsion, Addiction, or Myth?

  28. Sexual Compulsion on the Internet Sexual compulsion on internet: sexual behavior characterized at least by two key features Kinds Causes Treatments and therapy

  29. Cross-Cultural PerspectivesSex Therapy What does your text say about these perspectives? Western cultural belief system Large parts of northern Africa and the Middle East Tantric Scriptures

  30. Sexual Problems Among Homosexuals

  31. Personal Reflections Almost all people experience sexual disorders at some point in their lives. If you were in an ongoing relationship and were consistently experiencing a problem, would you go to a sex therapist? Why or why not? Most therapists believe that the earlier therapy is initiated, the better the chance for a cure.

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