Psychoanalytic principles in sex therapy.

Abstract

We are concerned here with how psychoanalytic principles can be used in the treatment of sexual problems and dysfunctions. Three areas will be covered: (I) the meaning of the term psychoanalytic principles, (2) some of what goes on in sex therapy, and (3) how some psychoanalytic principles are used. The better we understand sex therapy, the more we will see how applicable psychoanalytic principles are in this form of treatment. Psychoanalytic principles are applied in the procedure of investigating and treating specific conscious and unconscious processes of human behavior and functioning. This procedure ultimately leads to self-realization and fulfillment. In the application of psychoanalytic principles, various techniques are used: free association, dream interpretation, analysis of doctor-patient transference and countertransference relationships, and the analysis of resistances, blockages, and resolution of intrapsychic and interpersonal conflicts. These techniques make it possible to explore unconscious processes and motivations. They also enable us to define the characterological and personality traits that lead to the specific compulsive personalities of compliance, withdrawal, or expansiveness. Each of these types adopts various neurotic strategies in an attempt at finding a solution, and these strategies influence the individual's sexual life and behavior. For example, certain affective processes appear to have specific autonomous actions when they relate to sexual functioning. Thus intrapsychic and interpersonal conflicts will affect sexual functioning, whether through the self-idealization process, self-despising, or any other compulsive attempts at solution. Psychosexual trends start from birth and are culturally influenced from then on. Generally, symptoms of neurotic conflict and anxiety and the specific type of character and personality structure (self-effacing, detached, expansive, arrogant, and so on) result in specific forms of sexual dysfunction, (impotence, premature ejaculation, preorgasmic problems, and the like). Guilt feelings and subsequent conflicts play a tremendous role in sexual dysfunctions and are of basic importance in sex therapy. By bringing into conscious awareness unconscious feelings and associ-