Ep 21 Sexual Challenges and Dysfunction

You guys asked for it!! Here is last week's grad homework assignment! There are a variety of sexual challenges or dysfunctions that any person and couple can face. Erectile dysfunction, vaginismus, low libido, and painful sex are just a couple of the things couples can face. When addressing these issues, they are best approached through a systemic approach which means viewing the dysfunction through a variety of lenses to see what contributing factors there are. For many this can be helpful considering the following statistic. In some cases, as many as 77.5% of female partners whose male partner is experiencing a sexual dysfunction also qualify for a sexual dysfunction, suggesting a high rate of comorbid or co-occurring sexual disorders for relationship partners (Hobbs et al. 2008; Kaya et al. 2015). Having a systemic approach in navigating these issues could be very helpful and assist in resolving possible comorbidities. When using a systemic approach there are a wide variety of perspectives to keep in mind. We can start with the individual to gather information. Additionally, the therapist will work with the client’s psychological system which “is composed of … personality (including personality disorders), psychopathology, intelligence, temperament, developmental stages and deficits, attitudes, values, [and] defense mechanisms” (Hertlein et al. 2015, p. 48). And then move to the wider perspectives which would be dyadic work. An Intersystem Approach, as presented here, allows clinicians to incorporate multiple factors into treatment, including dyadic, individual, societal, cultural, family of origin, and religious. This gives both the clinician and the couple a more systemic and comprehensive understanding of how each person’s individual issues impact the dyadic relationship which impacts the couple’s sexual relationship, satisfaction, and levels of dysfunction. (Davies, B., Gibbons, I., & Hughes, A. 2021) Assume that you have a couple who comes to you for challenges in communication, and, as you continue with them, you learn that one partner has erectile dysfunction and the other partner struggles with painful sexual activity because of medications they are taking. Both partners share they want a more active sex life, and they have both sought medical interventions with no resolution. As a result, they report a lack of sex in their lives and feeling like there is no hope. Knowing that a large part of the struggle appears to be medical, how can you approach therapy with this couple? (Davies, B., Gibbons, I., & Hughes, A. 2021) Some approach’s that are going to be helpful for this couple are going to be Emotion Focused Therapy, Sensate Touch Practice, and a preventative plan for relapse. Some of the issues this couple could also be facing is a history of sexual abuse, previous relationship patterns, and internalized belief systems ab out gender roles in a relationship. If we do not use a systemic approach, we will miss an opportunity to find the other things also affecting the presenting issue. Specifically, Dave and Cindy’s sex life was influenced by unhealthy relationship patterns, individual biological issues and sexual scripts passed down through their history, families and society. Treatment using the Intersystem Approach would need to focus on the dyadic need to increase emotional intimacy and connection. (Davies, B., Gibbons, I., & Hughes, A. 2021) Davies, B., Gibbons, I., & Hughes, A. (2021). Treating comorbid sexual dysfunctions using the intersystem sex therapy approach. Contemporary Family Therapy, 43, 12–19. Hertlein, K. M., Weeks, G. R., & Gambescia, N. (2015). Systemic sex therapy (Vol. 20, No. 2–3). New York: Routledge/Taylor & Francis Group. Hobbs, K., Symonds, T., Abraham, L., May, K., & Morris, M. F. (2008). Sexual dysfunction in partners of men with premature ejaculation. International Journal of Impotence Research, 20(5), 512. https://doi.org/10.1