Chapter 17 Sexual Disorders & Sex Therapy.pdf
Chapter 17 Sexual Disorders & Sex Therapy.pdf PSY370
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This 6 page Class Notes was uploaded by Holly Houser on Tuesday April 21, 2015. The Class Notes belongs to PSY370 at University of Miami taught by Franklin Foote in Spring2015. Since its upload, it has received 162 views. For similar materials see Human Sexual Behavior in Psychlogy at University of Miami.
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Date Created: 04/21/15
Chapter 17 Sexual Disorders amp Sex Therapy Exam 3 Sexual Disorders All classified as o Lifelong vs Acquired I Lifelong they ve never had an orgasm I Acquired They ve had orgasms in the past but it s been difficult o Generalized vs Specific I Generalized they never have orgasms I Specific they do when masturbating but not when having coitus o Mild vs Moderate vs Severe I Mild most of the time they don t but every once in a while they do I Severe never have one amp the degree of distress When making diagnosis must assess and consider 0 Partner factors eg herhis sexual functioning health 0 Relationship factors eg communication discrepancies in desire 0 Individual Vulnerability factors eg poor body image history of abuse 0 Cultural Religious factors eg prohibitions attitudes towards sexuality 0 Relevant Medical factors eg diabetes high blood pressure nerve damage Kinds of Sexual Disorders Desire Disorders 0 Hypoactive sexual desire I Greatly reduced or no desire to have sex I If they suddenly have a very low sexual desire they have acquired it I If they never had sexual desire they ve had it lifelong o Discrepancy of sexual desire I if you re in a relationship you re never going to have the same degree of sexual desire o Aversion I Beyond not wanting sex one is feeling disgusted or afraid of sex I Sex phobia o Hypersexual I someone who has recurrent intense sexual fantasies urges or behavior that is excessive amp consumes a great deal of their time in the act of doing it or thinking about it amp they are having a dysphoric mood unhappy anxious angry sad has tried to control it but is unable to Arousal Disorders 0 Female subjective arousal disorder I Has normal sexual desire engaging in sex play she s lubricating high blood pressure but she says she doesn t feel sexually aroused I Body shows signs of physical arousal but she s not experiencing it I Most women have some degree of this 0 Female genital Arousal disorder I Reverse she feels sexually aroused in her mind but her body isn t reacting 0 Female combined arousal disorder I She wants to have sex but she s not getting physically or psychologically aroused I More common ofthe three 0 Erectile disorder I Men who want to have sex engaging in sex play but they don t get an erection or they can t maintain one to have coitus o Priapism I Man has an erection amp the erection doesn t go away amp lasts 4 or more hours I Can lead to infections amp death because the blood is trapped 0 Persistent genital arousal disorder I As far as we know only women get it pretty rare I A woman goes about her daily life amp all of a sudden gets really aroused I Lasts hours to days I Stay aroused after orgasm Combined Disorders 0 Female Sexual InterestArousal disorder Orgasmic Disorder 0 Male Orgasmic Delayed Ejaculation Disorder sexually aroused man doing sexually things amp can t have an orgasm I inhibited ejaculation does not have an orgasm no matter what I retarded ejaculation you have to really work at it amp it takes a long time How long is too long It s subjective He does eventually have an orgasm I retrograde ejaculation Not really a sexually disorder Man has an orgasm but doesn t ejaculate out of his penis He ejaculates into his bladder instead of his penis Almost always due to some medical side effect of surgery or infection Totally okay unless you re trying to get someone pregnant 0 Female Orgasmic Disorder I Women who we d be expecting to have an orgasm but she doesn t I Majority of women don t have an orgasm through coitus alone 0 Premature Early Ejaculation I hard to diagnose because what do we mean by early Pain Disorders 0 Dyspareunia I Used to be called this pain associated with coitus during or immediately after I More common in women than men but did occur in men 0 Vaginismus I vagina involuntarily shutting tightly amp the woman is unable to relax the muscle 0 GenitoPelvic Pain Penetration disorder I Only applies to women the combination of the two above 0 Anal Spasms I same thing that happens during vaginismus but with the anus Causes of Sexual Disorders Sociocultural sex is seen as sinful Medical high blood pressure diabetes most medical problems Psychological depression anxiety Lifestyle