A Systems-Developmental Approach to Counselling Couples with Sexual Problems: Part I — Theoretical Framework

We present a two part model for the understanding and treatment of long-standing sexual problems, especially those involving desire discrepancy between partners. In Part I, a theoretical model is outlined in terms of the normal developmental patterns of relationship development in current Western culture. We then discuss the balances and imbalances that develop as a consequence of differences in styles of loving, which affect sexual expectations and behaviour. In Part II we will examine the implications of the theoretical model for therapeutic intervention.     

Genito-Pelvic Pain Through a Dyadic Lens: Moving Toward an Interpersonal Emotion Regulation Model of Women’s Sexual Dysfunction

Researchers and clinicians alike widely acknowledge the inherently interpersonal nature of women’s sexual dysfunctions given that both partners impact and are impacted by these difficulties. Yet theoretical models for understanding the role of interpersonal factors in women’s sexual dysfunctions are severely lacking and have the potential to guide future research and inform more effective interventions. The most widely studied sexual dysfunction in women that has espoused a dyadic approach by including both members of affected couples is genito-pelvic pain/penetration disorder (GPPPD). In this article we use the example of GPPPD to introduce a novel interpersonal emotion regulation model of women’s sexual dysfunction. We first review current knowledge regarding distal and proximal interpersonal factors in GPPPD. Then, we describe our theoretical model and consider relevant pain and sex-related research on emotion regulation processes—emotional awareness, expression, and experience—in the context of GPPPD, including sexual function, satisfaction, and distress. Next, we review how existing theories from the fields of chronic pain and sex and relationships research have informed our model and how our model further builds on them. Finally, we discuss the implications of our model and its applications, including to other sexual dysfunctions in women.     

A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology

Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or “spectra”). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.     

(Imagining) Erotic Mutuality: Negotiating Difference in Sexual Orientation in an Analysis

This article explores the clinical limitations of an exclusive adherence to the oedipal paradigm for the understanding of erotic material in the transference/countertransference in analytic treatments where the participants identify with differing sexual orientations. Its central argument posits that possibilities for recognizing developmentally significant, evolved connections with patients of all genders and sexual orientations is subtly circumscribed when understanding of these phenomena is partitioned chiefly by the “either/or” of a positive or negative form of oedipal desire.

The argument goes on to query and challenge formulations of a universal bisexuality as a satisfactory resolution to this conundrum, again, particularly when the 2 analytic partners claim different sexual orientations. Part object relations as residue of an early and ubiquitous polymorphous perversity are proposed as useful theoretical and clinical alternatives. Case material is also provided.     

Maintaining Sexual Desire in Long-Term Relationships: A Systematic Review and Conceptual Model

The most universally experienced sexual response is sexual desire. Though research on this topic has increased in recent years, low and high desire are still problematized in clinical settings and the broader culture. However, despite knowledge that sexual desire ebbs and flows both within and between individuals, and that problems with sexual desire are strongly linked to problems with relationships, there is a critical gap in understanding the factors that contribute to maintaining sexual desire in the context of relationships. This article offers a systematic review of the literature to provide researchers, educators, clinicians, and the broader public with an overview and a conceptual model of nonclinical sexual desire in long-term relationships. First, we systematically identified peer-reviewed, English-language articles that focused on the maintenance of sexual desire in the context of nonclinical romantic relationships. Second, we reviewed a total of 64 articles that met inclusion criteria and synthesized them into factors using a socioecological framework categorized as individual, interpersonal, and societal in nature. These findings are used to build a conceptual model of maintaining sexual desire in long-term relationships. Finally, we discuss the limitations of the existing research and suggest clear directions for future research.     

The Influence of Attachment Styles on Sexual Communication Behavior

Attachment theory is one of the major theoretical frameworks for understanding romantic relationships. Attachment styles are formed through interactions with caregivers and shape an individual’s expectations of subsequent interpersonal relationships. In this study, we examined how attachment styles influence participants’ ability to communicate with their partners about problems in their sexual relationship. A community sample of 81 couples engaged in two video-recorded discussions, one representing an aspect of the couple’s sexual relationship where the male partner wanted change and the second representing an aspect of the sexual relationship where the female partner wanted change. Conversations were then coded, with each person being rated on three positive communication dimensions (positive affect, offering solutions, and responsiveness) and three negative communication dimensions (hostility, negative affect, and unskilled communication behaviors). As predicted, attachment avoidance was related to more negative and less positive communication for both the individual and his or her partner. Our observational data did not reveal any significant effects of attachment anxiety on sexual communication. These results can be contrasted with findings from self-report studies that do suggest an anxious attachment adversely impacts sexual communication.     

