Penis and Male Sexuality Facts


Sexual Therapy

In comparison to the frequency of failure in sexual functioning and the great amount of distress it causes, the number of specialist sex therapists is incredibly low. The majority of people with such problems still turn to doctors and psychotherapists for help.

These practitioners can be helpful, but they must first grasp a concept that runs counter to their normal practice - the patient in sex therapy is the sexual relationship between the partners, not either individual specifically.

Furthermore, psychiatrists are often trained to consider sexual dysfunction as symptomatic of deep-rooted psychological problems, whereas in our clinic the basic tenet is that most sexual problems are attributable either to ignorance or ambivalent attitudes to sex.

Of course, some sexual problems spring from childhood or adolescent traumas, but the frequency of sexual inadequacy suggests we are basically correct. This is fortunate, because education as a cure is a simpler process than the uprooting of psychological trauma.

The basic idea that it is their relationship that is to be treated is explained to patients at their first interview. There are always two therapists, a man and a woman, and at this interview they explain the procedure to be undertaken in the first four days.

They then go to separate rooms where the female therapist interviews the woman patient and the male the man.

They begin by asking what the problem is and how the couple have tried to deal with it previously, after which they proceed to more general questions, such as what the patient considers normal sexual techniques for lovemaking and techniques which are appropriate to the roles of man and woman in an intimate relationship. Then follows a series of searching questions about the couples' own relationship.

Although they have come voluntarily for therapy and are paying to receive their treatment, patients do not always tell, or even know, the whole truth.

The co-therapists are skilled at detecting when a person is holding back the truth, and after they have listened to the tape recordings of the first interview they hold a second one the next day, at which the female therapist questions the man and the male the woman.

At this session specific areas of the sexual history that the therapists have agreed are particularly interesting or relevant are further explored. Sometimes a patient will find it easier to volunteer information to a therapist of the opposite sex.

The non-demanding schedule of these first two days is intended to create an atmosphere conducive to therapy, one of relaxation, friendliness, and confidence in the therapists. On the third day the patients' medical histories are recorded.

Next is what is known as a "round table discussion", during which the patients and both therapists sit down together and discuss salient points which have arisen so far.

At this point the co-therapists will probably have arrived at a possible explanation of the causes of the couple's problem, and this is now presented to them and talked over.

We effectively hold up a mirror for them and feedback verbally what they have just told us - very often they look at their partner as though they didn't know each other and are just really seeing each other for the first time. This new awareness and insight is the beginning of the therapy.

The therapists hope by the end of this discussion session to have accomplished the major task of reopening communication between the patients.

Two points are made to virtually every couple at this stage. The first is that a sexually dysfunctional partner must get out of the habit of taking a "spectator role" in sexual activity, i.e., observing his or her responses.

Most people with sexual dysfunctions - including premature ejaculation or delayed ejaculation - do this out of anxiety, and it only increases the problem.

The second point is that sex must not be goal-oriented, that neither partner should feel under pressure to "produce, perform, and achieve." Whereas much therapy has been directed at teaching people to do something, the real point is that they don't have to do anything.

This point is applied in the first directed physical encounter between the couple. They choose two periods in the day when, in the privacy of their room, they undress and spend time simply caressing each other, taking turns massaging and fondling each other so as to give pleasure purely through the sensation of touch.

Intercourse, in any sex position, is not permitted at this stage of therapy.

They are specifically instructed not to touch either's genitals or the woman's breasts during these first "sensate focus" sessions, for the purpose is to encourage sensory awareness in an atmosphere of relaxation in which there is no pressure to proceed to intercourse.

Day four begins with a discussion of the partners' responses and feelings evoked by the sensate focus sessions of the previous day.

Two further sessions are then held during which touching of the genitals and breasts is permitted, provided that it is done in a manner that does not demand a sexual response.

Having thus learned to be relaxed together and to give and receive sensuous pleasure without sex, the two are now prepared for therapy to treat their specific problem. For information on sensate focus, see here.

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