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Israel M. Guzman
21 November 2011
Sexual DysIunctions and Their Treatment: A Concise Review
In 1966, William Masters and Virginia Johnson published their book, Human Sexual
Response. In it, they careIully describe the physiological responses that accompany sexual
stimulation. They also pose essential ideas that hitherto had not been established by previous
research. Masters and Johnson had discovered that male and Iemale sexual responses are very
similar physiologically. They also demonstrated that women achieve orgasm primarily through
clitoral stimulation. These discoveries gave the clinical and scientiIic community a much needed
systematic study oI the human sexual response. It has since been the deIinitive study oI what the
average sexual response entitles in both men and women. Looking to expand their research,
Masters and Johnson published Human Sexual Inadequacy, a study Iocused on sexual problems.
With the publishing oI the latter book came the revolution oI sex therapy by treating sexual
problems simply as diIIiculties that could be treated using behavioral therapy. The authors were
able to abolish the preconceived notion that sexual problems were the result oI underlying
neuroses or personality disorders (Yarber, Sayad, Strong, 2010). So, what is a sexual problem
and how is one treated? This question is what the present work will intend to answer.
Sexual Iunctioning is the group oI related actions and responses that contribute to the
whole act oI sexual expression. The human sexual response is the Iundamental cycle that
underlies sexual expression. In both men and women the stages oI sexual response Iollow the
same pattern: excitement, late excitement or plateau, orgasm and resolution (Yarber, Sayad,
Strong, 2010). II the individual is healthy, he or she will go through all the motions without any
problems. Although there are a vast number oI people that present no complications during
sexual expression those with dissatisIactions or problems cannot be ignored. The impediments
one might have that aIIect the stages oI sexual response are known as sexual dysIunctions by the
Diagnostic and Statistical Manual of Mental Disorders (DSM) and World Health Organization`s
International ClassiIication oI Diseases and as sexual Iunction dissatisIaction by the Working
Group Ior a New View oI Women`s Sexual Problems. Sexual dysIunctions or sexual Iunction
dissatisIactions can be oI both psychological and organic origins. They also aIIect sexual desire
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by reducing the libido. It is worth notable mention that as oI 2011, none oI the classiIication
systems have included problems oI hypersexual activity.
The DSM classiIies sexual Iunction diIIiculties as disorders and characterizes them
according to the aIorementioned Masters and Johnson`s sexual response cycle. The current
version oI the DSM (deIines sexual dysIunction as 'disturbance in sexual desire and in the
psychophysiological changes that characterize the sexual response cycle and cause marked
distress and interpersonal diIIiculty (APA, 2000). In order to diagnose a person with a sexual
disorder the problem should be persistent and recurrent. The WHO`s International ClassiIication
oI Diseases describes sexual dysIunction as 'the various ways in which an individual is unable to
participate in a sexual relationship as he or she would wish (WHO, 1992). On the other hand,
the Working Group Ior a New View oI Women`s Sexual Problems presents one with yet another
classiIication oI sexual complications. According to the group, which is largely Iocused on
Iemale sexual dissatisIaction, sexual Iunction dissatisIaction is a common outcome oI a diIIiculty
in sexual Iunctioning (Yarber, Sayad, Strong, 2010). The philosophies oI each system might be
diIIerent but the treatment procedures dealing with sexual complications share many similarities.
Although each treatment aims at eradicating the complication there are pros and cons that
accompany them. Nevertheless, it is important to get treated in order to maintain a satisIying
sexual experience and Ior the prevention oI potential interpersonal complications.
The beneIits oI sexual treatments include a healthier sex liIe, deeper intimacy and better
communication with partner, and overall selI-satisIaction. William Masters and Virginia Johnson
devised the Iirst scientiIically based treatment Ior sexual complications. Their approach to
reducing iI not eliminating the dysIunction had a cognitive-behavioral basis. In this type oI
treatment, one is taught to open the lines oI sexual communication with one`s partner. Because
the majority oI sexual Iunction problems are the result oI sexual ignorance, Iaulty techniques or
relationship problems, the couple is educated and motivated to become more Iamiliar with their
bodies, learn to communicate more eIIectively with their partners, and they receive training in
procedures designed to help them diminish their Iears about sexuality (Oltmanns, Emery, 2011)
There is also psychosexual therapy which combines behavioral exercises with insight therapy
(Yarber, Sayad, Strong, 2010). The last two treatments have proven signiIicant in treating sexual
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complications by shedding light on the couple`s Irustrations and anxieties thusly being able to
treat the sexual dilemma.
By Iar the greatest disadvantage oI cognitive-behavioral and psychosexual therapy is the
cost that is incurred in both. Fortunately, 90 oI sexual Iunction diIIiculties can be successIully
treated by using the Iirst three phases oI the PLISSIT model. The model`s name is an acronym
Ior its phases: permission, limited inIormation, speciIic suggestions, and intensive therapy. Using
this model signiIicantly reduces the economic burden that would have been brought on by the
more extensive therapies. OI course, iI the individual or couple continues to Iace sexual Iunction
complications then the intensity oI the therapy will increase to the last level oI the PLISSIT
model: intensive therapy. No matter what therapy is used, it is crucial that the proIessional be
well-trained and capable oI meeting one`s needs.
The responsibilities oI the therapist are great. He or she is given the task oI being the
couple`s mediator and a type oI authority. He or she must ask the couple seeking treatment why
they have sought him or her. AIter gathering their age (sexual complications can vary Ior
diIIerent age groups), their sexual orientation (problems seen in homosexual and bisexual
relationships diIIer in many ways Irom heterosexual problems), their culture and/or race (culture
dictates the way in which sexual issues may be discussed, and belieIs about sexuality and
reproduction inIluence decisions about acceptable sexual behaviors (Oltmanns, Emery, 2011)),
and working situation (work stress can unquestionably inIluence sexual behavior). This is just
preliminary inIormation that will help the therapist when assessing the case and determining the
most eIIective treatment Ior the couple.
The classiIication and treatment oI complications oI sexual Iunctioning has come a long
way. From Richard von KraIIt-Ebing`s conservative approach with dealing with sexual deviance
(von KraIIt-Ebing, 1894) to Sigmund Freud`s erroneous and victimizing view oI treating sexual
dysIunctions as neuroses and signs oI personality disorders (Yarber, Sayad, Strong, 2010) to
William Masters and Virginia Johnson`s groundbreaking work in Human Sexual Inadequacy,
one`s understanding oI sexual Iunction dissatisIaction is expanding immensely. It will be
interesting to see more research being done on homosexual, bisexual, and transgender couples
since this area is lacking. There are certainly a large number oI couples and individuals in the
LGBT community that seek treatment Ior their sexual dissatisIactions. This demand needs to be
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met. Over all, the Iuture seems promising as a growing number oI individuals and couples are
Iinding the satisIaction they have dreamed oI.




Bibliography
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental
Disorders (4
th
ed., text rev.). Washington, DC: Author.
Oltmann, T. F., Emery, R. E. (2011).Abnormal Psychology. New York: Pearson.
Von KraIIt-Ebing, R. (1894). Psychopathia Sexualis. C. G. Chaddock, trans. Philidelphia, PA:
The F.A. Davis Company, Publishers.
World Health Organization (1992). Reproductive Health. A Key to a brighter future. Biennial
report. 1990-1991. Geneva, Switzerland: Author.
Yarber, W. L., Sayad, B. W., & Strong, B. (2010). Human Sexuality. Diversity in Contemporary
America. New York: McGraw-Hill.