LECTURE ON MASTERS AND JOHNSON:
TREATMENT OF SEXUAL DYSFUNCTIONS & RESEARCH DISCOVERIES
SEXUAL DYSFUNCTIONS
DESIRE STAGE
HYPOACTIVE SEXUAL DESIRE
SEXUAL AVERSION
CAUSES:
PSYCHOLOGICAL OR SOCIOCULTURAL
ANXIETY
ANGER
SITUATIONAL STRESSORS
UNHAPPY RELATIONSHIP
PARTNER NOT INTERESTED
FEAR OF ... PREGNANCY, LOSS OF CONTROL
RELIGIOUS BELIEFS
CULTURAL BELIEFS (AGE, PURITY, MOTHERHOOD)
DEPRESSION
OBSESSIVE-COMPULSIVE DISORDER
HISTORY OF SEXUAL ABUSE/ASSAULT
BIOLOGICAL
HORMONE LEVEL
MEDICATIONS/ILLEGAL DRUGS
ILLNESS OR PAIN
EXCITEMENT/AROUSAL STAGE
FEMALE SEXUAL AROUSAL DISORDER
(LINK WITH FEMALE ORGASMIC DISORDER)
MALE ERECTILE DISORDER
BIOLOGICAL
VASCULAR ABNORMALITIES (MOST COMMON)
(DIABETES, MULTIPLE SCLEROSIS,
SPINAL CORD INJURIES)
HORMONES
PSYCHOLOGICAL
SAME AS HYPOACTIVE SEXUAL DESIRE
PERFORMANCE ANXIETY
VICIOUS CIRCLE
ORGASM STAGE
PREMATURE EJACULATION
INEXPERIENCE
ANXIETY
MALE ORGASMIC DISORDER
PERFORMANCE ANXIETY
LOW TESTOSTERONE
NERVE DAMAGE
FEMALE ORGASMIC DISORDER
NEGATIVE CULTURAL ATTITUDES?
DEPTH AND PLEASURE OF RELATIONSHIP?
TREATMENT OF SEXUAL DYSFUNCTIONS
BEFORE MASTERS AND JOHNSON:
FREUDIAN APPROACH
PSYCHOSEXUAL PROBLEMS FROM CHILDHOOD
LONG-TERM PSYCHOANALYSIS
"INDIRECT TREATMENT"
MASTERS AND JOHNSON: LATE 1960'S
"DIRECT TREATMENT" OF DYSFUNCTIONS
SIMILARITY TO BEHAVIORAL APPROACH
1.
DEFINE PROBLEM BEHAVIOR
2.
WHAT CURRENT FACTORS
MAY BE CONTRIBUTING TO PROBLEM?
3.
HOW CAN THEY BE CHANGED?
EARLY FORM OF TREATMENT
(1960'S & 1970'S)
--
FLY TO ST. LOUIS FOR 1-2 WEEKS
--
LIVE IN HOTEL NEAR HOSPITAL
--
MALE AND FEMALE THERAPIST
--
DAYS 1 AND 2
PHYSIOLOGICAL ASSESSMENT
ASSESSMENT OF ATTITUDES
TOWARD SEX
--
END OF DAY 3
HOMEWORK
SENSATE FOCUS
THE ONE WHO "GIVES" AND THE ONE WHO "GETS"
--
SENSATE FOCUS
NO STIMULATION
OF BREASTS/GENITALS
EXPERIENCING PLEASURE
COMMUNICATION
CONTROL
RELAXATION / SLOW PACE
NOTE RELATIONSHIP TO FACTORS
AFFECTING ANXIETY
-- DAY 5 OR 6
GENITAL AND BREAST STIMULATION ALLOWED
DIVERGENCE OF TREATMENT DEPENDING ON PROBLEM
EXAMPLE: INHIBITED FEMALE ORGASM
(DAY 5 OR 6 ONWARDS)
A.
GENITAL STIMULATION OF FEMALE
B.
FEEDBACK
C.
WOMAN FOCUSES ON WHAT GIVES HER PLEASURE
D.
INTERCOURSE
WOMAN ON TOP OF MAN
EMPHASIS ON SENSATIONS
WOMAN MOVES ONLY IF FEELS GOOD
MAN MOVES ONLY IF IT FEELS GOOD TO HER
EMPHASIS ON GRATIFICATION OF HER DESIRES
MORE ABOUT MASTERS AND JOHNSON'S APPROACH
--
EMPIRICALLY VALIDATED
--
"PARADOXICAL INSTRUCTION"
--
SINGLE THERAPIST O.K.
--
ONE SESSION PER WEEK O.K.
--
HELEN SINGER KAPLAN
--
"SEXUAL SURROGATES"
MASTERS AND JOHNSON: RESEARCH DISCOVERIES
1.
THE CLITORIS IS VERY IMPORTANT
TO SEXUAL STIMULATION IN FEMALES
2.
"CLITORAL" ORGASMS
ARE PHYSIOLOGICALLY INDISTINGUISHABLE
FROM "VAGINAL" ORGASMS
-- CORROBORATION FROM
ANATOMICAL RESEARCH
-- RELEVANCE TO FREUDIAN THEORY
3.
SIMULTANEOUS ORGASMS ARE PROBABLY FAIRLY RARE.
TOO MUCH EFFORT TO ACHIEVE THEM
MAY DETRACT FROM SEXUAL PLEASURE.
4.
WOMEN'S ABILITY TO BECOME SEXUALLY AROUSED IS MORE
OR LESS CONSTANT ACROSS THE MENSTRUAL PERIOD.
5.
DURING FIRST SIX MONTHS OF PREGNANCY:
(A) WOMEN'S SEXUAL DESIRE IS
ABOUT THE SAME AS AT OTHER TIMES
(B) INTERCOURSE DOES NOT USUALLY CAUSE HARM
TO EITHER MOTHER OR FETUS
7.
SIZE OF PENIS IN FLACCID STATE
NOT STRONGLY CORRELATED WITH SIZE IN ERECT STATE
6.
PENIS SIZE UNRELATED TO
(A) SEXUAL DESIRE
(B) LEVEL OF SEXUAL ACTIVITY
(C) PLEASURE OF MAN OR PARTNER
(ALTHOUGH SOME WOMEN PREFER
LARGER PENIS)