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Sensate focus is a sex therapy technique introduced by the Masters and Johnson team. [1] It works by refocusing the participants on their own sensory perceptions and sensuality, instead of goal-oriented behavior focused on the genitals and penetrative sex. Sensate focus has been used to treat problems with body image, erectile dysfunction, orgasm disorders, and lack of sexual arousal. [2]
The exercises are conducted by the couple at home, between therapy sessions. Although the couple are nude or in underwear and touching each other during the exercises, they are instructed to abstain from sexual intercourse during or close to the sessions. [3] [4] Both participants are instructed instead to focus on their own varied sense experience, instead of focusing on performance or orgasm. [5] [6] Initially, the emphasis is on touching in a mindful way for oneself without regard for sexual response or pleasure for oneself or one's partner. [7] [8] A sex therapist will usually guide the timing and technique of the sensate focusing. In the first stage, the couple may touch each other's bodies excluding breasts and genitals. They are encouraged to enjoy and become increasingly aware of the warmth, texture and other qualities of their partner's skin. Participants attend to whatever they find interesting in each other, rather than attend to what they think the other wants.
Contact with the breasts, or male or female genitalia is banned at least for the first initial session, but other aspects of intimacy are explored: touching, talking, hugging, kissing, and so on. This includes taste, smell, and sound, as partners are encouraged to talk to each other, to express emotion, and to encourage each other.
The aim here is to minimize pressure and expectations, and to appreciate new sensual possibilities. Patients often report an improvement in their sex life generally with less anxiety. As the man reports increasing awareness and attention paid to these holistic sense aspects of sex, potency often returns. This works well for women too. Women report more sensation in their vagina, and lubrication.
The second stage increases the touch options to include breasts. Sensation and gathering information about the partner's body is still encouraged and intercourse and touching of the genitals is still forbidden. The participants then use a technique of placing their hand over their partner's hand in order to show what they find pleasurable in terms of pace and pressure. Learning about the partner's body is still the goal rather than pleasure. Further stages gradually re-introduce touching of breasts and genitals, then intercourse. Orgasm is never the focus.
This is also used as a treatment for impotence in males, and arousal difficulties, especially where anxiety is involved. [9] Because of performance anxiety in men, the obsessional focus on the penis can result in impotence. The therapist will encourage the man to forget about his penis, and forget about his partner's genitals, and instead concentrate on the sensual possibilities available in the feel of his own and his partner's skin, hair, mouth, body, (breasts), etc.
Erectile dysfunction (ED), also referred to as impotence, is a form of sexual dysfunction in males characterized by the persistent or recurring inability to achieve or maintain a penile erection with sufficient rigidity and duration for satisfactory sexual activity. It is the most common sexual problem in males and can cause psychological distress due to its impact on self-image and sexual relationships. Majority of ED cases are attributed to physical risk factors and predictive factors. These factors can be categorized as vascular, neurological, local penile, hormonal, and drug-induced. Notable predictors of ED include aging, cardiovascular disease, diabetes mellitus, high blood pressure, obesity, abnormal lipid levels in the blood, hypogonadism, smoking, depression, and medication use. Approximately 10% of cases are linked to psychosocial factors, encompassing conditions like depression, stress, and problems within relationships.
Orgasm, or sexual climax, is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the pelvic region characterized by sexual pleasure. Experienced by males and females, orgasms are controlled by the involuntary or autonomic nervous system. They are usually associated with involuntary actions, including muscular spasms in multiple areas of the body, a general euphoric sensation, and, frequently, body movements and vocalizations. The period after orgasm is typically a relaxing experience, attributed to the release of the neurohormones oxytocin and prolactin as well as endorphins.
A cock ring or cockring is a ring worn around the penis, usually at the base. The primary purpose of wearing a cock ring is to restrict the flow of blood from the erect penis to produce a stronger erection or to maintain an erection for a longer period of time. Medically, they are sometimes used on their own, or in conjunction with a penis pump to assist in the management of erectile dysfunction. Genital adornment is another purpose, as is repositioning the genitals to provide an enhanced appearance.
The Masters and Johnson research team, composed of William H. Masters and Virginia E. Johnson, pioneered research into the nature of human sexual response and the diagnosis and treatment of sexual disorders and dysfunctions from 1957 until the 1990s.
The coital alignment technique sex position is used primarily as a variant of the missionary position and is designed to maximize clitoral stimulation during sexual intercourse. This is achieved by combining the "riding high" variation of the missionary position with pressure-counterpressure movements performed by each partner in rhythm with coitus.
Anorgasmia is a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation. Anorgasmia is far more common in females than in males and is especially rare in younger men. The problem is greater in women who are post-menopausal. In males, it is most closely associated with delayed ejaculation. Anorgasmia can often cause sexual frustration.
Premature ejaculation (PE) occurs when a man expels semen soon after beginning sexual activity, and with minimal penile stimulation. It has also been called early ejaculation, rapid ejaculation, rapid climax, premature climax and (historically) ejaculatio praecox. There is no uniform cut-off defining "premature", but a consensus of experts at the International Society for Sexual Medicine endorsed a definition of around one minute after penetration. The International Classification of Diseases (ICD-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse.
