Sex and Sexuality: The Good, the Bad, and the Ugly. a Sex Therapist’s Perspective

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"Human sexuality touches all of us. Sexual functioning and dysfunction are closely tied to people's self-esteem, self-respect, and to their relationships with their intimate partners. This book will describe and explore the interplay of intimacy and sexuality, how it can enhance relationships, and how it can negatively affect them, or be affected by them. Paraphilias are what we call 'perversions,' which include voyeurism, to much more severe and socially unacceptable behaviors such as sadomasochism, pedophilia, zoophilia, rape, and more. Amongst its other contributions, this book will place sexuality where it belongs, within the context of relationships, and will demonstrate how it is related to intimacy and may enhance it, how it may be negatively influenced by destructive relationships, and how dysfunctions or paraphilias may influence the intimate union"-- Contents Prologue: An Introduction and Sneak Peek into What to Expect An Important Point Chapter 1 Religion, Culture, and the Evolution of Sexuality Religion’s View of Sexuality Judaism Christianity Islam Hinduism Buddhism A Brief Cultural Overview of Sexuality Latin America Russia and Japan Russia Japan Sexual Behaviors Sexual Techniques Sexuality in Different Societies Masturbation Pre and Extra Marital Sex Attitudes toward Homosexual Sex Disease Sex and Violence The Evolution of Sexual Reproduction Sexual Differences Sexual Selection Mating Strategies Cultural Influences on Human Sexual Behavior How Does Culture Influence Sexuality and Intimacy? Contexts of Sexuality Non-Relationship Sexual Pleasure The Pleasure Theme of Sexuality in the Last 60 Years Sexuality in the 21st Century Sexual Freedom and Problems Sex and the Media References Chapter 2 How Is Research in Human Sexuality Conducted? Sex Research in North America: Let’s Take a Brief Tour Along the Centuries What Changed Since Those Early Days? Sex Research in America at Present Some Examples of Sex Surveys The Stigma of Sexual Research; Yes, It Does Exist What Are the Implication of Sex Research to Participants and Researchers? Doing Sexuality Research with Children Research on Alcohol and Sexuality: Issues and Approaches Challenges Related to Sex Research References Chapter 3 How Do We Respond to Sexual Stimulation? Female Genitals The Clitoris: Anatomical and Psychological Issues Why Was the Clitoris Treated the Way It Was? Male Genitals The Intricacy of Human Sexual Response Cycle What if Emotional and Physical Satisfaction Do Not Happen? The Masters and Johnson’s Model of Sexual Response Helen Singer Kaplan’s Model Sex Differences in Sexual Response Is There Proof for the G-Spot? How Do Our Genitals Respond during Sexual Activity? Males’ Genital Response Penile Erection Genital Response in Women Vaginal Response Vaginal Stimulation Can Cause an Analgesic Effect Orgasm Gender Differences in Orgasms Male’s Responses during Orgasm Female Orgasmic Responses How Does Orgasm Actually Feel? Sexual Arousal in Women: Clitoris and Orgasm The Psychological Components of the Orgasmic Experience What Are the Orgasm’s Functions? Females How Can Women’s Pleasure Be Enhanced? The Orgasm Gap, and How to Address It The Refractory Period Female Ejaculation How Do We Respond to Sexual Stimuli? How Do Hormones Play during Sex? Taking One More Look at Women’s Sexual Response Do Men and Women Experience Intercourse Differently? What Is Sexual Arousal? Sexual Arousal and Emotion Sexual Arousal and Genital Feedback Sexual Arousal and Desire The Way People Define Sexual Desire and Sexual Arousal How Experts Define Sexual Desire and Arousal Women’s Sexual Desire What to Do When Each Partner Has a Different Level of Sexual Desire? Gender Differences References Chapter 4 Our Sexual Behaviors, and How They Are Formed We All Want a Fulfilling Sexual Relationship Do Men and Women Differ in Their Sexual Behavior? Women’s Genital Touching Recent Data on Americans’ Sexual Behavior Sexuality and Culture The Influence of Culture on Sexual Behavior The Effect of Culture on Love, Sex and Intimacy Gender and Sexual Behavior What Is Responsible for Those Gender Differences? Sexual Expression How We Feel and How It Affects Our Sexual Activity Solitary Sexual Behaviors Asexuals Sex Toys Partnered Sexual Behaviors Myths about Men’s Sexuality and How They Affect Their Behavior Sexuality in Later Life: Do the Elderly Have Sex? Sexual Behavior Health and Sexual Activity