Sex therapy is based on behavior therapy. It is a type of re-educative therapy. The fundamental of behavior therapy is that all the behaviors are learned, even the maladaptive behaviors. The behavior therapist helps the client to unlearn the unadaptive behavior and replaces it with newly learned adaptive behavior. The aims of behavior therapy are primarily educational and techniques facilitate improved self control.

From amongst several techniques that are used in behavior therapy, ‘systematic desensitization technique’ is used in sex therapy. Prior to 1970, sexual dysfunctions were managed by psychiatrists. After  1970, the masters and Johnson model of sex therapy made it possible to treat sexual dysfunction by psychologists, social workers, nurses, counsellors, and medical doctors.

Their approach included :

Instead of treating the affected individual, the couple is treated. It is the relationship that is affected. This strategy provides an opportunity to gain  the co-operation and understanding of both the partners in overcoming the problem.

Two therapist-a man and a woman work together as a team. This gives each partner a same sex therapist to whom he or she can relate more easily.

Masters and Jonson recognized that it was important to identify organic conditions that might require medical or surgical treatment instead of sex therapy.

They also found that explanining the anatomy and physiology of sexual response to the clients often had important therapeutic benefits.

To individualize the therapy so as to meet the specific needs of each couple.

The therapist must avoid imposing his own values on the client.

The fear of performance and ‘spectatoring’ are often central to the cases of sexual dysfunction. The pressure of performance is removed initially by banning sexual contact. Couples are then helped to rediscover the sensual pleasures of touching and being touched without the goal of particular sexual response (Sensate Focus Exercise).

Blaming each other for the sexual problem is discouraged.

When a couple’s relationship improves outside the bedroom, it is apt to have positive results in the bedroom too.

Basis : Sexual response is the function of Autonomic nervous system and is a physiological change when effective sexual stimuli are present , and a person is psychologically prepared to respond to them. All the sense organs are to be used to create a situation conducive to sexual response . (touch is most important).

Systematic Desensitization : A mode of psychotherapy where all the anxiety provoking stimuli are arranged in an ascending level, and the client is exposed to, one by one, both the partners are to be involved

Relaxation: Deep breathing, deep muscle relaxation and plesant imagery are incorporated.

Reassurance.

Stages :

  • Sensate focus
  • Woman superior position
  • Lateral position
  • Men superior position

Format: No rigid format Variations in time, frequency and structure depending upon the dysfunction, the patient and the therapist.

Results: Not as definite as in pharmacotherapy.

As you shall sow and water, so you shall reap: A skilled and knowledgeable therapist is like a good seed. Client’s receptive mind is like fertile soil. Compliance and co-operation by wife is like watering by gardner. When all the three factors combine, the results are good. 

When sex therapy works, it does wonders and results are unparalleled for that particular couple.

Contraindications:

  • Severe Depression
  • Active psychopathology
  • Substance abuse
  • IIIness
  • Hostility in couple-interaction