PubMed · 1856450
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J W Slap. 1991. The schema model.. https://doi.org/10.1177/000306519103900216
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While the psychoanalytic process explores the past, it does so within the context of the immediacy of the present. A clinical vignette is used to demonstrate the distinction between unconscious fantasies which, though buried, are alive in the present, and the historical past which shaped those fantasies. On that basis, interpretations and reconstructions are distinguished. The tension between singular process and dyadic interaction is also considered in the light of the centrality of present experience. Finally, the place of current sensation in connection to memory is addressed.
Our work with women with sexual aversion documents the presence of marked sexual avoidance behaviors as specified in the DSM-III-R1 diagnostic criteria for this disorder. At the same time, we demonstrate the presence of normal sexual desire and capacity for orgasm in these women. These two findings offer support for a valid diagnostic differentiation between sexual aversion disorder and hypoactive sexual desire disorder. Inherent in the diagnosis and treatment of sexual aversion disorder is an appreciation by the clinician of the tremendous approach-avoidance conflict that exists in these patients. The behavioral and cognitive avoidance features, therefore, need to be elicited actively by the clinician during all phases of assessment and treatment. These features are not always offered readily by the patients for fear of having to relinquish these strategies and their related sense of control over the overwhelming anxiety that sexual intimacy can produce. Consequently, treatment is not always straightforward and successful.