The sex therapist 2 how it all began

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Mindfulness-based therapy for sexual issues has been one of the most ificant changes in the field.

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For more information on earning CE credit for this article, go to www. More than half a century has passed since famed sex researchers William Masters, MD, and Virginia Johnson began their pioneering research on sexuality and sexual dysfunction. That work laid the foundation for modern sex therapy, and some of the techniques they described in the s are still being used today, says Jennifer Vencill, PhD, a d psychologist and certified sex therapist at the Mayo Clinic in Rochester, Minnesota.

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Yet times have changed since those days when miniskirts could scandalize and television couples slept in separate beds. Building on the tools described by Masters and Johnson, a new generation of researchers has identified novel ways to view sexuality and innovative ways to treat sexual problems, including issues with arousal, desire, pain and inability to orgasm.

Even insuch topics can make people blush. Yet psychologists owe it to their patients to update their understanding of sex therapy, experts say.

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Whether sex therapy is a cornerstone of your practice or something you address only briefly, here are five developments to watch. Sex therapists use a variety of approaches to treat sexual dysfunction. In addition to the techniques outlined by Masters and Johnson, tools such as cognitive-behavioral therapy CBTemotion-based therapy and couples communication techniques have been the treatment mainstays for sexual problems. Now, mindfulness-based sex therapy is increasingly recognized as an effective intervention, many sex therapists say.

Mindfulness-based therapies are exciting because they are both effective and broadly applicable to many types of sexual problems, Peterson says. The patients were receiving dialectical behavior therapy, which emphasizes mindfulness meditation as a way to address emotion dysregulation. At the same time, she was studying sexual difficulties among women who had survived gynecologic cancer. It struck her that the two groups shared similarities: a lack of sense of self and feeling disconnected from their bodies.

If mindfulness could help those with suicidal thoughts, Brotto wondered, might it also help cancer survivors feel connected and present during sexual encounters? The intervention Brotto developed involves eight weekly sessions delivered in a group format. The treatment is similar to mindfulness-based cognitive therapy, Brotto says, but tailored for a sexual context. Patients learn how to tune in to erotic sensations, for instance, and how to integrate the techniques into sexual encounters back in the bedroom. In a series of controlled trials over the years, she and her colleagues have demonstrated the effectiveness of mindfulness-based sex therapy, not only among gynecologic cancer survivors but also for people with other sexual disorders.

Recently, for instance, they tested the intervention in a small pilot study of women with low sexual desire and arousal—the most common sexual complaint in women, and one with few treatment options. Participants reported ificant improvements in sexual desire, sexual function and sex-related distress after the treatment The sex therapist 2 how it all began Journal of Sex ResearchVol.

Mindfulness-based sex therapy is now used around the world, and several other research groups are testing it in various populations. A meta-analysis by Kyle Stephenson, PhD, found evidence that mindfulness-based therapy was effective for treating female sexual dysfunction The Journal of Sex ResearchVol. Viagra, the first FDA-approved oral treatment for erectile dysfunction, hit the market in Drug companies have introduced multiple Viagra competitors for men, and inthe FDA approved the drug Addyi flibanserin to treat low sexual desire in premenopausal women.

Meanwhile, however, psychologists are demonstrating that more focus should be put on psychological interventions, which have proven to be effective.

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In a consensus statement from the International Consultation on Sexual Medicine, Marita McCabe, PhD, and colleagues concluded that psychosocial factors are clear risk factors for sexual dysfunction, and both women and men with the condition should be offered psychosocial evaluation in addition to medical evaluation and treatment, when appropriate The Journal of Sexual MedicineVol.

In men, sexual desire is strongly influenced by testosterone, Rowland notes. But in women, sexual dysfunction is often more complex. Of course, both men and women with sexual dysfunction should rule out biological causes, Althof says. Historically, sex therapy has been rooted in a traditional view: cisgender, heterosexual encounters between a man and a woman. Even within that already narrow definition, sex therapy has mostly been available to white, middle- and upper-middle-class married couples.

Increasingly, though, researchers who study sexuality and sex therapy are taking a broader perspective. But the traditional sensate focus script is very heterosexual and describes gendered anatomy. Portrayals of transgender bodies are often presented in demeaning or hypersexualized ways in popular culture, which can contribute to negative feelings that transgender people have about their own bodies and sexuality.

But they predict that this will be an important area for future research. Increasingly, researchers are looking more closely at the role of partners. When one partner has sexual dysfunction, it can make sex more stressful and the sex therapist 2 how it all began pleasurable for his or her partner. In a review of the literature for the International Consultation on Sexual Medicine, Brotto and colleagues found studies consistently demonstrating that dysfunction in one partner often contributes to problems in sexual satisfaction as well as sexual functioning for the other partner The Journal of Sexual MedicineVol.

Now, more researchers are beginning to look at both individual and relational data in studies of sexual dysfunction, Vencill says. For instance, among heterosexual women who experience pain during intercourse, sympathetic partners might be inclined to stop a sexual encounter that becomes painful.

Such findings are starting to inform the way sex therapists treat patients and their partners, Vencill says. In some ways, sex is less taboo than it was when Masters and Johnson began their research. Nonetheless, sex is still a topic that makes people uneasy. In the United States and many other culturessex often involves mixed messages. At the same time, many people still balk at the idea of seeking help for their sexual problems. Digital interventions can build a bridge to people who have reservations talking about sex in person.

For those interested in learning more, the American Association for Sexuality Educators, Counselors and Therapists offers continuing education and certification for sex counselors, therapists and educators. The Society for Sex Therapy and Research also offers resources for professionals, including psychologists, with clinical or research interests in human sexual concerns. Researchers, too, can find much to explore in the fields of sexual functioning and sexuality, Althof adds.

Greystone Books, Wiley-Blackwell, Principles and Practice of Sex Therapy5th ed. Binik, Y. Guilford Press, Sexual Dysfunction in Men Rowland, D. Hogrefe, Brewer Ed. Nova Science To earn CE credit, after you read this article, complete an online learning exercise and take a CE test.

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Upon successful completion of the test—a score of 75 percent or higher—you can immediately print your certificate. To purchase the online program visit www. For more information, call Select the free online programs through your MyAPA .

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up now ». Mindfulness Sex and Sexuality. Cite this. Weir, K. Sex therapy for the 21st century: Five emerging directions. Monitor on Psychology50 2. Overview CE credits: 1 Learning objectives: After reading this article, CE candidates will be able to: Discuss current and emerging therapies for sexual problems. Discuss attitudes about sex and sex therapy. Letters to the Editor Send us a letter.

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