Sexual dysfunctions are dyadic phenomena

This Essay will discuss and explain sexual dysfunctions as dyadic phenomena by taking into account and comparing the first and the second-generation therapists’ approach. Attitudes towards sex and sexuality significantly changed through history. Cultural and medical foundations constantly tried to “prescribe” the “right ways” to experience one’s sexuality (Ellison, C.R., in Kaschak & Tiefer, 2001). Almost until the end of the twentieth century, one of the right ways was the notion of promoting and manufacturing orgasm. Orgasm became absolute must and had to occur during intercourse. The notion of multiple orgasms started in 1966 and from there the pressure began. People became preoccupied whether or not would perform well.

Masters and Johnson (1970) developed the conceptualisation and language of sex therapy. Sexual intercourse was classified as normal, while difficulties to function through the sexual response cycle were defined as dysfunctions. Sexual dysfunction is any variation away from four normal stages, i.e. excitement, plateau, orgasm and resolution. During the 1970s and 1980s sex therapy was oriented towards dysfunctions and sexual performance, but neglected intimacy. Masters and Johnson created the norms of sexual behaviour and experience, therefore put pressure on those who did not “fit” into those norms.

The aim of the therapy was to achieve orgasm or to stop premature ejaculation by implying different techniques. The focus was on physical behaviour trying to eliminate the symptoms of sexual dysfunction, failing to look at psychological performance. For example, the first stage of sexual response cycle, i.e. excitement meant to be physical, not psychological excitement. In like matter, Kaplan, H.S. (1974) concentrated on reversing the symptoms, but with unmanageability of symptoms, she turned her focus towards “psychodynamic path” (Kleinplatz, P.J. in Kaschak & Tiefer, 2001, p 8). She was the first one who addressed the problem of low sexual desire focussing “upon intrapsychic factors, emphasising on sexual behaviour and attitudes”, but her model of sexual dysfunction overlooked the issues of intimacy (cited in Talmadge & Talmadge, 1986, p 4).

Furthermore, Masters and Johnson with their model brought forward performance anxiety. Manuals which taught people how to master their sexual skills, created a test of sufficiency and consequently a fear of inadequacy. Master’s and Johnson “new approach” to sexual problems looked at sexual behaviour, in order to work out the person’s cognition. They introduced the “sensate focus” technique, i.e. various behaviour exercises, in order to “fix” sexual pleasure without anxiety. “Sensate focus” a trade mark of sex therapy focused on the symptoms, making people to bring sensations into focus. The individualistic approach of the first generation sex therapists, positions the individual as a cause of the problem in the relationship, ignoring the fact that problem occurs within the relationship.

The second generation of therapists took a different, away from individualistic approach, looking at the relationship itself, and dysfunction as dyadic phenomena. A problem was not anymore something that belongs to a client, but something that belongs to a couple. According to Schnarch, D. (2000) what is important is to “resolve the need for personal differentiation or self validation” (Schnarch, D. in Leiblum & Rosen, 2000, p 17). People have a tendency to validate themselves emotionally through the reactions of their partners. Schnarch argues that sexual desire problems occur when there is a lack or no differentiation in the relationship.

His systematic approach emphasises sexual desire problems as not a symptom of a problem that arises elsewhere in the relationship, but as the process of a relationship (Schnarch, D., 2000). He sees desire problem as a message that something is wrong with interpersonal communication, rather than recognising it as a result of communication hardship. In order to overpower sexual desires Schnarch points at the interpersonal feature of the problem. He argues that “high desire” and “low desire” are the positions in a relationship which relate to a relationship system as a whole and reflect some other unresolved issues in the system.

He emphasases that “desire out of emptiness” i.e., the first generation view of sexual desire, does not provide relationship stability. People who desire their partners out of neediness, loneliness and desperation for contact would not maintain long-term desire in their relationships (Schnarch, D., 2000). Wanting somebody makes someone feels vulnerable, insecurity and longing for your partner to make you feel fulfilled, brings heartaches and disappointments. On the contrary, personal maturity and “desire out of fullness” promotes mutual relationships and deep sexual desire (Schnarch, D., 2000).

According to Schnarch sexual desire is a systematic process and “high and low sexual desire are position in a system” (Schnarch, D. in Leiblum & Rosen, 2000, p 23). High or low sexual desire are not a characteristic of an …

Fusion: contrary to the previous stage, this stage does not require the interaction of individual boundaries, but concentrates on fusion of the same. The partners experience comfort in their relationship and they identify themselves through their relationship. Mutuality is their …

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