Psychological treatment of sexual dysfunction

Specific treatment recommendations are treatment of sexual dysfunction. Many disorders will respond to pharmacological treatment. However, treatment of a broad range of sexual dysfunction may need more structured psychological treatment. In this form of treatment the couple is seen together whenever possible.

There are three stages:

(i) Improving communication,

(ii) Education

(iii) Graded activities’.

1 Improving communication has two main aims: (i) to help the couple to talk more freely about their problems and (ii) to increase each partner’s understanding of the wishes and feelings of the other. These aims may be appropriate to various kinds of problems. For example, a woman may believe that her partner should know instinctively how to please her during intercourse; she may then interpret his failure to please as lack of affection rather than as the result of her not communicating her wishes to him. Alternatively, the man may wish the woman to take a more active role in intercourse but be unable to say this to her. A further aim of this stage of treatment is to enable the couple to achieve a general relationship that is more affectionate and satisfying.

2 Education focuses on important aspects of the male and female sexual responses; examples are the longer time needed for a woman to reach sexual arousal, and the importance of foreplay, including clitoral stimulation, in bringing about vaginal lubrication. Suitably chosen books on sex education can reinforce the therapist’s advice. Educational counselling is often the most important part to treat erectile dysfunction, and it may need to be repeated when the couple have made some progress with the graded activities described next.

3 Graded activities begin by negotiating with the couple a mutually agreed ban on full sexual intercourse. The couple are encouraged instead to explore the pleasure that each can give the other by tender physical contact. The partners are encouraged to caress each other but not to touch the genitalia at this stage. When they can achieve caressing in a relaxed way that gives enjoyment to each partner, the next stage is genital foreplay without penetration. When genital foreplay can be enjoyed by both partners,the next stage is the resumption of full intercourse in a gradual and relaxed way, in which the partner with the greater problem sets the pace. In this stage a graduated approach starts with ‘vaginal containment’, in which the penis is inserted gradually into the vagina without thrusting movements. When this graded insertion is pleasurable for both partners, movement is introduced, usually by the woman at first. At each stage, each partner is encouraged to find out and provide what the other enjoys. The couple are advised to avoid checking their own state of sexual arousal. Such checking is common among people with sexual disorder, and has the effect of inhibiting the natural progression of sexual arousal to intense orgasm. Each partner should be encouraged to allow feelings and physical responses to develop spontaneously whilst thinking of the other person.

Hormones have no place in the treatment of sexual dysfunction except in cases where there is a primary hormonal disorder. The overall results of sex therapy are that about a third of cases have a successful outcome and another third have worthwhile improvement. Patients with low sex drive generally have a poor outcome.

What is Frigidity?

Frigidity is often described as complete absence of sexual arousal in women. These women cannot get aroused even after long and appropriate touching of the vagina. This is therefore a completely different problem than inability of achieving intense orgasm. Sexology is a relatively new science which explored sexual occurrences and sexual behavior of men and women. Every new discovery in this area is replacing old knowledge or it simply changes it. 

There are many limits that do not allow us to get completely accurate information about sexual problems. This is the reason why many researchers had different opinions about frigidity too. For example, English surgeon Acton thought that the opinion that some women don’t experience sexuality is absurd. On the other hand, Freud thought that a woman is frigid if she is unable to achieve orgasm during normal sexual intercourse. Today, frigidity is described with all the casual factors together. But how can we tell if some women is suffering from frigidity?

Some people believe that only women that don’t feel sexual arousal and don’t achieve orgasms can be called frigid. Other people think that a woman is frigid if she doesn’t feel need for sex but can achieve orgasm. Still others believe the opposite – that a woman is frigid if she does feel need for sex but has never experienced an orgasm. In other words, a strict definition of frigidity is impossible to construct, at least not in only one sentence. It is worth mentioning that some claims about female frigidity have been scientifically disproved a long time ago.

Some factors that lead to frigidity

-          Wet dreams – there are many women who believe they are frigid but they have erotic dreams and they masturbate regularly. This only means that they experience sexuality in dreams and masturbation and that’s how they release their sex drive. They are not frigid.

-          A selfish man – this type of men were used to occasional and casual sex encounters and all of a sudden they realize that their wife is sexually unresponsive. They only rely on their masculinity and think that this is all they need in order to provide pleasure to their women. They are bad husbands and bad lovers because they only think about their own needs. In other words, he just takes and gives nothing in return.

-          Feeling of guilt – Some women practice masturbation regularly but they do this with a feeling of guilt that is buried deep in the sub consciousness. These things create limitations and they cannot relax during sex. They even don’t let the partner touch them in the same way they touch themselves and become unnecessary cold.

-          Fear of unwanted pregnancy – This is one of the main reasons for temporary frigidity. Although the contraceptive methods are improved and they guarantee almost 100% protection some women are still afraid that they might end up pregnant. This feeling of fear is especially present in women that cannot use birth control pills and they consider that other methods are unreliable.