Sensate focus touch in sexual health and sex therapy: A critical literature review

Abstract

ABSTRACT Introduction Sensate Focus Touch forms the foundation of modern sex therapy and continues to be widely used in both medical and mental health. Seen initially as purely a behavioral and educational technique, its similarities to mindfulness and somatic approaches have expanded our understanding of the mechanisms involved in its’ use. Masters & Johnson's more recent instructional modifications were poorly disseminated and have been the subject of a number of publications endeavoring to update the field. A preliminary literature review was conducted in 2015 to investigate the use of Sensate Focus. The most recent literature review covers the period 2014-2019 and was a follow up to that initial study. Objective The objective of the study was to examine the use and efficacy of Sensate Focus especially with varied populations, therapies and applications and to note instructional variations in medical and mental health publications. Methods A systematic database search of scholarly works published between January 2015 and June 2018 in medicine and mental health was conducted using the search term “sensate focus”. Non-English, duplicate, unrelated and publications by the authors were removed. The 48 works which met full criteria were reviewed. Results Publications in both medical and mental health continue to reflect the widespread use of Sensate Focus for a variety of sexual concerns with medical, psychosocial and mixed etiologies. The application of Sensate Focus to more diverse populations including cancer survivors, individuals with chronic pain, sexual trauma survivors, individuals with addictions and others was represented in the literature as well as the innovative use of group and online treatment programs. The literature also showcased a variety of therapeutic approaches combined with Sensate Focus including medical interventions, psychoanalytic, CBT, somatic and mindfulness. However, many studies simply mentioned the use of Sensate Focus without specifically defining its use, and other studies overwhelmingly utilized the 1970 version of “touching to give and receive pleasure” rather than the updated version which emphasizes touching in a mindful way without regard for pleasure in the initial stages. Numerous studies identified Sensate Focus as efficacious but extrapolation remains difficult due to the use of combined therapies such as CBT in the research design. Conclusion The use of Sensate Focus continues to be reflected in the medical and social science literature with evidence of efficacy in treating a wide variety of sexual concerns, including those of combined etiology. More diverse populations are being served in increasingly innovative ways with a new understanding of the somatic and mindfulness elements of Sensate Focus. Confusion remains about the specific updated instructions and the difference between use of Sensate Focus for sexual distress vs optimization of intimate sexual interactions. In general, more rigorous investigation is needed including operational definitions of variables, randomized control trials, long term follow up and isolating Sensate Focus as independent from other treatment modalities. Disclosure Work supported by industry: no.