3. Specific treatment

Many of the techniques described in the foregoing paragraphs are also applied in the treatment of patients who do not have a regular partner and those who are not (exclusively) heterosexual. Touching and self-stimulation exercises can help to overcome an aversion to sex, a negative self- image, the fear of losing self-control which sometimes characterizes problems of arousal and sexual desire, and anorgasmia. Learning to control the pelvic floor muscles and to relax them at the appropriate moment can also benefit sexual functioning. The basic principles of therapy for vaginismus, premature ejaculation, anorgasmia or anhedonic orgasm disorder also apply to single patients. Erectile problems which occur only during intercourse, not during masturbation, are difficult to treat without the involvement of the partner, although it is possible to use cognitive behavioural therapy designed to reduce the fear of failure, increase self-confidence and improve the patient’s perception of his or her own body. Group therapies have been developed for women with orgasm disorders, for men with erectile problems and for couples with various types of sexual dysfunctions. A course of treatment applies the techniques and exercises described in the foregoing paragraphs within a number of structured group sessions. Two type of other treatments need special attention because they require special powers and authorities:

  1. medical treatment
  2. psychotherapy