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Human Sexuality

Human Sexuality. Sexual Function Difficulties, Dissatisfaction, Enhancement, and Therapy. Sexual Desire and Activity. “ebb and flow”- natural to have highs and lows in sexual desire and activity Most report occasional sexual difficulties (McCarthy & McCarthy, 2003).

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Human Sexuality

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  1. Human Sexuality Sexual Function Difficulties, Dissatisfaction, Enhancement, and Therapy

  2. Sexual Desire and Activity • “ebb and flow”- natural to have highs and lows in sexual desire and activity • Most report occasional sexual difficulties (McCarthy & McCarthy, 2003)

  3. Defining Sexual Function Difficulties • What constitutes a sexual “problem” • Discourses on normality/abnormality • Cultural scripts • DSM-IV

  4. Difficulties and Dissatisfaction • Difficulties: problems/issues with sexual functioning • Inability to participate in sexual relationships as we wish • Dissatisfaction: subjective response to sexual difficulties

  5. Sexual Dysfunctions • Disturbance in sexual desire and in the physiological sexual response • Causes “distress” • “persistent or recurrent”

  6. Female Sexual Dysfunction • Critique: often based on physical criteria • How should we measure female sexual dysfunction? • Less research on female sexual problems • Role of psychological and contextual factors

  7. Female Sexual Dysfunction • Need for greater focus on (Basson, 2003; 2004): • Subjective sexual arousal • Female sexuality as distinctive/different from male sexuality • Role of attachment, personal history, etc.

  8. Female Sexual Dysfunction • Contextual/relational factors • Socio-cultural factors; • Cultural norms and ideals; • Inadequate information about female sexuality

  9. Survey Findings • National Health and Social Life Survey • 1,749 women; 1,410 men • Women: 43% reported sexual difficulties • Men: 31% reported sexual difficulties

  10. Survey Findings • Sexual dysfunction/difficulties are more common in men and women who have been sexually victimized • Both physical and psychosocial factors were implicated

  11. Sexual Desire Disorders • Lack of fantasies and desire for sexual activity • Causes distress and interpersonal difficulty

  12. Sexual Desire Disorders:HSD • Hypoactive sexual desire: lack of sexual desire • Causes more stress in marriages than any other sexual problem (McCarthy & McCarthy, 2003)

  13. Sexual Desire DisordersHSD • Often transitory • May be associated with depression, stress, and interpersonal difficulties • **high sex drive is not a disorder in the DSM**

  14. Sexual Desire DisordersSexual Aversion • Sexual Aversion Disorder: aversion to and avoidance of genital contact • Anxiety, fear, or disgust toward sex • Actions are taken to avoid sexual situations

  15. Sexual Desire Disorder:Sexual Aversion • Sexual Aversion Disorder • panic attacks and physical symptoms • past sexual trauma • negative parental reactions to sexuality • sexual pressure from a partner

  16. Sexual Arousal Disorders • Female Sexual Arousal Disorder: lack of physiological sexual response • Male Erectile Disorder: erectile dysfunction; • associated with sexual/performance anxiety, low excitement, potential medical issues

  17. Sexual Arousal Disorders • The disorder may have physical or psychological roots

  18. Orgasmic Disorders • 2nd most common sexual problem, after low sexual desire • Female Orgasmic Disorder; may be related to negative/guilty attitudes about sex, relationship problems

  19. Orgasmic Disorder • Male Orgasmic Disorder: delay or absence in orgasm; inhibited or delayed ejaculation • Premature ejaculation • Often related to sexual anxiety

  20. Sexual Pain Disorders • Sexual Pain Disorders: Genital pain associated with intercourse; psychological origins • Inadequate sex education, sexual trauma, sexual guilt, relationship problems

  21. Physical Causes of Sexual Dysfunction: Men • Alcoholism, smoking, drug use (Vine, 1994) • Diseases of the heart/circulatory system • Other physical illnesses • A side effect to certain medications

  22. Physical Causes of Sexual Dysfunction: Women • Diseases/chronic illnesses • Stress and fatigue • Hormonal changes

  23. Sexual Dysfunction: Treatment • Accurate information about sexuality • Communication skills • Fostering positive sexual attitudes • “homework”

  24. Treatment • Cognitive therapies: • Looking at sexual attitudes/beliefs • Addressing erroneous/unhealthy sexual attitudes

  25. Treatment • Behavioral components: • Addressing concrete behaviors • “homework”- sexual exploration • Partner exploration • Taking away sexual pressures

  26. Couples therapy • Treating sexual dysfunction as a relationship issue • Taking away blame • “Neutrality and mutuality”

  27. Treatment • Addressing fear/anxiety associated with sexuality • The client’s personal history • Performance anxiety

  28. Sexual Addiction • Not in the DSM-IV • Does sexual addition exist? • What is it? • How is it treated?

  29. Sexual Addiction • Sexual addiction/compulsive sexual behavior • A form of impulse control disorder? (Barth & Kinder, 1987) • Approximately 2 million sexual addicts in the U.S. (Delmonico & Carnes, 1999)

  30. Sexual Addiction • Continuing to participate in sexual behaviors despite negative consequences (Bird, 2006) • Damaging to oneself and others • More likely to engage in risky sexual behaviors • Often report feelings of shame/isolation

  31. Sexual Addiction • The Internet: • New arena for sexual addicts (Griffiths, 2001) • Pushing mild addicts into deeper addictions? • Affordable/anonymity (Cooper, 1998)

  32. Sexual Addiction: Women • Female sexual addicts: • Relationship-oriented online sexual behavior • often leading to real life sexual encounters (Schneider, 2000)

  33. Sexual Addiction: Women • Women report experiencing greater shame than men • Women are less likely to engage in group counseling/12 step programs

  34. Sexual Addiction: Men • More prevalent in men • Gay/bisexual men are slightly more likely to report sexual addiction (Cooper, 2000)

  35. Sexual Addiction • Research suggests sexual addiction often occurs with other psychological disorders • Co-morbidity

  36. Sexual Addiction • Sexual addicts: significantly more likely to experience clinical depression (Weiss, 2004) • Tentative link: sexual addiction and untreated ADHD (Schwartz, 2003)

  37. Sexual Addiction • Link between loneliness and pornography usage (Yoder, 2005)

  38. Sexual Addiction • Sexual addiction and OCD • Individuals with both conditions experience greater fear and avoidance regarding thoughts • Less pleasure related to performing sexual compulsions (Schwartz & Abramowitz, 2003)

  39. Treatment of Sexual Addiction • Couples/family therapy • Medication (SSRIs)

  40. Treatment of Sexual Addiction • Cognitive restructuring • Confrontation • Defining “sexual sobriety” and sexual boundaries • Empathy/grief counseling

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