Behavior therapy of the sexual disorders

The behavioral therapies are bringing with them a new and interestingly effective approach to the treatment of sexual disorders based upon theories of learning. The two basic means used are: (1) reciprocal inhibition, as shown in J. Wolpe's (1958, 1961) systematic desensitization, wherein anxietyprovoking situations are overcome by the presentation of graduated fear stimuli in the presence of relaxation, and (2) aversive techniques, wherein pleasureful sexual sensations are converted to painful ones by chemical or electrical means. Systematic desensitization is what its name implies, a systematic or gradual desensitization to a noxious agent, through the use of the patient's visual imagination. It is most successful when employed against anxiety-provoking situations such as impotence, premature ejaculation, and frigidity. Also against the nonsexual aspects of homosexuality, exhibitionism, and other sexual deviations. The pleasureful aspects of the sexual deviations present another problem. It is no easy task to induce a person to give up what to him is exquisite pleasure. Consequently, aversive therapy is used to convert the pleasure into pain. More of this later. Systematic desensitization is preceded by the taking of a detailed history as in any good medical examination. The history is of particular importance; it is used to determine the fear elements which enter into a disorder. As an instance, a woman who feared snakes was given a realistic synthetic snake to handle. She did so without compunction. Asked why it had not disturbed her, she replied that it was not the snake itself that bothered her, but the eyes and the forked tongue. Any list of fears must include these items separately. For another example, Eysenck (1960) recorded the history of a man with impotence which was present only when attempting intercourse with his wife at home; he did not experience it anywhere else. It appeared that as a young man he had been surprised by an irate husband in the process of seducing his wife. The husband thrashed the patient within an inch of his life. It happened that the wall