Physical Health and Sexual Activity Does Mental Health Affect Our Sexuality? The Effect of Medications on Sexual Behavior Sexual Desire Sexual Dysfunctions Human Mating and Sexual Selection Sexual Selection in Humans Sexual Fantasies and Their Function What Is the Function of Sexual Fantasies? Sexual Fantasies from an Attachment Theory’s View Attachment Orientation and Its Relation to Sexual Interactions Sexual Fantasies Deviant Sexual Fantasy in Adult Males Sex in the 21st Century Internet and Sexuality: How Are They Connected? Pornography on the Internet What Are the Effects of Online Pornography? Online Use for Offline Sex: Advantages and Disadvantages Hooking Up Why, We May Wonder, Has Hooking Up Become the Norm on College Campuses? Sexting and Sextortion References Chapter 5 Belonging, Love and Intimacy Longing to Belong Why Do We, Actually, Yearn so Much to Belong? Love, Attraction, and Intimate Relationships Philosophers’ View of Love How Does Love Affect Us? How Was Love Seen in Ancient Times? Love and Attachment The Nature of Love Love as a Tool to Enhance Commitment Love Is Found All Over the World Love in Various Cultures How Do Men and Women Differ in Love? The Way We Select a Mate Mating Strategies What Is, Intimacy, Actually? The Effects of Intimacy on Our Health What Is the Meaning of Passion? Romantic Passion Attachment and Romantic Passion How Do We Keep Sexual Passion Alive? Affection Following Sexual Activity The Effect of the Internet on Romantic Relationships What Contributes to Sexual Satisfaction? Evaluating Marital Success Characteristics of a Successful Marriage Differences in Love and Relationships between Men and Women Love as a Basis for Marriage Romantic Attitudes ‘Cracks’ in the Couple’s Bliss Love and Loneliness Are Not Supposed to Go Together The Wear and Tear of Love Personal Situational What’s in Marital Satisfaction and Dissatisfaction Marriage, Divorce, and Their Effects on the Immune System The Influence of Intimacy on Heart Disease The Psychosocial Risk Factors for CHD How Do Personality, Social Environment, and Emotional Adjustment Affect CHD? Designing Living Quarters to Create a Relatedness Experience References Chapter 6 Communicating about Sex The Essence of Intimate Communication Communication and Relationships, in General Sexual Communication The Function of Sexual Communication What Are Sexual and Relational Satisfaction? Gender Difference in Couple’s Communication How Do We Talk Effectively About Sexuality? Sexual Communication Sexual Communication Improving Our Sexual Communication The Effects of Affectionate Communication Sexual Satisfaction and Intimate Behaviors in the Relationship Sexual Communication with Parents and Friends, and Well-Being Sexual Behavior and Communication Pain and the Effect of Communication Sexual Communication and Sex Toys Parties References Chapter 7 Sexual Orientation: Whom Do We Prefer as a Sexual Partner? What Is Sexual Orientation? Asexuality: Not Desiring Sex Characteristics of Sexual Orientation Bisexuality Homosexuality What Contributes to Becoming Gay or Heterosexual? Homosexuality: A Drive Down Historical Memory Lane The Shades of Sexual Orientation Religion and Homosexuality: Do They Go Together? Sexual Orientation and Neural Correlates Unraveling Sexual Identity Occurrence of Non Heterosexual Orientation Men’s and Women’s Sexual Orientation The Historical Stigma Related to Sexual Orientation Stigma Associated with an LGB Orientation What Is Sexual Fluidity? Do Facial Features Differentiate between Heterosexuals and Homosexuals? The Beginning of Sexual Attraction Consequences of Sexual Orientation Sexual Orientation and Well-Being Gender Nonconformity and Well-Being Sexual Orientation Cross-Culturally Sexual Orientation: How Does It Start? Is It, at All, Relevant That We Know What Causes a Specific Sexual Orientation? OK, So Can Sexual Orientation Be Changed? The Treatment of Non-Heterosexuals throughout History Is There Anything That Can Be Helpful in Sexual Reorientation? How Does Sexual Orientation Affect Mate Preferences? References Chapter 8 Can Psychological and Medical Conditions Affect Sexuality? Men’s Medical Conditions That May Negatively Affect His Sexuality Andrology Cancer Psychological Factors Involved in Breast Cancer Social Factors Related to Breast Cancer The Impact of Gynecological Surgeries Gynecological Malignancy Physical Impact of Vulval Carcinoma Psychological Effects of Vulval Carcinoma The Impact of Vulval Carcinoma on Sexual Function A Treatment Approach Prostate