Sex therapy

Sex therapy refers to a type of psychotherapy that addresses a person's sexual problems. This kind of therapy focuses on how mental health relates to the physical act of sex. Sex therapists usually focus on concerns about sexual function and sexual intimacy. Patients can receive individual therapy or participate in joint therapy with their sexual partner. The goal of sex therapy is to help a patient engage or reengage in an active and healthy sex life. Sex therapy is available for people of all ages and sexual orientations. Many therapists also work with older patients who are coming to terms with their decreasing sexual drive and abilities.

Background: Ancient methods

Sex therapy has existed in various forms throughout history. The ancient Indians, Chinese, Greeks, and Romans all had sex manuals. India's ancient Hindu texts known as the Kama Sutra and the Vedas encouraged healthy doses of sexual activity in a person's life and believed that sex was part of spiritual fulfillment. The Hindus also incorporated tantric yoga into their sexual activities, believing in careful sexual preparation that involved prayers and meditation. These arrangements were developed to promote the ultimate physical, emotional, and spiritual sexual experience. Ancient peoples viewed celibacy and abstinence, voluntarily acts of denying oneself sexual intercourse, with great suspicion.

Christianization of Sexual Behavior

Western views of sexuality differed from those in the East. Christian doctrine promoted suppression of sexual desire to achieve a "perfect" state of human consciousness. Historians document the gradual yet severe division of sex and spirituality in the West as beginning in the eighteenth and nineteenth centuries. Religion played an important role in this separation, and nineteenth-century Western culture increasingly regarded sex as an act solely meant for reproduction. Attitudes also shifted to focus on male pleasure. It became a woman's duty to please her husband, ignoring her own pleasure. Since female pleasure did not matter, sexual dysfunction such as the inability to orgasm or premature ejaculation was never an issue.

Scientific Inquiry

By the twentieth century, attitudes about sex became more scientific. Sigmund Freud, an Austrian neurologist who founded the practice of psychoanalysis, developed a number of theories about how people related to sex. His new method of psychoanalysis involved using talk therapy to freely discuss how conscious actions related to unconscious thought. By mining a person's thought and memories, Freud believed he could identify the reason for a patient's sexual symptoms.

Other psychologists questioned the traditional nature of human sexuality. The research of sexologists Alfred Kinsey and Henry Havelock Ellis helped give a voice to repressed female sexuality and challenged dated claims about sex's association with mental illness. Kinsey highlighted the commonness of then-taboo sexual activities such as homosexuality and premarital sex. He also found a high incidence of sexual dysfunction in males. His findings led him to conclude that sexual behavior was so wide-ranging and subjective that sexual normalcy simply could not exist.

Dawn of Modern Sex Therapy

Despite such research, sex therapists primarily focused on controlling sexual behavior that was considered deviant through the 1950s. Behaviors such as masturbation and homosexuality were discouraged. Homosexuality was treated as a mental disorder for many years.

Two human sex researchers from Washington University in St. Louis, Missouri, revolutionized the field of sex therapy in the late 1950s. William Masters and Virginia Johnson formed the Masters and Johnson research team in 1957 and conducted hundreds of studies related to human sexual behavior through the 1990s. Their 1970 book Human Sexual Inadequacy became a critical text in the development of further sex therapy techniques, emphasizing the important relationship between measurable physical responses to erotic stimulation and sex therapy methods. Masters and Johnson pioneered the practice of couple's therapy and encouraged equal attention to both partner's pleasure during sexual intercourse.

Masters and Johnson's research overlapped with the sexual revolution of the 1960s and 1970s, a movement that further evolved sex therapy methods. As the decades progressed, sexual behavior became more liberated and less bound by religious morals. Sexual pleasure became an important component of a healthy life. Further research revealed that sexual dysfunction could be treated on more than just a physical level. Sex therapist Helen Singer Kaplan introduced a variety of psychodynamic techniques into sex therapy such as counselling and behavioral exercises. Kaplan also prescribed medications to her patients, including antidepressants and antianxiety medications, to help them overcome sexual phobias. Medications were later developed to aid the sexual function of males, including Viagra. The works of Masters, Johnson, and Kaplan continued to influence sex therapy treatment techniques through the twenty-first century.

Overview

Sex therapy focuses on a number of sex-related problems. Emotional problems covered in sex therapy include sexual identity concerns, intimacy issues, post-traumatic stress due to a sexual experience, and psychiatric disorders related to arousal and orgasm. Physical problems often involve failed sexual performance such as erectile dysfunction and premature ejaculation. Other physical issues include painful sexual intercourse.

Psychologists, social workers, physicians, and licensed sex therapists usually provide sex therapy. Qualified sex therapists receive accreditation from the American Association of Sexuality Educators, Counselors and Therapists (AASECT). Sex therapy does not involve the act itself. Sex therapists discuss patients' sexual issues with them and create treatment plans to help them overcome their problems. Therapists often encourage patients to include their partners in therapy. Treatment is dependent on the source of sexual dysfunction. Some treatment plans require medication, while others focus mostly on therapy. Therapists focus on helping patients achieve their desired level of comfort during intimate activities. Through therapy, patients experiencing sexual problems can better understand their own needs and those of their partners, leading to balanced and fulfilling sexual experiences. In the case of older adults experiencing a decrease in sex drive and function, sex therapists can help individuals or couples address this decline in sexual satisfaction.

Bibliography

Garrett, Mario D. "Sex, Romance, and Relationships of Older Adults." Psychology Today, 10 May 2013, www.psychologytoday.com/blog/iage/201305/sex-romance-and-relationships-older-adults. Accessed 12 Feb. 2016.

Goodwach, Raie. "Sex Therapy: Historical Evolution, Current Practice. Part I." Australian and New Zealand Journal of Family Therapy, vol. 26, no. 3, 2005, pp. 155–64.

Leiblum, Sandra R. "Sex Therapy Today: Current Issues and Future Perspectives." Principles and Practice of Sex Therapy, Fourth Edition. Guilford Press, 2007, pp. 3–22.

"Sex Therapy: Overview." Mayo Clinic, www.mayoclinic.org/tests-procedures/sex-therapy/home/ovc-20170347. Accessed 12 Feb. 2016.

Walker, Lauren M., and John W. Robinson. "Back to the Basics: Origins of Sex Therapy, Sexual Disorder and Therapeutic Techniques." Reproductive System & Sexual Disorders, vol. 1, no. 2, 2012.