not getting enough sleep unhealthy diet Sexual disorders can also affect these things it s a back and forth Having one sexual problem can cause another sexual problem What Causes Sexual Disorder Medical causes 0 General ill health and many specific diseases especially those affecting I Circulatory system I Endocrine system Have to have the right hormones endocrine I Nervous system Have to have the right nerve signals I Reproductive system 0 Infections 0 Injuries I Infections amp injuries are stressful to the body amp resources go to treat those I Spinal cord injuries can affect the nerves that go to the genital area 0 Surgeries Medications What Causes Sexual Disorders 0 Psychological Causes 0 General emotional problems eg low selfesteem anger anxiety depression etc Prior Learning via experience or modeling Sex specific negative emotions I Prior learning you have an impression in your mind I performance anxiety concerned you won t perform well sexually I fear of pregnancySTDs I fear of pain I fear of intimacy I fear of discovery afraid someone will walk in on you or find out I denial of pleasure I intolerance of pleasure 0 Cognitive Interference I poor body image I failure to perceive arousal I misinterprets arousal I Spectatoring Therapies for Sexual Disorders General Techniques 1 Give Accurate Information Self Awareness 0 Body exploration I Their own body amp their partner s body I Get them comfortable with their own bodies Sensate Focus a series of exercises that gradually allows a couple greater physical intimacy thus teaching them to relax and enjoy the process of sex rather feeling pressure to perform 0 Non genital exploration limited touch I Touches receiver from the top of the head to the feet everywhere except for the genitals amp breasts Point is exploration for the toucher No goal just touch see if you can learn anything new about the person s body 0 Genital exploration I Same thing but include the breast amp genitals I Still exploring I Begin with limited touch like 2 fingers I Can use a more variety of touch 0 Non genital pleasuring I Same thing we did before but trying to give receiver pleasure without touching genitals I Not to get sexually aroused I Receiver s more active 0 Genital pleasuring I Don t need to just use their hand I Can use all parts of their body 0 Simultaneous pleasuring I Doing the same thing but they re both touching each other at the same time What about sexual surrogates o someone trained in how to do this to be a partner for someone who has a sexual disorder but no partner or their partner isn t willing to participate in the therapy Very effective Typically don t have coitus Not many sexual surrogates anymore Reasons herpes amp HIV prosecutors saw this as prostitution OOOO Therapies for Sexual Disorders General Techniques 2 Cognitive Therapy 0 alter maladaptive thoughts and scripts 0 address nonsexual psychological disorders Couple Counseling 0 communication amp con ict resolution 0 increase relationship positive behaviors Kegel Exercises Guided Masturbation 0 Especially for men who have pre mature ejaculation or erectile dysfunction Womanontopmanonbottom coitus 0 Advantages empowers the woman woman can maximize possibility of getting clitoral stimulation man can be more relaxed Treatment for Hypoactive Desire Hypoactive desire 0 Very common amp complicated 0 Number of things that cause it is high amp every couple will be different Psychosexual therapy may include some combination of 0 Information 0 Guided masturbation o Sensate focus o CognitiveBehavioral Therapy 0 Couple therapy esp communication expanding affection 0 Lifestyle Coaching making relationship priority Medical 0 Lack Testosterone most common in post menopausal women 0 Wellbutrin buproprion I anti depressant only one that doesn t interfere with sexual functioning in a minority of cases it improves sexual functioning o DHEA I precursor of testosterone o Flibanserin I created anti depressant but increases libido as well not available in US not clear it works the way they say it works German company Therapy for Erectile Disorder If psychogenesis due to some form of anxiety 0 Almost always from some sort of anxiety 0 Sensate focus 0 Give man pleasure o Womanontopmanonbottom coitus 0 Mutual pleasure coitus Medical treatments 0 Pills Viagra sildenafil Levitra vardenafil Cialis tadalafil 0 Herbal Remedies I Korean Red Ginseng Yohimbine Yohimbine does not work at all Korean Red Ginseng works almost as well as the pills o Injections pellets I minor to 0 pain also if they re old they might miss 0 Mechanical Pumps I almost 100 effective I Gives man erection 0 Surgical Implants I may not be able to have an orgasm
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