Cancer Effects of Prostate Cancer Sexual Rehabilitation Cancer and Sexuality in Adolescents and Young Adults Can Sex Cause Cancer?! Sexual Behaviors Counseling Patients with HPV-OSCC Can HPV – OSCC Be Prevented? Sexuality as Practiced by Those with Congenital Disability Sexuality and Obesity Obesity and Concurrent Illnesses Mental Health and Psychological Disorders Depression Anxiety Sexual Dysfunction in Patients with Eating Disorders Schizophrenia Treating Sexual Dysfunctions That Were Induced by Antipsychotic Medication General Medical Conditions Diabetes Mellitus Cardiovascular Disease Hypertension Neurology A General Review Epilepsy Multiple Sclerosis (MS) Prevalence of Sexual Dysfunctions among People with MS Depression and MS Parkinson’s Disease (PD) Sexual Dysfunction in Parkinson’s Disease (PD) PD, Sexuality and Intimate Relationships Parkinson’s and Paraphilia (Sexual Aversion) Effects of Surgery and Pharmacotherapy on Sexual Functioning of People with PD The Effect of Spinal Cord Injury (SCI) on Sexuality and Intimacy Sexual Stigmatization Spinal Cord Injury as a Barrier to Sexual Satisfaction What about the Injured Men’s Partner? SCI Cross-Culturally The Impact of Dementia on Intimacy and Sexuality References Chapter 9 The ‘Bad’: When Things Don’t Go the Way They Should How Common Are Sexual Problems? What Are Sexual Disorders? Incidence of Sexual Dysfunctions Prevalence Risk Factors for Sexual Dysfunctions In General, What Causes Sexual Dysfunctions? Taking a Closer Look at Causes of Sexual Dysfunctions Intrapsychic Factors Interpersonal and Relational Factors Cultural Psychosocial Factors Organic Factors Causing Sexual Problems Central Nervous System Neurological Disorders Sexual Difficulties Caused by Drugs Sexual Problems May Be Caused by Sex Which Is Not Satisfying Sexual Dysfunctions in Men and Women Sexual Desire Disorders Erectile Dysfunction Orgasmic Disorders Sexual Dysfunctions Which Are Painful Female Sexual Dysfunctions Models of Female Sexual Response Cycle Sexual Dysfunctions Defined Sexual Function/Response Medical Conditions and Sexual Function and Dysfunction Some Comments about the Treatment of Female Sexual Dysfunction Causes of Sexual Desire Disorders in Women The Impact of Life and Relationship on Female Sexual Functioning Females’ Orgasmic Disorders Causes of Anorgasmia Neurophysiological Factors in Orgasm Psychosocial Factors Not Interested in Sex: Female Hypoactive Sexual Disorder (HSDD) The Characteristics and Prevalence of HSDD Vulvodynia and Its Effect on Intimate Relations What Triggers PGAD? The Disturbing Effects of Childhood Sexual Abuse CSA and Its Effect on Sexual Functioning The Effect on Women The Effect on Men A Look at CSA and Sexual Dysfunctions Men’s Sexual Problems Sexually Dysfunctional Men and Their Approach to Sex Diminished Ejaculatory Problems Hypoactive Sexual Desire in Men Physiology of Hypoactive Sexual Desire Treatment of Hypoactive Disorder in Men Rapid, or Premature Ejaculation (PE) What Is Premature Ejaculation (PE)? How Common Is PE? The Causes of Premature Ejaculation Psychological Theories about What Causes PE The Effect That PE Has on the Man and on His Partner Delayed Ejaculation Causes of DE Men’s Sexual Dysfunction and Health How Is Sexual Dysfunction Related to Psychological Health? Sexuality of the Aging Man Difficulties in Getting and Maintaining Erection in Older Age Prevalence of ED in Older Age Sexual Desire and Aging Orgasmic and Ejaculatory Dysfunction in the Elderly Erectile Dysfunction (ED) of the Elderly What Should the Physician Do When an Older Person Complains of Sexual Dysfunction? Sexual History Physical Examination Treatment Approaches Counseling Medical Treatment Vacuum Constriction Devices Surgical Treatment Sexual Dysfunctions and Self-Efficacy How Are Self-Efficacy and Sexual Response Connected? Sexual Health of Men and Women What Affects Our Sexual Health? Helping Couples Deal with Sexual Problems The Effects of Infertility The Psychosocial Implication for Infertile Men The Psychosocial Implications for Women Unable to Become Pregnant Treating Sexual Dysfunctions in Couples References Chapter 10 The ‘Ugly’: Unlawful Sexual Behaviors Paraphilias Historical Perspective What Is Legal and What Is Not Sex Offenders Deviant Sexual Interest Origins of Deviant Sexual Arousal Factors Maintaining Sexual Offending How Does Disruptive Attachment Influence Children? Cognitive Distortions The Various Sex Offender Types Intimate Relationships of Sex Offenders Public View of Sex Offenders How Does the