The Nature of Sexual Problems
Working with sexual problems requires specific knowledge of sexuality and sexual functioning. Scharff and Scharff (1991: 4) point out that, over the years, psychoanalytic therapies have struggled to address such problems without the benefit of the necessary knowledge about sexual functioning and dysfunctions. Sexual problems often bridge the artificial division that has been made between physical and psychological problems. This is a result of the way that sexual functioning and the personality as a whole interrelate, and the fact that sexual functioning is impinged upon by both internal and external factors. In the face of this complexity it is not surprising that the therapeutic approaches that have been developed to deal with sexual difficulties vary greatly in their focus.
This chapter outlines the anatomy and physiology of sexual response in men and women, looking particularly at the differences and similarities. While the sections on anatomy and physiology are primarily concerned with describing the external and internal genitalia, it is important to note that the whole body is involved in sexual behaviour and response. Stimulating many parts of the body can bring erotic pleasure to the giver and receiver, men and women, whatever their sexual orientation. The sections that follow suggest how the interaction of biological, intrapsychic, interpersonal relationships and cultural issues contributes in varying ways to sexual difficulties, and discuss how our conceptualizing and understanding of sexual problems is influenced by these factors.
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