Sexual Variants, Abuse, and Dysfunctions

1. Sexual Variants, Abuse, and Dysfunctions Psychological problems that make sexual fulfillment especially difficult for some people who develop unusual sexual interests that are difficult to satisfy in a socially acceptable manner.

2. Sociocultural Influences on Sexual Practices and Standards • Degeneracy Theory (1750’s) Simon Tissot • Semen necessary for male physical and sexual vigor • Abstinence Theory (1830’s) Graham and Kellogg • “Secret vice” causes physical symptoms & insanity • Ritualized Homosexuality (E.G. Sambia) • Semen conservation and female pollution • Homosexuality and American Psychology • Sickness. Change in DSM II 1973 (2-6%)

3. Sexual and Gender Variants • Paraphilias- group of persistent sexual behavior patterns in which unusual objects, rituals, or situations are required for full sexual satisfaction. • Characterized by a compulsive quality. • Distinguished by the insistence and relative exclusivity with which sexuality focuses on the acts or objects in question without which orgasm is often impossible. • Relational dissatisfaction with partner who discovers themselves to be an object in the paraphilic’s drama.

4. The Paraphilias I. • Fetishism • Sexual variant in which sexual interest centers on some inanimate object or nonsexual part of the body. • Transvestic Fetishism • Achievement of sexual arousal and satisfaction by dressing as a member of the opposite sex. • Voyeurism • Achievement of sexual arousal through clandestine “peeping”. • Exhibitionism • Intentional exposure of genitals to others without their consent.

5. Paraphilias II. • Sexual Sadism • Achievement of sexual stimulation and gratification by inflicting physical or psychic pain or humiliation on a sexual partner. • Sexual Masochism • Achievement of sexual stimulation and gratification from experiencing pain or degradation in relating to a lover. • Frotteurism • Achievement of sexual stimulation and gratification from rubbing against a non-consenting person.

6. Paraphilias: Causal Factors • Male • Visual Sexual Imagery • Perhaps men are more dependent on physical stimuli more than women. • Current hit on internet pornography sites for females 45% • Erotic Target Location Theory • Application of classical conditioning to sexual preferences • Most have more than one.

7. Paraphilias: Treatment • Aversion Therapy • Electric Shock • Assisted Covert Sensitization • Cognitive-Behavioral Treatment

8. Sexual Abuse • Sexual contact that involves physical aor psychological coercion or at least one individual who cannot reasonably consent to contact. • Childhood Sexual Abuse • Definition (rates 5-30%) • Related to ptsd, personality disorders, dissociative symptoms, aversion to sex, sexual inappropriateness, low self-esteem, etc. • False Memory Syndrome

9. Sexual Abuse II. • Pedophilia • A paraphilia in which an adult’s preferred or exclusive sexual partner is a prepubertal child. • Treatment • Cognitive Restructuring • Social Skills Training • Castration • High recidivism rate 25-50%

10. Human Sexuality • Considered One of the Major Motives of Life

11. Sexual Dysfunctions • Definition- Impairment either in the desire for sexual gratification or in the ability to achieve it. • Four Phases of Human Sexual Response • Desire Excitement • Excitement Plateau • Orgasm Orgasm • Resolution Resolution • Dysfunction can occur at any of the first three phases.

12. Sexual Dysfunction: Prevalence • Altogether 45% of men and 55% of women reported some dysfunction during the last year. • Women • 33% report lack of sexual interest • 24% report inability to experience orgasm • Men • 29% reported climaxing to early • 17% reported sexual anxiety • 16% reported lack of sexual interest

14. Dysfunctions of Sexual Desire • Sexual Desire Disorders • Hypoactive Sexual Desire Disorder • A sexual dysfunction in which a person shows little or no sexual drive or interest. • Sexual Aversive Disorder • A sexual dysfunction in which the person shows extreme aversion to, and avoidance of, all genital sexual contact with a partner

15. Dysfunction of Sexual Arousal • Male Erectile Disorder • A sexual dysfunction in which a man is unable to achieve or maintain an erection sufficient for successful sexual intercourse (impotence). • Female Sexual Arousal Disorder • A sexual dysfunction involving the absence of sexual arousal feelings and unresponsiveness to most or all forms of erotic stimulation.

16. Orgasmic Disorders • Premature Ejaculation • Persistent and recurrent onset of orgasm and ejaculation with minimal sexual stimulation, occurring before, at, or shortly after penetration and before the man wants it to. • Male Orgasmic Disorder • A persistent delay in the ability to ejaculate or an inability to ejaculate during intercourse following a normal sexual excitement phase. • Female Orgasmic Disorder • Persistent or recurrent delay in or absence of orgasm following a normal sexual excitement phase.

17. Dysfunctions Involving Physical Pain • Vaginismus (see next slide) • Involuntary spasm of the muscles at the entrance to the vagina that prevents penetration and sexual intercourse. • Dyspareunia • Painful coitus (typically has an organic cause) • Functional Dyspareunia- psychologically based problem related to aversion to sexual intercourse.

18. Treatment of Sexual Dysfunction:consider Pro and Cons • Medication (viagra) • Erectile and perhaps female sexual arousal. • Sensate Focus • Orgasmic, Vaginismus • Use of Dilators of Increasing Size • Vaginismus • Cognitive-Behavioral (see next slide) • Dyspareunia, vaginismus, erectile, premature