Trauma-Related Beliefs as Mediators of Sexual Abuse Impact in Adult Women Survivors:

A 56-item measure of trauma-related beliefs was piloted with 59 female adult sexual abuse survivors. The measure includes four internally-consistent subscales which assess beliefs reflective of Finkelhor and Browne's (1986) traumagenic dynames model: Self-Blame/Stigmatization, Betrayal, Powerlessness, and Traumatic Sexualization. Multiple regression analyses examined the relationships between trauma-related beliefs and other psychological/behavioral outcomes. Self-Blame/Stigmatization beliefs predicted lower self-esteem, interpersonal problems, depression, anxiety, and overall psychological distress. Betrayal beliefs predicted interpersonal problems, an external locus of control, and sexual problems. Powerlessness beliefs predicted lower self-esteem, depression, and external locus of control, and sexual problems. Powerlessness beliefs predicted lower self-esteem, depression, and external loxus of control. Traumatic sexualization beliefs predicted anxiety and sexual avoidance. Results are discussed in terms of implications for theoretical model development and treatment planning for sexual abuse survivors.     

Absent in theory,invisible in practice: Queering HBSE for a more inclusive social work profession

A sound theoretical foundation is a necessary element of social work education that prepares students to confront the challenges of practice with critical knowledge of the human experience. Queer theory is a strength-based framework for understanding sexual and gender identities that fall outside of the current social norms, and offers a highly relevant and useful pathway for the education of social work practitioners. Despite its utility for enhancing understanding and acceptance of gender and sexual minority (SGM) people, it is underutilized in social work compared with other disciplines. Additionally, this study reports on the gender and sexual identities of social work students and their endorsement of help-seeking behaviors related to issues of gender and sexual nonconformity. These empirical-based perspectives undergird the tenets of queer theory and support its application in research endeavors aimed at better understanding the human experience. A theoretical and empirical-based argument is made for the queering of HBSE to strengthen both explicit and implicit curricula in social work education. This study expands on the limited usage of queer theory within social work and directly challenges the normative and binary nature of sexual and gender identity evident within the professional literature and implications for education and research are offered.     

What Theories and Methods From Relationship Research Can Contribute to Sex Research

Sexual and relationship satisfaction tend to be closely linked in the context of romantic relationships. Understanding how sexual processes influence relationships and how aspects of the relationship influence a couple’s sex life can provide insight into the maintenance of sexual desire and satisfaction over time. In this article, we review how theories and methods that form the foundation for relationship research have made—and will continue to make—sexuality research a stronger, more theoretical, and methodologically sophisticated science. We discuss the key theories that have been used to advance our understanding of who is more likely to be sexually satisfied in relationships, when sex is most satisfying, and how couples can have more satisfying sex lives and relationships. We then provide an overview of dyadic and repeated-measures designs and demonstrate how the use of these types of research methods allows relationship and sexuality researchers to answer novel and nuanced questions about how romantic partners influence each other, as well as how sexual processes unfold in couples’ daily lives and over time. Throughout the review, we highlight what we see as fruitful directions for future research at the intersection of sexuality and relationships.     

Feminist and queer criminology: A vital place for theorizing LGBTQ youth

Creating safe environments for lesbian, gay, bisexual, transgender, and queer and/or questioning (LGBTQ) youth has become a significant public health concern. Despite the disparities in the risk factors associated with identifying as a member of the LGBTQ community, the theoretical frameworks for understanding these issues, particularly within criminology, have been limited. The purpose of this work is to review the historical treatment of gender and sexual orientation within criminology. More specifically, this work reviews how gender was introduced into criminology through the work of feminist criminology, followed by the need for theorization that further analyzed sexual orientation. This then became the focus of queer criminology. After tracing the historical development of gender and sexual orientation, the author uses the theoretical foundations of both to show how it applies to recognizing the issues faced by LGBTQ youth. Finally, the author discusses why consideration of these frameworks is paramount in understanding the issues faced by LGBTQ youth, as well as how such consideration and understanding can help mend the existing gap in providing safer environments for LGBTQ youth.     

Human Sexual Development is Subject to Critical-Period Learning: Paradigm-Shifting Implications for Sexual Therapy and for Child-Rearing

ABSTRACT. Objectives: Our study was designed to study the origins of the variation in sexual interest in normal adult human beings. Methods: Retrospective data were entered anonymously by 2,201 female participants and 1,242 male participants using computer-assisted self-interview. Results: In both sexes, participants who began sexual behaviors before age 13 had the highest interest in sex as adults as measured by frequencies of masturbation and partner sex. Our findings were consistent with learning to function sexually being subject to critical-period learning. Conclusions: Critical-period learning provided a theoretical basis for understanding variation in interest in sex among adult individuals of both sexes. These results have implications for understanding the origins of hypoactive sexual desire, and they also have implications for child-rearing practices.     

