Female sexual arousal and its impairment: The psychodynamics of non-organic coital pain

Abstract

Abstract In this paper sexual arousal in women is viewed from an object relations perspective, in an effort to explore the psychological—interpersonal factors mediating futt genital arousal in intimate relationships. Female psychosexual development is described as the process of integrating genital anatomy into maturing psychic structures, along with the girl's separation and identification issues with her primary objects. Body ego formation, early dependency and oedipal transitional states are discussed in the context of mother-daughter relationships. A consideration of the physical concomitants of pain associated with intercourse suggest that it results from an impairment of sexual arousal, whereby the creation of an internal space for penile containment does not take place. It is proposed that psychogenic dyspareunia and vaginismus are disorders of female arousal, representing sexual disempowerment, comparable to erectile difficulties in men. Clinical material is presented to demonstrate how an object relations understanding of female arousal can be combined with psychosexual therapy, in an integrated approach to dyspareunia with no organic origin.