Automatic Sexual Chemistry
Disorders of sexual interest have become one of the more commonly presenting disorders and their treatment is by no means straightforward. Schover & LoPiccolo (1982) found that up to 50 of patients presenting in the 'sex therapy clinic' complained of 'inhibited sexual desire' and yet, as Hammond (1990) notes, this is one of the most complex and least successfully treated of the sexual disorders. Careful evaluation is required to exclude medical and psychiatric causes. If of a psychological aetiology, such disorders may arise from inadequacies in sexual stimulation an inability to become absorbed in sexual intimacy distracting negative self talk, thoughts or images anxiety, guilt, or anger or a lack of sexual pleasure resulting in little interest due to there being insufficient pay-off for sexual activity. Traumatic sexual experiences and inadequate parental models are also frequently implicated in the aetiology of disorders of sexual desire (Hammond, 1990). The nature of the...
Hypnotic Absorption In Fantasy Including Sexual Fantasy Causes The Fantasy To Be Responded To As Reality
Additionally the malleability of fantasy in the hypnotic state can result in shifting sexual arousal, from response to some unacceptable (fetish) fantasy, towards an acceptable fantasy. This reorientation towards a more appropriate sexual context can occur with the patient using fantasy in conjunction with sexual intimacy or in masturbatory changes in sexual focus, as suggested by Marquis (1970).
HIV prevention programs that primarily dispense AIDS information have not been shown to influence risk behavior levels because, as evidence from studies demonstrates, knowledge by itself is necessary but not sufficient to produce behavioral changes. Intensive, small-group programs that simultaneously target knowledge, attitudes, motivations, and cognitive and behavioral skills have been tried and found to produce reductions in high-risk sexual behaviors, including some that are substance related, among people with serious mental illness. Effective elements from randomized outcome trials of these HIV risk-reduction interventions (Kelly 1997 Otto-Salaj et al. 2001) include 1) information and skills training in sexual assertiveness, negotiation, problem solving, use of condoms, and risk self-management 2) intensive sessions (6-15 hours to achieve reductions in high-risk behaviors) 3) training participants to become AIDS educators or advocates 4) booster or maintenance sessions, which...
Hypnosis, when added to traditional approaches to the treatment of sexual dysfunction in both males and females, facilitates treatment and extends treatment options. Hammond (1990) noted the advantages in using hypnosis as an adjunct to traditional forms of sexual dysfunction, particularly in the way hypnotically-based techniques may assist in working with the single individual if the patient's partner is unwilling, unavailable or non-existent. Hypnosis provides direct and indirect ways of effecting changes in negative thought processes at both the superficial and deeper schematic level. As Araoz (1982) noted, it is often the negative thinking of patients with sexual disorders that perpetuates difficulties. The involvement of thought, image and symbolism in sexual interest, arousal and behavior cannot be overemphasized. Changing the information, associations, symbols and images that contribute to dysfunction is a primary goal of therapy. Hypnosis provides a powerful means of...
We have seen that women's access to nontraditional occupations may be compromised by hiring biases that disadvantage gender-incongruent candidates. To directly counter the tendency to prefer men for masculine and women for feminine jobs, individuating information is helpful (but not fully compensatory).
Hammond (1990) reviews the wide variety of dysfunctions that may respond to the 'master control room technique' where the patient is taken in the hypnotic state to the 'control room' of their mind (sited in the hypothalamus ) and from here the patient can make whatever alterations in the area of sexual functioning are required (e.g. suggestions of entering the control room and turning up sexual interest in a step-wise fashion from 0 towards 10, using any one of a number of switch metaphors).
It is recommended for women with bad menopausal symptoms, including flushing. It may slightly reduce the risk of thin bones (osteoporosis). Generally, in women who do not have symptoms, HRT does not make women less depressed, sleep better, be more sexually satisfied, interested, or active, or help their brain work better. There are always examples of women who are very pleased with their HRT and feel that it improves their hair and their skin. It is sensible for women to consult their doctor about these matters.
