Tilley Psychological Services

Sexual Difficulties

General Information

Effects of Sexual Abuse

Incompatible Sex Drive

Treatment

 

General Information

Sexual dysfunctions are often related to medical causes in which it is presumed that psychological or emotional factors play no significant role. For example, some types of medications or medical conditions can lead to erectile dysfunction (inability to achieve or maintain a full erection) in men – once the medical condition is addressed, the dysfunction disappears.

 

Psychosexual disorders or dysfunctions, however, are disorders of sexual functioning in which psychological factors are considered to play a major, if not exclusive, causative role.  For example, an erectile dysfunction can result when a man is afraid that he will be unable to please his sexual partner.  Many people (especially men) are reluctant to seek medical advice regarding a sexual dysfunction because they are afraid that the difficulties arise from psychological factors, and to seek assistance would be to admit some level of inadequacy or inferiority..  Furthermore, we are still suffering the effects of the Victorian era - we are still uncomfortable talking about sexuality in many ways.  In fact, many types of interference in sexual functioning are relatively straightforward to address.  In those cases where psychological factors underlie the interference, it is often the case that the person is unhappy or anxious in other ways – the sexual difficulties may simply be the most blatant symptom of the person’s lack of satisfaction with his/her life.  Treatment of such factors can easier than is expected by the person experiencing the distress, and will generally lead to a full return of sexual functioning and satisfaction.

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Effects of Sexual Abuse

People who have been sexually assaulted, either as children or as adults, almost always experience later interference in their sexual functioning. This often does not even require particularly intrusive events - some people experience difficulty after growing up in an environment in which degrading comments are made about their sexuality. Whether or not physical contact is made, inappropriate exposure to sexual activity often leads to feelings of shame about sexuality, along with a connection between sexuality and trauma. Then, instead of feeling normal arousal and interest in sexual activity, the sexually abused person begins to feel fear, anxiety, or shame about sexuality.  They can also experience flashbacks, which can be sensory (often visual images or smells), and can include physical pain.  This connection becomes neurologically reinforced and leads to lack of sexual desire.  It is sometimes difficult to break, but it can be broken.  Breaking the connection requires patience on the part of both the person who has the difficulties, as well as their partner.  Breaking the connection also requires addressing the emotional after-effects of the sexual abuse.  If you are in this situation, please seek help to address your pain so you can move on to the life that you were intended to live.

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Incompatible Sex Drives

One difficulty that is common among couples is differing sexual desires (usually the man has a greater sex urge, although this is not always true).   Because many of us do not understand the physiological and psychological factors that contribute to sex drive, this difference often leads to a power struggle between partners: the partner with the lower drive feels "pawed" or "molested", while the partner with the higher drive feels "rejected" or "unsexy".  I know this may come as a shock to many of you, but men and women are different - yes, it's actually true!  Particularly after a woman gives birth, hormonal and emotional changes can lead to a lowering of sex drive.  In this situation, or in any situation in which one partner feels they have to "put out" to meet the needs of the other person, sex drive actually lowers rather than increases (and the frustration of the other partner increases, rather than lowers).  Fair or not, this actually sets up an "automatic resistance" in the person with the lower sex drive, who also is frustrated with lack of enjoyment of sexual activity.  When we understand how we are different, and how we can support each other in a more open and intimate relationship, the power struggle can be let go and couples can return to enjoying intimacy at all levels. 

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Treatment

Clarification:  If you are experiencing a problem with your sexual functioning, the first thing to do is to talk to your doctor and rule out any physical causes.

 

Education:  As I have noted above, we are still suffering from the impact of the Victorian era.  Many people over the age of about 30 still only have a very basic understanding of how our bodies work, and some of that has come from pornography (not a reliable source, to say the least).  We have made some progress, in that we are now teaching basic biology in schools.  However, there are two things that are lacking here.  The first is an understanding of physiology - not just where the pipes are, but how they all work together, and how the brain is involved in sexual drive and sexual behaviour.  The second thing lacking is an integration of basic sexual knowledge into relationships.  Even the "enlightened" among us have difficulty talking about sexuality within relationships, and the important connection between intimacy and sexual interest.  Most adults today have certainly not had this kind of education.  There are many books (not pornography), videos, and websites available that provide good sexual knowledge.  My suggestion is to get one of these and read it with your partner. 

 

Practical Strategies:  There is an increasing voice in the media today talking about how regular sexual activity is good for the health of males - oh, and females too.  (Apparently, ladies, we're still somewhat of an afterthought here.)  I don't know if anyone has researched the health of a partner who feels compelled to have sex!  Having said that, there may be a balance between recognizing that you can sometimes engage in sexual activity for the sake of the relationship.  The partner with higher sex drive may feel somewhat miffed by this, because it is a "chore".  Okay.  Not every cup of coffee, or glass of wine, or hot fudge sundae, is the best you have ever had.  Not every sexual experience is the best you have ever had.  If you require that your sex partner always feel great excitement, then you will further reinforce the "automatic resistance" - that is not going to get you where you are going.

 

For Men:  "Chick flicks" are pornography for women.  Go to the movies with them, actually pay attention to what is happening, and learn - these movies are set up to appeal to women, so watch what the male leads do and adopt some new behaviours.   

 

For Men:  If you are in the basement watching the hockey game while your partner is upstairs doing the dishes, do not expect and her to be interested in sexual behaviour.  If you want to be close, after the hockey game is done go and clean the bathroom, or something.  Then, watch what happens.

 

For Women: Men are different than us.  Stop trying to make them into a woman, and stop feeling guilty about what you feel.  Start communicating: stop talking and start listening.  You might be surprised what your partner will say if you allow the space for the words and feelings to come out.

 

By the way, this discussion may sound heterocentric, and in some ways it is.  However, the same patterns play out in homosexual couples.  Just because you are both of the same sex does not mean that you are of the same level of sex drive.  Do not be ashamed to ask for some help. 

 

Communication:  Talking, in general, can lead to an improvement in the level of emotional intimacy.  If there is something that your partner does, or does not do, that bothers you, talk about it.  This is where reading a book together might help to open the conversation.  Women, ask a question, then stop and really listen to the response.  Men, don't put women down for wanting to talk - you want to also, you just don't really know how.  If you cannot communicate as a couple, get some help doing so.

 

Therapy:  There is probably no other area of human life, especially one that is so complex, in which we are expected to know what to do without any instruction or guidance.  There is probably no other area of our lives about which we have such difficulty communicating.  If you are experiencing some difficulties in your sexual life, see a therapist who can help you learn to understand your own sexuality, and to communicate about what you need. 

 

Alternative Therapies:  I have seen some diets or supplements that are intended to increase sex drive.  I am somewhat sceptical about these, but they may be worth a try.  (By the way, there is research happening currently on a substance that may actually act as an aphrodisiac - stay posted.)  Generally, anything that improves physical and psychological health is likely to improve psychosexual health.  If you are going to try any of the supplements, do so under the direction of a qualified health practitioner. 

 

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Contact me at 780-702-8905 or email linda@tilleypsych.com