Human Sexuality

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 DisordersHSD

• 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 DisorderSexual 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 clients 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