[What is a sexual disturabance?].
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Behaviour therapy is defined, and the therapeutic approach evolved by Masters and Johnson described. Their key concept of the desirability of treating couples and using co-therapists is evaluated in the light of research findings. It would seem that co-therapy is desirable, but a single therapist can do useful work with a single patient, a couple, or a group of couples using a behaviour therapy framework. Two illustrative cases are described.
Clinical experience of couple and sexological consultations indicates that some symptoms find in the heterosexual couple are the expression of a nevrotic solution of latent homosexual tendencies. This means that homosexual tendencies are repressed, or actualized through an imaginary elaboration or a symbolic one, by staying unconscious or manifesting through acting in a state of obnubilation. These different situations are illustrated by sexual dysfunctions (some forms of impotence and frigidity), hostile rejection and homosexual panic, jalousy, triolism and alcoholic aspects. This brief analysis is concluded by some reflexions from the clinical, social, couple and individual points of view.
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The Hamburg sexual counseling unit has been working since 1979 as a model project of the Federal Ministry of Youth, Family and Health. The therapeutic work done by the unit is based on the concept originally worked out by Master and Johnson, which was modified at the Department of Sex Research at Hamburg University in such a manner that it is both helpful and feasible as a treatment pattern for patients coming from all social classes. Basing on sexual symptoms, a problem definition is worked out which aims at underlining the subjective importance for the patient of the symptom concerned. The important factor is the ratio of stabilizing and destabilizing elements of a disturbance, in other words, the question as to the function of the sexual disturbance in the psychic or partnership balance either in the sense of rejecting desires for change or of reinforcing the "healthy" components of the symptom in the sense of prompting a motivation for change. In this regard, therapy is considered as one of many possibilities of effecting a change. Particularly successful has been the employment of couple therapy and group therapy for couples and for women.
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The object of this paper is to show that there are different forms of sexual anomalies which permit of basic and therapeutic differentiation. Atavisms of responding have been observed to play an essential role in real perversions.
There is no doubt that there are sexual disorders which are diseases, i.e. they need medical aid. As with every disease, also in sexual disorders investigation of the most probable causes has particular theoretical and practical value. Etiological investigations in this field stumble against special difficulties; compared to other fields of sex research they have been neglected up to now or were too concentrated in one direction. It is suggested that in every sexual disorder requiring treatment etiology should be gone into more deeply than hitherto. From animal experiments and human cases four different etiological possibilities can be deduced.
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