The diagnosis of fetishism can be made if the person experiences recurrent intense sexual urges and fantasies involving such objects, if he acts on these, if the preference has been present for more than six months, and if the object is the most important source of sexual stimulation. Will fetishism still be classified as a mental disorder in .8 20 years' time
In the early phases in particular, when language had yet to develop to its present level, the correct interpretation of nonverbal facial communication, such as happiness, sadness, aggression, compliance, pain, and sexual interest, provided a critical survival role in the tight social groups in which Homo lived. Another important growth area of the brain in hominid evolution is the neocortex, the front part of the brain where the higher mental functions such as thinking and planning take place, and where self-consciousness presumably resides.
The studies reviewed so far are all about autobiographical memory. But once one starts to look, one finds plots similar to the bump in autobiographical memory in other domains as well. A full explanation of the bump needs to take such plots into account and decide whether they are relevant to processes occurring in autobiographical memory. The oldest such plot I know about appears in Ribot (1882). He claims that for most people, imagination rises and drops in a fashion similar to the plots shown for autobiographical memory. For a select few, such as Ribot, I assume, it continues at a high level though old age. Like the bump, it has components. Early in the lifespan, imagination is used for play, then for sexual fantasy, and finally for more mature use.
In normal men, no correlation is found between circulating testosterone levels and sexual drive, frequency of intercourse, or sexual fantasies. Similarly, there is no correlation between testosterone levels and impotence or homosexuality. Castration of adult men results in a slow decline in, but not a complete elimination of, sexual interest and activity. See Clinical Focus Box 37.2 for a discussion of the effects of testosterone administration.
Techniques of in vitro fertilization were first developed to aid couples who had not been able to conceive through normal sexual relations. In this technique, eggs were surgically removed from the mother and mixed with the father's sperm in the laboratory. If fertilization took place, one or more embryos were introduced into the mother's uterus in the hope that an embryo would implant and develop into a full-term infant. Almost immediately, these techniques were used in other animals, especially endangered species. It offered many advantages over natural reproduction. In pairs that showed little sexual interest in each other, eggs and sperm could be extracted, mixed in the laboratory, and viable embryos could be introduced into the female's uterus. Also, if there was little genetic diversity in a zoo population, sperm from a donor at another location could be sent and used. By the end of the twentieth century, in vitro fertilization was being coupled with surrogate motherhood. Here,...
More than 90 of all men with MS and more than 70 of all women with MS report some change in their sexual life after the onset of the disease. Men most often report impaired genital sensation, decreased sexual drive, inability or difficulty in achieving and maintaining an erection, and delayed ejaculation or decreased force of ejaculation. Women report impaired genital sensation, diminished orgasmic response, and loss of sexual interest they also may be bothered by intense itching, diminished vaginal lubrication, weak vaginal muscles, and a reflex pulling together of the legs (adductor spasms).
Two major viral sexually transmitted diseases (STD), genital herpes and genital warts, dramatically increased in frequency during the sexual revolution of the 1960s and 1970s. The painful itchy lesions of genital herpes (Fig 20-6) and the accompanying local and systemic symptoms were described in Chapter 20. Dozens of recurrences, mainly attributable to HSV-2 but increasingly to HSV-1 also, may dominate the life of the hapless carrier. Genital warts, caused most commonly by the human papillomaviruses HPV-6 and HPV-11, can take the form of prolific excrescences on the external genitalia, perineum, vaginal introitus, penis, or anus (known as condyloma accuminatum (Fig. 18-3), or the form of a less conspicuous flat lesion on the cervix (condyloma planum) they are discussed in Chapter 18. Certain oncogenic HPV types, particularly types 16 and 18, produce cervical dysplasia which may progress over the course of many years to invasive cancer the same HPV types are also eti-ologically...
Clinical difficulties in sexual functioning can arise at any phase of the normal sexual response and can come about from a wide variety of causes. The phases represented in normal sexual response are respectively sexual interest sexual arousal sexual penetration sexual orgasm, post-sexual resolution and post-sexual feelings. At each phase of the emotional and physical response, male sexual functioning may be hindered. Factors involved in the likely aetiology of the respective disorders are dealt with later.
