SEX THERAPIES

There are various approaches to the therapy of common sexual dysfunctions, covering behavioural therapy, psychoanalysis and hypnosis, couple therapy of the type described by Masters and Johnsons, other forms of shortterm therapy based on psychotherapy, and various methods of group therapy.

The range of therapeutic approaches is very wide. Some of the main features and advantages of the different methods are highlighted below.

(a) Somatic therapy:

- even though few sexual dysfunctions are of organic origin, it is essential for Doctor to begin with a physical and, if appropriate,an endocrinological examination;

- physical, pharmacological( HOMEOPATHY IS MOST EFFECTIVE IN MANY SUCH CASES ), and/or surgical therapies have been estabished for coital and erotic disabilities secondary
to another dysfunction, as in hormonal deficiency during development; geriatric hormonal insufficiency;

hermaphroditism, vaginal atresia, and other birth defects of the sex organs; traumatic injury or disease of the sexorgans; genital tract infection; depression and other psychiatric disorders;

accidental and iatrogenic toxic effects; and
disability secondary to metabolic, autoimmune, and other systemic diseases;

- in general, in cases of sexual dysfunction such as dyspareunia and impotence, there is a tendency towards excessiveuse of hormonal therapy, which should be used only in well-defined instances.

(b) Behavioural therapy - the modern approach is characterized by:

- careful and precise definition of the ultimate goal of treatment;

- insistence on the changing of attitudes rather than immediate change of behaviour, since it is possible for certain
combinations of attitudes to block the whole process of sexual functioning;

- flexible and rational orientation to meet the needs of the individual patient.

(c) Psychoanalysis can be useful with regard to:

- determination of the significance of symptoms in the context of the total personality;

- the quality of sexual functioning;

- the importance of fantasy and imagination in sexuality.

(d) Hypnosis, althrough its nature is not fully understood, can be useful in the process of desensitization and in inducing
relaxation, for example:

- hypnotic visualization of the sexual act;

- sensory utilization of hypnosis to induce positive sensations such as a feeling of heat at the base of the abdomen to
induce easier achievement of sexual pleasure.

(e) Couple therapy based on the Masters and Johnsons model has sugested the following advantages:

- focus on the couple and on the pathological aspects of their relationship;

- therapy practised by the couple during an intensive and continous period of two weeks;

- insistence on the expression of feelings - the goal of sexual therapy is not only the relief of symptoms butenhancement of the sexual experience through richer fantasy and sensitivity and more positive attitudes towardsexuality.

(f) Group psychotherapy offers some advantages in permitting an exchange of experiences and the establishment of animproved environment where sexual attitudes can be reformed.

(g) Other short therapies. Other approaches using very different and original methods have been suggested, These include, on the one hand, psychotherapy with a psychodynamic orientation emphasizing the verbalization of emotions, and on the other hand a number of methods aimed at increasing "body awareness" (sensory relaxation, massage, vibrators, etc.).