Desire and Arousal

This topic was of particular interest to me, because I think nearly every person will encounter this as an issue either personally or with a partner at some point in their lives, and it will no doubt come up often with couples. I though the groups presented the topic very well, and covered many facets of the challenges in both males and females. The wiki page is comprehensive (thanks a lot guys, for setting the bar so high! :)), covering everything from DSM criteria, to assessment and treatment. I appreciate the plethora of articles as resources and enjoyed the comic relief, and especially agreed with the porn sentiments expressed by (go figure) Russell Brand. I heard a talk by Adam Savage on the subject of porn a while back that spoke to me. Luckily, I was able to find the clip. Should you care to give it a listen, it can be found here: http://themoth.org/posts/storytellers/adam-savage.

Dr. Berman Video

In the episode, there were many facets explored in the three relationships that Dr. Berman worked with, including medical factors (e.g. vaginal blood flow), emotional aspects (e.g. sexual trauma history and trust barriers), and physical stimulation (e.g. oral sex or kissing). Most were related to desire and arousal. The topics and approaches had varying success levels, but all yielded some positive outcomes for these three couples.

For the oldest couple, part of what Dr. Berman presumed was the issue was physiological, that the female partner may have been in peri-menopause, as evidenced by the results of her blood flow metric. To intervene in ways within their control, Dr. Berman worked to develop the couple’s communication around sexuality, such as each person’s fantasies, and encouraged the wife to rediscover her sexuality as she had been neglecting this part of herself. When they shared their respective fantasies, it was revealed that they were very compatible, but had never shared them with the other. The surprise they had at this revelation was noticeable in their faces. One intervention was to have the husband take control of an evening. The wife had a fantasy of her male partner overpowering her, and this seemed to strengthen his role as an empowered man. I was quite impressed with just how successful each of these interventions was for this particular couple. The evening during which the husband took control ended up being a fruitful date night. She seemed to be impressed by his choices on many things, such as her outfit and his restaurant choice. Most importantly, she was able to orgasm in a shared sexual experience, which had not happened in quite some time, according to their reports.

For the couple who were not yet married, the presumed issue was one related to difficulty trusting, that both the desire and arousal challenges on the part of the female partner were based on past trauma. Delving into this seemed to be effective at improving the degree of understanding that he had for her, which in turn fostered more compassion and patience on his part. Her desire for him to kiss her more was explored, and though the underlying concerns were never brought to the surface, they did report improvement in the frequency of kissing, for what this is worth. It is undetermined whether he enjoyed it, and whether this would be a sustained change.

The third couple had similar challenges. The female in this marriage, as with the just described female partner, did not show any signs of physiological arousal challenges and the issue instead was considered more psychological in nature. One difference in this couple was that the trust issues from past trauma (though not reported as sexual trauma) presumed to be part of the problem were on the part of the male, through his relationship with his father. Like the previously described male, he was challenged with rigid cleanliness standards, in this case influencing his interest in performing oral sex. While they too reported increased frequency, it was difficult to tell if there was second order change or just behavioral change. Another intervention used was for him to relinquish power during a rock climbing activity, then a blindfolded walk through town, aimed at helping him relinquish control to her.

Lastly, all three were given sex toys to use. This seemed somewhat successful for all as they reported liking them, but seemed especially important for the first couple I mentioned, as the vibrator resulted in her long-awaited orgasm. I was pleasantly surprised (following the last film we watched) with Dr. Berman’s style of therapy. She seemed to be more multi-faceted than the medical model I anticipated, and she seemed to offer her clients an unexpected degree of respect and openness to their preferred varieties of human sexual expression. I saw some validating and challenging questions that I would see encouraged in our training, and saw some specific interventions we might also use, such as sharing fantasies and histories to increase mental and emotional intimacy/connection, and using toys to increase the physical stimulation to add to the emotional stimulation that would bring the people closer to the orgasm threshold.