Public View Rehabilitation? Stigmatization of Sex Offenders Stigma Inside Correctional Institutions: The Effect of the Stigma Offenders of Child Sexual Exploitation Materials (CSEM) What Motivates CSEM Offenders? Internet Access The Thoughts and Beliefs Experienced by CSEMs Sexual Arousal and Use of CSEM Treatment Approaches That May Help CSEM Offenders Intervention Approaches Treatment of Paraphilias Group Therapy Treatment Effectiveness References Chapter 11 Sexual Variations: It’s Different, But Not Always ‘Bad’ Clarifying Paraphilic Terminology How Prevalent Are the Various Paraphilias? Sleeping with the Dog … Frotteurism Hypersexuality Asexuality Fetishism The Underlying Causes of Fetishism Partialism Inanimate Extension of the Body Sadomasochism Transvestism Asphyxiophilia Necrophilia The Main Paraphilias Pedophilia Child Sexual Abuse Is Child Sexual Abuse Common? The Sexual Disorders That Follow CSA The Relationship of Sexual Disorders to CSA Exhibitionism Voyeurism Can Treatment Help Paraphilic Disorders? Incest Victims of Sexual Offences Sexual Addiction Cybersexual Addiction: The Role of the Internet The Reasons for Using the Internet for Sex A Therapist’s Perspective on Sexual Addiction References Chapter 12 The Ins and Outs of Sex Therapy Great Lovers The Goals of Psychotherapy When Facing a Sexual Problem: What Do We Expect from Therapists? Managing Boundaries between Client and Therapist Reversing Sexual Side Effects of Medications What Changed: Evolutions and Revolutions in Sex Therapy The History of Treating Sexual Dysfunctions From the Ancients to the Middle Ages The Precursors of Sexual Medicine Recent History Masters and Johnson: Biopsychosocial Sex Therapy Pioneers Biopsychosocial Sex Therapy and Biomedicine What Happens When Love and Sex Clash? Psychological and Relational Factors in Sexual Functioning The Predisposing, Precipitating, and Maintaining Factors of Sexual Dysfunctions How Does Anxiety Affect Sexual Dysfunction? Depression and Its Effect on Sexual Function Interpersonal Factors of Sexual Function and Dysfunction Psychological Treatment of Female Sexual Dysfunction Sexual Arousal Disorders Orgasmic Disorders Treatment Approaches for Anorgasmia Male Sexual Dysfunctions Hypoactive Sexual Desire Disorder (HSDD) Erectile Dysfunction (ED) Medical and Psychological Treatment Approaches for ED The Viagra Revolution Psychological Factors in ED How Is ED Treated? Rapid (or Premature) Ejaculation Treatment of Premature Ejaculation Treatment of DE (Delayed Ejaculation) Reframing Attitude Change Integrated Treatment for Sexual Dysfunction Issues in Defining Women’s Sexual Dysfunctions Sexual Dysfunction and Dysfunctional Sexuality Addressing Sexual Trauma Treatment Painful Sex What Can Treatment Offer? Mindfulness-Based Sex Therapy Sexual Addiction and Child Sexual Abuse Treatment Option for Sexually Abused People Sexual Dysfunctions: Efficacy of Psychological Interventions When Sexual Appetite Differs: Can We Do Anything about It? Enhancing Your Sex Life Intensifying Erotic Pleasure The Movement from Sex Therapy to Sexuality Counseling Medicalization of Sexual Problems What Do Men Want? And Women, What Do They Need? Sexuality Counseling Towards Optimal Sexual Health The Evolution and Future of Sex Therapy References Chapter 13 Sexuality and Relationships Sex and Belonging The Need for Intimacy and Belonging The Need for Love Choosing a Sexual and Intimate Partner Sexual Relations Establishing Intimate Relationships Practical Concerns Which May Be Present Sexual Desire Inhibition Social Inadequacy Fear of Entrapment The Instinct to Withdraw The Need for Self-Protection Disgust about the Potential Partner Disgusted by Sex The Importance of Sexuality What Does It Take to Create Relational Intimacy? Intimacy and Sexuality What Contributes to Sexual Satisfaction? Keeping Passion Alive Sexual Activity and Well-Being The Effects of Affectionate Experiences Relational Intimacy and Sex The Interplay of Attachment Style and Sexuality The Effect of Childhood Attachment on Adult Sexuality Attachment and Sexual Behavior Does Sex Contribute to the Attachment and Maintenance of Relationships? Distress Regulation, Attachment, and Sex Sexual Motivation of Couples Treating Relational and Sexual Dysfunctions Sexual Satisfaction and Relationship Happiness in Midlife and Older Couples When the Relationship ‘Squeaks’: As Lack of Intimacy, Loneliness, and Sexual Infidelity Raise Their Ugly Head Love and Loneliness Infidelity References Epilogue Index About the Author Blank Page