Modern sex therapy is a behavioral therapy-oriented procedure with psychotherapeutic elements that is used to treat sexual dysfunction. The goal of the procedure is to invalidate misconceptions, fears and so-called sex myths. This form of therapy is always preceded by sexual counseling, which is sufficient to clarify the problem and possibly already to find solution strategies. In the conversation, misconceptions and conflicts can be worked through by competent counseling, both before and during sex therapy.
Indications (areas of application)
- Ejaculatio praecox – premature ejaculation due to lack of control.
- Increased sexual desire (“sex addiction”)
- Lack or loss of sexual desire
- Lack of sexual satisfaction
- Non-organic vaginismus – involuntary reflexive spasms (spasms) of the vaginal muscles.
- Non-organic dyspareunia – psychogenic disorder with sexually induced pain.
- Orgasmic disorders – absent or delayed orgasm.
- Sexual aversion – sexual phobia, disgust and fear of sexual intercourse.
- Failure of genital functions – e.g. erectile dysfunction (ED; erectile dysfunction).
- Other or unspecified sexual dysfunction.
The procedure
For a long time, sex therapy was exclusively psychotherapeutic and was not very successful. It was not until 1970 that Master and Johnson succeeded in creating a fundamental basis for behavioral sex therapy with their concept. Today’s forms of therapy differ mostly only by additions. The central tasks of sex therapy are:
- Education about sexual development and information about the physical and psychological factors that determine the establishment of a satisfying sexual relationship.
- Reduction of misconceptions and sexual inhibitions or fears.
- Uncovering the interactions between sexual partners that lead to disorders.
The setting of therapy is couples therapy, since Master and Johnson assumed that a sexual problem develops in a partnership. However, individual therapy and group therapy are also possible. The concept consists of systematically structured exercises or homework, which are carried out by the patients in their familiar environment. These symptom-oriented behavioral instructions are used to learn new behaviors, which are then worked through in psychotherapeutic conversation. Here, experiences with resistance or success as well as solution strategies are discussed. The purpose of the homework is to break the self-reinforcement circle: triggered by a sexual trauma or failure, fears of failure and expectations arise, which lead to avoidance behavior and reinforce the problem or even cause a renewed failure. Behavioral exercises proceed in a stepwise manner:
- Alternate stroking and kissing without touching the erogenous zones.
- Alternating stroking and kissing with touching the erogenous zones
- Playing with the arousal
- Insertion of the penis, coitus
Clear boundaries and a protected setting of the exercises reduce the pressure of expectations and relieve the patient. Another well-known technique is the paradoxical intervention. Already at the beginning of therapy, couples are prohibited from sexual intercourse, thereby reducing the fear of it, this eventually leads to the breaking of the ban. Other topics of sex therapy include physiological and medical processes of the sexual response cycle, pointing out misconceptions about the penis and vagina, sexuality in old age, and myths about the female orgasm or phallus. The introduction of Viagra or sildenafil, etc., has led to an increasing medicalization of sexual dysfunction. While these drugs are effective for organic and psychological dysfunctions, the underlying psychological problem is usually neglected.
Benefits
Sex therapy is a useful and necessary treatment for sexual dysfunction. Therapy can help eliminate fears of failure and resolve partner conflicts.
