Psychological Approach to Dysfunctions

Psychoeducation and correction of sexual myths.

A large part of sexological treatment is educational. Many problems arise from ignorance or erroneous beliefs ("myths") about how sex "should" work.

For example, the belief that the man should always take the initiative or that sex should work perfectly like an automatic machine.

The therapist provides truthful information about anatomy, response times, and statistical normality.

Explaining that it is normal for women to require more arousal time than men, or that erections can fluctuate during the act, helps to reduce the pathologizing of normal processes.

Correcting these unrealistic expectations relieves pressure on the partner and sets realistic goals.

Reducing performance anxiety and guilt

The central goal of psychological intervention is to break the vicious cycle of anxiety. The preoccupation with "performing" blocks the natural sexual response.

The patient is taught to change the focus of attention: stop monitoring his erection or lubrication (spectator role) and focus on the pleasurable sensations of the moment (sensory focus).

Guilt is also worked on, especially when one member feels that it is "defective" and is depriving the other of pleasure.

The situation is reframed so that they stop seeing themselves as guilty and see themselves as responsible for their own pleasure and learning.

Cultivating the "erotic key" involves helping them to reconnect with what excites them mentally, reducing the distress associated with the sexual encounter.

Encouraging assertive sexual communication.

"Sexual telepathy" does not exist; assuming that a partner knows what we like is a recipe for failure.

Therapy encourages open and specific communication about sexual preferences. The partner is encouraged to guide the other: "I like it better this way," "softer," "not there."

This not only improves technique, but enhances intimacy. Improving sexual self-esteem is part of this process.

When a person feels comfortable expressing desires and setting limits without fear of rejection, anxiety decreases.

Effective sexual communication transforms sex from a stressful guessing test to a collaborative and pl