The sexual reproduction process requires a pair of distinct partners of opposite sexes to mate, hence the need for courtship, so that animals can find and attract prospective mates for producing offspring. It is the sexual interest of the opposite sexes that leads to mating therefore, copulation in most animals is preceded by a period of courtship. The mating of most lower animals is governed by endocrine secretions specific to certain seasons. In female mammals, receptivity to mating is called estrus, which is operative only for short periods during the year. Cows have several such periods of estrus during the year dogs have one or two.
Afew canines are monogamous, but only for a particular season. Some monkeys and apes, not including chimpanzees, follow this rule. Foxes may be monogamous, and the American beaver is one rare mammal that practices monogamy for life. Even in the higher mammals, including humans, monogamy causes a decline in sexual interest for the partner and eventually sexual relations may cease if there is no stimulus of novelty. There is also the other extreme, where the animals are solitary and only meet for copulation, such as the titi monkey.
It is believed that this development necessitated far more intensive child care and a closer bond between the parents, which nature then enforced by increasing the mutual sexual attraction of the parents through anatomical changes (large breasts and nonseasonal sexual receptiveness), and mental stimuli (an intense partner bond and monogamy). Greater infant dependency may also have stimulated a division of labor short-range food collecting, rearing, and teaching of the children being performed by women, and longdistance collecting, scavenging, hunting, and fighting by men. More complex social interaction during group living, hunting, and child care also led to the development of sign language and the first forms of speech. With greater handling skills, and an increasingly shared knowledge about hunting, food
Inquiry about potential endocrine-related symptoms should be routine when antipsychotic medications are prescribed. Monitoring should include changes in breast size, lactation, sexual interest and function, and, in women, menstrual history. Essential topics for discussion with patients include the subjective distress related to the emergence of any medication side effect and the impact of treatment-emergent side effects on willingness to take the antipsychotic medication. Patients will vary considerably in their subjective distress to sexual side effects (Wesselmann and Windgassen 1995), although the development of any sexual side effects is associated with increased risk of medication nonadherence (Perkins 2002). Long-term treatment adherence may benefit from education and discussion of the short- and long-term potential risks of hyperprolactinemia, and the risks and benefits of treatment (Hummer et al. 1999).
It is unclear whether asymptomatic hyperprolactinemia is of any clinical consequence, especially if the prolactin level is not extraordinarily elevated. In symptomatic patients with high prolactin levels, anti-psychotic dose reduction should always be considered as a first option, because hyperprolactinemia is usually dose related. In addition, there are now several prolactin-sparing antipsychotics available, including quetia-pine, olanzapine, and ziprasidone. Switching to one of these antipsychotics is thus a potential treatment option when dose reduction is not effective or feasible. Direct treatment of symptomatic hyperprolactinemia with a dopamine agonist (e.g., cabergoline, bromocriptine, amantadine) may be considered for patients who have had a good response to the current prolactin-elevating antipsychotic, who require depot antipsychotics, or who do not wish to switch medications (American Psychiatric Association 1997). There are numerous case reports of reduction...
Without group backup, a lone prehistoric or hominid hunter would not fare well. Loss of estrus would also seem to have disruptive social possibilities. Rape, fetish obsessions because males have no instinctual guide to what is sexy, and a double standard denying that females have sexual desires all are made possible by the lack of clear female signals. Anthropologist Sarah Hrdy suggests that the human pattern may simply resemble that of species such as orangutans, who show no visible estrus signals. Study subjects ranging from Connecticut college women to Kalahari hunter-gatherers have reported peaks of female sexual interest around their time of ovulation.
It is well known that androgen replacement restores sexual function in hypogonadal men. These include sexual desire (libido), sexual fantasies, sexual enjoyment and frequency of sexual thoughts, sexual activities, and erectile function. In younger hypogo-nadal men, sexual performance, including erectile dysfunction, is improved by androgen replacement therapy (13-17). In older men, erectile dysfunction is usually multifactorial other causes, such as vascular, neurogenic, psychogenic, medication-induced, and cavernosal problems may predominate. Improvement in erectile function by testosterone treatment of androgen-deficient older men may be minimal or not as significant as in younger subjects (18-20). Although objective data are limited, it is possible that in androgen-deficient older men whose erectile dysfunction has been improved by phosphodiesterase V inhibitors (e.g., Sildenafil, Vardenafil, and Tadalfil) sexual performance may benefit by cotreatment with testosterone through...
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