PSYC 436 Chapter Notes -Masters And Johnson, The Sensuous Woman, Sex Therapy

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19 Apr 2012
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PSYC 436
Reading Pg. 381
The Future of Sex Therapy: Specialization or Marginalization?
Yitzchak M. Binik & Marta Meana
Abstract and Introduction:
The practice of sex therapy gained professional and popular
acceptance since the publication of Masters and Johnson 1970
book: Human Sexual Inadequacy
The immediate future of this field is assured, as public demand
fuels the need for more information and pharmacology institutes
focus on finding medical approaches that promise a more fulfilling
sex life
Consequently, this popularity and institutionalization may have a
marginalization effect, as sex therapy begins to be thought of as a
special form of therapy requiring highly specialized training
Therefore, the authors are investigating the future or sex therapy,
and whether a re-calibration is in order
Creating the “Sex Therapy” Brand
Origin of the term “Sex Therapy
oMasters and Johnson might have first used the term in their
1958 grant proposal, but those documents have been lost
oTerm linked to the publication of Human Sexual Inadequacy
o1974 – professional literature referenced “sex therapy”
Sex therapy as a novel approach to treat sexual dysfunction using:
oPsychoeducational
oTime-limited intervention
oBehavioral homework techniques
oCouple communication training
Conceptualized as manifestations of underlying conflict in the
individual or couple
Treatment: target conflicts rather than sexual symptoms
oBinik & Meana: believe this approach is not sufficiently
different from other psychotherapies and does not warrant a
special status
oWhy did it develop as a specialization?
Public: finally had a “legitimate profession to consult
about sexual dysfunction
Health Professionals: finally there was a group to refer
patients to
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Taking Sex Therapy to the Public
Time hailed Masters and Johnson’s Human Sexual Inadequacy as
pioneering work, while contrasting it with uncertain information
presented in two self-help best sellers published around the same
time: Everything You Wanted to Know About Sex But Were to
Afraid to Ask (Reuben, 1969) and The Sensuous Woman (Garrity,
1971)
oAs a result: therapists honed in the publics demand for self-
help books and videos
oRadio, TV, and sex advice columns became important
communication channels for therapists
oSex therapists became characters in movies and TV shows,
ie. Sex and the City
The term “sex therapy” has become a brand name in the Western
world
oInternet: sexual information websites
oSexual advice pod-casts available
oGoogle search (in 2007) – yielded 598,000 hits for “sex
therapy”, outnumbering “couples therapy” and “marital
therapy”
Reports of sex therapy clinics and practitioners outside of Western
culture
oEx. Avasthi, Sharan, & Nehra, 2003
From Popularity to Institutionalization
Professional legitimacy was harder won than public acceptance
Behavior therapy movement and non-psychoanalytic medical
community in the 1970-80s generally accepted Masters and
Johnson type of sex therapy
oCriticized by non-behaviorally oriented psychotherapists (ie.
Shainess, 1971) – worried it would depersonalize sex
DSM-III (1980)
oReflected growing interest in sexual dysfunction
oCreated new category of psychosexual dysfunctions (ie.
vaginismus)
  shift towards symptoms and their
operationalization
Currently: CBT, most psychiatry and gynecology residency
programs have dropped sexuality from its agenda
oEven though most sex therapy techniques apply CBT to
treatments of sexual dysfunction
Only professional specialty in which interest in human sexuality
has grown: urology
oEstablished an international sexual medicine movement
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Will the “Real” Sex Therapist Please Stand Up?
At the time, there were few or any legal restrictions on the use of
the term “sex therapist
oSome people from various backgrounds were advertising
themselves as sex therapists
oUnregulated growth; increasing professional, ethical and
legal concerns
  Lead to the development of self-regulating sex
therapy associations, such as the American
Association of Sexuality Educators, Counselors, and
Therapists
Accepted professionals from varying disciplines
so long as they could demonstrate knowledge
and competence about sexual functioning and
therapy
o Raised professional standards of sex
therapy
Positive side: specialization breeds expertise
Negative side: breed general relinquishing of responsibility by
non-specialists and expert superiority
oQuestions posed by Binik & Meana:
1. Is this distinction sufficient to warrant this
supposed specialization?
2. Does this claim to specialization promise to deliver
more than it can?
Sex and the Other Psychotherapies
All major psychotherapeutic orientations are named in accordance
with:
oTheory underlying the therapy (ie. psychoanalytic,
cognitive-behavioral)
oMode of delivery (ie. family, couple or group therapy)
oDefining techniques (ie. play or narrative therapy)
  Interventions are a conglomeration of well-known
techniques/approaches that target a particular
symptom or problem
  Techniques are applicable to a number of mental or
emotional problems
Sex therapy functions outside of these assumptions
o“Sex therapy” rather than “sexual dysfunction therapy
Binik & Meana: semantic argument, but unique use
of language carry meaning and can reflect
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