Julia R. Heiman

Affective and physiological sexual response patterns: The effects of instructions on sexually functional and dysfunctional men

To more clearly characterize the patterns of cognitive-affective and physiological responses concomitant with male sexual dysfunction, the present study compared 14 sexually dysfunctional and 16 sexually functional men. All individuals listened to two sexually explicit tapes and engaged in a self-generated fantasy, while genital, heart rate and scaled cognitive affective responses were recorded. Two types of instructions, a performance demand set and a non-demand sensate focus set, preceded the erotic tapes in counterbalanced order. As predicted, dysfunctional men showed less genital tumescence to tapes preceded by the demand than the non-demand instructions. Contrary to expectation, functional men showed greater penile tumescence to the tapes preceded by demand instructions. Self-reported sexual arousal did not follow the penile tumescence pattern but instead indicated that the dysfunctional sample was significantly less subjectively aroused to the tapes and fantasy. There were other significant differences between the groups. Dysfunctional men showed greater general psychological distress, as measured by the SCL-90, including elevated somaticism, anxiety and depression scores. During the experimental session, dysfunctional men also evidenced greater awareness of a variety of physiological responses, as well as more negative and fewer positive cognitive-affective states. These data are discussed in terms of the interaction of affective and physiological responses, differences in contextual meanings of instructional sets given the presence of a dysfunction, and theoretical and clinical conceptualizations of male sexual functioning.

Effects of erotic stimuli on sexually functional and dysfunctional women: Multiple measures before and after sex therapy

Abstract A group of 11 women entering sex therapy for treatment of low arousal, and a comparison group of 11 women experiencing no arousal deficit, viewed an erotic film, listened to an erotic audiotape, and engaged in sexual fantasy during two experimental sessions. Session I occurred pre-treatment for the low arousal group. Session II occurred post-treatment. The adequate arousal group was tested at comparable points in time. Sexual arousal was measured subjectively by self-rating and physiologically by a vaginal photoplethysmograph. Contrary to expectation, the two groups showed equivalent significant increases in physiological response during the erotic stimuli in both sessions. However, the adequate arousal group rated subjective arousal significantly higher than the low arousal group in Session I, while no difference was found between the groups in Session II. Significant correlations were present between physiological response and ratings of several affective reactions to the audiotape, though few significant correlations were found between physiological and subjective sexual arousal measures. These data indicate a discrepancy between genital responses and ratings of sexual arousal for which several interpretations are offered.

The Role of Cultural Values in the Prevention and Treatment of Sexual Problems

The psychotherapist is often perceived as an objective, dispassionate arbiter of mental health, free of cultural biases. In point of fact, however, the psychotherapist is influenced by the culture in which he or she lives (London, 1964). The therapist’s conceptualization of human personality is inevitably shaped by the values of the dominant elements of his or her society. The danger in this cultural bias of therapists is that psychotherapy may become nothing more than an acculturation process. Culturally valued behavior may become synonymous with “mental health,” and culturally disapproved behavior may be labeled “mental illness,” a point that has been made repeatedly by Szasz (1960). In such a situation, the psychotherapist may tend to emphasize cultural conformity at the expense of the client’s individual needs.