“Don’t Look Now”: The Role of Self-Focus in Sexual Dysfunction

Abstract

Couples and family counselors are in a position to aid in the remedy of sexual dysfunction when it has a cognitive or psychological basis. One important source of sexual dysfunction is cognitive distraction that results from certain forms of self-focus during sexual activity with a partner, a phenomenon sex therapists have labeled spectatoring. I briefly describe the various ways such self-consciousness is associated with sexual dysfunction and the vicious cycle that often results. I also introduce sensate focus, the primary therapeutic intervention that has been promoted for spectatoring. Although often overlooked, spectatoring and sensate focus may not be equivalent for men and women. Accordingly, shortcomings in applying the standard techniques to all cases are highlighted, and alternative interventions are described.