This is the 2007 version. Click here for the 2017 chapter 16 table of contents.

Sex Therapy gets more Complicated

In the 1980s and 1990s, the profession of sex therapy became more difficult and complicated. Problems that yielded easily to treatment, like premature ejaculation, no longer turned up in the therapist's office. People read about easy solutions, and many people were able to treat themselves without paying for a therapist. Family doctors became more comfortable dispensing advice about such techniques.

What sorts of problems started being brought to therapists more often?

Sex therapists began to see a new type of client: people with difficult problems that resisted self-treatment. Patients with "easy" problems like premature ejaculation and failure to reach orgasm were replaced by patients with problems like loss of sexual desire or aversion to sex. These problems tended to involve complex social factors. For example, they might involve the lasting effects of a strict upbringing, or rape, or childhood sexual abuse, or the fading of chemistry in a marriage. To deal with these problems, a therapist had to do more than simply recommend a technique. Time-consuming psychotherapy or marriage counseling was necessary. Even then, the problems were difficult to solve. As Sidney Jourard observed many years earlier:

What did Jourard say, which foreshadowed the emphasis in treatment decades later?

...It is my experience that problems brought to me as supposedly purely sex problems turn out inevitably to be problems that arise from fouled-up relationships. (Jourard, 1961)

Nowadays, sexual disorders are not necessarily treated by a sex therapist. In most cases, clients benefit by seeing a therapist who is interested in the whole person. Such a therapist addresses not just sex problems but the whole relationship.

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