Sexuality is an important part of life that encompasses partnership, activity, behavior, attitudes, and function, and sexual activity is associated with physiological, psychological, behavioral, and environmental factors. Sexual dysfunction, characterized by disturbances in sexual desire and psycho-physiological changes associated with the sexual response cycle in men and women, is a major influencing factor in marital discord as dysfunction diminishes the pleasurable aspect of sexual expression. Erectile dysfunction in men is viewed as an important public health problem. Though medications, placing medical devices, and surgeries are helpful in the treatment of sexual dysfunction, these techniques may not be suitable for some patients due to drug interactions or side effects, inconvenience, or personal choice. Under such situations, behavioral therapy is found to be more beneficial because it has no side effects, and the treatment outcome may be permanent. It is considered that the cognitive behavioral treatment technique is an effective approach in treating sexual dysfunction.
Sexual response is the integration of various physical, psychological, environmental, and emotional factors involving feeling, behavior, attitudes, expressions, age, environment, and health. Both men and women may experience some occasional alterations in sexual response, which may not be an indication of dysfunction. But a “persistent or recurrent inability to react emotionally or physically to sexual stimulation,” during the “desire, excitement, plateau, or orgasm stage of the sexual response cycle,” conforming to a healthy person or “according to one’s own standards of acceptable sexual response” has to be deemed as sexual dysfunction (Sexual Dysfunction: What is Sexual Dysfunction). Sexual dysfunction can be lifelong, acquired, situational, or generalized, and common types of sexual dysfunctions are: inhibited sexual desire (ISD), Vaginismus, Anorgasmia, and Dyspareunia, most commonly present in women; and premature ejaculation (PE), male orgasmic disorder, and erectile dysfunction are commonly present in men.
National Institutes of Health Consensus Panel describe erectile dysfunction in men as an important public health problem, and data from “Massachusetts Male Aging Study (MMAS) showed that 34.8% of men aged 40 to 70 years had moderate to complete erectile dysfunction, which was strongly related to age, health status, and emotional function.” (Laumann, Paik, and Rosen). Studies indicate that the “prevalence of sexual dysfunction among all women is between 25% and 63%”, sexual dysfunction “in postmenopausal women varies from 68% to 86.5%”, and sexual dysfunction is “higher in women (43%) than in men (31%).” (Addis et al.).
Reports suggest that sexual dysfunction is found to impact women’s self-esteem and quality of life and causes emotional distress, leading to relationship problems. Though the occasional loss of sexual desire in either sex is common, “persistent loss of desire disrupts sexual relationship,” which necessitates clinical intervention for effective cure. (EngenderHealth, p.2)
Sexual dysfunction may be caused by “physical or psychological, or a combination” of both factors and psychological factor is the leading cause among these two factors (Chameleon). Physical factors may be hormonal inadequacy, history of diabetes, spinal injury and neurological disorder, and medication effect”. Psychological factors include: “anxiety about sex and misconceptions, fears of pregnancy or sexually transmitted diseases, depressed mood, ignorance about sex and strict moral attitudes” (Chameleon). Relationship factors are found to be the major cause of sexual problems, and psychological treatment, particularly cognitive behavioral therapy (CBT) package, has beneficial effect in treating sexual dysfunction.
Cognitive-Behavioural Therapy (CBT) is a general classification of psychotherapy and has varied approaches with their own developmental history. It is considered that therapeutic approach to CBP was developed by Albert Ellis, in the mid-1950s, which was known as “Rational Emotive Therapy (RET)” RET principles are derived from the teachings of stoic philosophers like Epictetus, and Marcus Aurelius; behaviourists like John Dollard, Neal Miller, George Kelly; and neo-Freudian psychotherapist like Alfred Adler. In the 1960s, Aaron Beck developed Cognitive therapy, and Maxie C. Maultsby developed Rational Behaviour Therapy, and with the publication of David Burn’s 1980’s best selling book ‘Feeling Good’ CBT has received much popularity. (History of Cognitive-Behavioural Therapy). Cognitive behavioural therapy (CBT) recognises that “belief, thought, emotion, and behaviour all interact with, and affect each other”, and hence CBT is based on the concept that changing negative thinking patterns and behaviours can have a powerful effect on a person’s emotions. (Crawford). Through improving physical, emotional, and mental capabilities, aided with cognitive behaviour techniques, sexual dysfunction could be nursed and marital harmony nurtured.
Works Cited
Addis, Ilana et al. Sexual Activity and Function in Middle-Aged and Older Women. Obstet Gynecol. 2006.
Crawford, John. Cognitive Behavioural Hypnotherapy: What is Cognitive Behavioural Therapy. Hypnotherapy for life. 2008. Web.
History of Cognitive-Behavioural Therapy. National Association of Cognitive-Behavioural Therapist. 2008. Web.
Chameleon. Sexual Dysfunction: Causes. BABCP: British Association for Behavioural and Cognitive Psychotherapies. 2007. Web.
Laumann, Edward O., Paik, Anthony., and Rosen, Raymond C. Sexual Dysfunction in the United States. JAMA. 1999.
Sexual Dysfunction: What is Sexual Dysfunction. EngenderHealth. 2007. Web.