Sexual stimulation is any stimulus that leads to, enhances and maintains sexual arousal, and may lead to orgasm. Although sexual arousal may arise without physical stimulation, achieving orgasm usually requires it.
Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction as a "person's inability to participate in a sexual relationship as they would wish". This definition is broad and is subject to many interpretations. A diagnosis of sexual dysfunction under the DSM-5 requires a person to feel extreme distress and interpersonal strain for a minimum of six months. Sexual dysfunction can have a profound impact on an individual's perceived quality of sexual life. The term sexual disorder may not only refer to physical sexual dysfunction, but to paraphilias as well; this is sometimes termed disorder of sexual preference.
The human sexual response cycle is a four-stage model of physiological responses to sexual stimulation, which, in order of their occurrence, are the excitement, plateau, orgasmic, and resolution phases. This physiological response model was first formulated by William H. Masters and Virginia E. Johnson, in their 1966 book Human Sexual Response. Since that time, other models regarding human sexual response have been formulated by several scholars who have criticized certain inaccuracies in the human sexual response cycle model.
Sex therapy is a therapeutic strategy for the improvement of sexual function and treatment of sexual dysfunction. This includes dysfunctions such as premature ejaculation and delayed ejaculation, erectile dysfunction, lack of sexual interest or arousal, and painful sex ; as well as problems imposed by atypical sexual interests (paraphilias), gender dysphoria, highly overactive libido or hypersexuality, a lack of sexual confidence, and recovering from sexual abuse ; and also includes sexual issues related to aging, illness, or disability.
Sexual medicine or psychosexual medicine as defined by Masters and Johnsons in their classic Textbook of Sexual Medicine, is "that branch of medicine that focuses on the evaluation and treatment of sexual disorders, which have a high prevalence rate." Examples of disorders treated with sexual medicine are erectile dysfunction, hypogonadism, and prostate cancer. Sexual medicine often uses a multidisciplinary approach involving physicians, mental health professionals, social workers, and sex therapists. Sexual medicine physicians often approach treatment with medicine and surgery, while sex therapists often focus on behavioral treatments.
Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.
A sexless marriage is a marital union in which little or no sexual activity occurs between the two spouses. The US National Health and Social Life Survey in 1992 found that 2% of married respondents aged 18 to 59 reported no sexual intimacy in the past year. Comparatively 92% of married respondents aged 65 to 80 reported no sexual intimacy in the past year. The definition of a non-sexual marriage is often broadened to include those where sexual intimacy occurs fewer than ten times per year, in which case 20 percent of the couples in the National Health and Social Life Survey would be in the category. Other studies show that 10% or less of the married population below age 50 have not had sex in the past year. In addition less than 20% report having sex a few times per year, or even monthly, under the age 40.
Delayed ejaculation (DE) describes a man's inability or persistent difficulty in achieving orgasm, despite typical sexual desire and sexual stimulation. Generally, a man can reach orgasm within a few minutes of active thrusting during sexual intercourse, whereas a man with delayed ejaculation either does not have orgasms at all or cannot have an orgasm until after prolonged intercourse which might last for 30–45 minutes or more. Delayed ejaculation is closely related to anorgasmia.
Lesbian sexual practices are sexual activities involving women who have sex with women (WSW), regardless of their sexual orientation. A woman who has sex with another woman may identify as a lesbian if she is exclusively sexually attracted to women, or bisexual if she is not exclusively sexually attracted to women, or dispense with sexual identification altogether. The term may also be applied to a heterosexual or asexual woman who is unsure of or is exploring her sexuality.
Stephen Barrett Levine is an American psychiatrist known for his work in human sexuality, particularly sexual dysfunction and transsexualism.
Sexuality can be inscribed in a multidimensional model comprising different aspects of human life: biology, reproduction, culture, entertainment, relationships and love.
Postorgasmic illness syndrome (POIS) is a syndrome in which people have chronic physical and cognitive symptoms following ejaculation. The symptoms usually onset within seconds, minutes, or hours, and last for up to a week. The cause and prevalence are unknown; it is considered a rare disease.
Although spinal cord injury (SCI) often causes sexual dysfunction, many people with SCI are able to have satisfying sex lives. Physical limitations acquired from SCI affect sexual function and sexuality in broader areas, which in turn has important effects on quality of life. Damage to the spinal cord impairs its ability to transmit messages between the brain and parts of the body below the level of the lesion. This results in lost or reduced sensation and muscle motion, and affects orgasm, erection, ejaculation, and vaginal lubrication. More indirect causes of sexual dysfunction include pain, weakness, and side effects of medications. Psycho-social causes include depression and altered self-image. Many people with SCI have satisfying sex lives, and many experience sexual arousal and orgasm. People with SCI may employ a variety of adaptations to help carry on their sex lives healthily, by focusing on different areas of the body and types of sexual acts. Neural plasticity may account for increases in sensitivity in parts of the body that have not lost sensation, so people often find newly sensitive erotic areas of the skin in erogenous zones or near borders between areas of preserved and lost sensation.