Theoretical perspectives of male sexual abuse: conceptualization of a case study

The purpose of this article is to demonstrate the traumatic impact that sexual abuse can have on a young male's development by addressing mediating dispositions that can render a child vulnerable to the effects of sexual abuse. Consideration is given to three different theoretical perspectives that are not exclusive to male victims but shed light on the impact that sexual abuse can have on the development of a young boy. These perspectives include early family relationships and attachment theory, developmental psychopathology, and trauma theory. These theoretical lenses provide a conceptual understanding into why some victims are vulnerable to the effects of sexual abuse. Each theoretical view is applied to a case study of an adolescent male with a history of early trauma and sexual abuse. Clinical implications are discussed.     

Theoretical Perspectives of Male Sexual Abuse: Conceptualization of a Case Study

The purpose of this article is to demonstrate the traumatic impact that sexual abuse can have on a young male's development by addressing mediating dispositions that can render a child vulnerable to the effects of sexual abuse. Consideration is given to three different theoretical perspectives that are not exclusive to male victims but shed light on the impact that sexual abuse can have on the development of a young boy. These perspectives include early family relationships and attachment theory, developmental psychopathology, and trauma theory. These theoretical lenses provide a conceptual understanding into why some victims are vulnerable to the effects of sexual abuse. Each theoretical view is applied to a case study of an adolescent male with a history of early trauma and sexual abuse. Clinical implications are discussed.     

A Cognitive Ecological Model of Women'S Response to Male Sexual Coercion in Dating

Summary

We offer a theoretical model that consolidates background, environmental, and intrapersonal variables related to women'S experience of sexual coercion in dating into a coherent ecological framework and present for the first time a cognitive analysis of the processes women use to formulate responses to sexual coercion. An underlying premise for this model is that a woman'S coping response to sexual coercion by an acquaintance is mediated through cognitive processing of background and situational influences. Because women encounter this form of sexual coercion in the context of relationships and situations that they presume will follow normative expectations (e.g., about making friends, socializing and dating), it is essential to consider normative processes of learning, cognitive mediation, and coping guiding their efforts to interpret and respond to this form of personal threat. Although acts of coercion unquestionably remain the responsibility of the perpetrator, a more complete understanding of the multilevel factors shaping women'S perception of and response to threats can strengthen future inquiry and prevention efforts.     

Exploring and Adapting a Conceptual Model of Sexual Positioning Practices and Sexual Risk Among HIV-Negative Black Men Who Have Sex With Men

Estimates show a 50% lifetime human immunodeficiency virus (HIV) risk among Black men who have sex with men (BMSM) in the United States(U.S.). Studying the dynamics of sexual positioning practices among BMSM could provide insights into the disparities observed among U.S. groups of men who have sex with men (MSM). This study explored sexual positioning dynamics among HIV-negative BMSM and how they aligned with a theoretical model of sexual positioning and HIV/sexually transmitted infection (STI) risk among MSM. In-depth qualitative interviews were conducted with 29 HIV-negative BMSM between ages 25 and 35 in Los Angeles. Comments related to sexual behaviors were reviewed for relevance regarding oral or anal sexual positioning practices. Data presented represent the range of themes related to decision making regarding sexual positioning. Personal preference, partner attraction, HIV avoidance, and feeling obligated to practice partner preferences influenced sexual positioning. Drug use also affected decision making and was sometimes preferred in order to practice receptive anal intercourse. These variables build on the conceptual model of sexual positioning practices and sexual risk, and add understanding to the relationship between preferences, practices, and risk management. Future research on risk among HIV-negative BMSM should quantify the relative impact of personal preferences, partner attraction, partner type, compromise, and substance use on sexual positioning practices and risk.     

The Role of Sexual Communication in Couples’ Sexual Outcomes: A Dyadic Path Analysis

In a study of 142 couples, we gathered survey data to show how sexual communication influences sexual and relationship satisfaction as well as sexual and orgasm frequency. In two dyadic data path analyses, we observed the significant paths of influence that sexual communication has on sexual and relationship satisfaction, as well as sexual and orgasm frequency. Our findings revealed greater amounts of sexual communication were associated with increased orgasm frequency in women and greater relationship and sexual satisfaction in both sexes. We also observed important differences in the associations of sexual communication and general communication on satisfaction levels. With these analyses, we expand the current literature to broaden our understanding of the role that sexual communication plays in committed relationships.     

Confessions of an Identity Junkie

How is it that sexual identity can become such a troubling preoccupation? In this paper, the author explores the problems she has experienced regarding sexual identification due to fluctuating desires and changing circumstances. Charting a course through her personal life using the pioneering theoretical work of Jeffrey Weeks, Judith Butler, and Donna Haraway, she intimately examines the contradictions, difficulties, and possible political functions of sexual identification.