What is a Sexual Dysfunction

Is referred to sexual dysfunction for all conditions where there is an inhibition of desire, arousal or orgasm, or for conditions where there is pain during sexual activity. However, diagnosis is made only when the presence of these conditions create a significant individual or relational disease. According to the origin of the disorder, sexual dysfunction can be differentiated as organic, when causes are exclusively physical or consequential of drugs assumption; psychogenic, when the genesis and maintenance of the symptom are only attributable to psychological factors; or combination, if both, psychological and general medical conditions, including use of certain substances effects, are responsible for developing and / or maintenance of symptom.

The psychological component of sexual dysfunction

Generally, even when we are dealing with purely organic sexual dysfunction, over time it triggers a psychological mechanism of maintenance of the symptom. In erectile dysfunction, for example, as a self-fulfilling prophecy, the expectation of failure, it returns the same failure as the end result. In most cases this was because during sexual activity the focus is on dysfunctional thoughts, or anticipatory negative thoughts, like "I'll make it?", " I'll be able to achieve an erection?" "I get excited”. These thoughts create selective attention on dysfunctional stimuli, diverting attention from the functional ones, that are essential to obtain a functional sexual response. In this way a vicious circle in which sexual function is constantly undermined is created. In cases of premature ejaculation, beyond the initial cause, over time it triggers a mechanism of control, where man want to control the ejaculatory time, and the solution adopted is to try to "not hear", to be distracted. This only adds to the automated system because the basic problem is in "no feel", which leaves space for the imagination that is sweeping much of the physical sensations. In cases of delayed orgasm, on the contrary, it triggers the mechanism of contrast, so man try to speed up focusing on the concrete, the "feel", leaving out the imagination that is much more powerful and immediate. So, sexuality becomes a practice very hard and very boring. Education, unrealistic expectations, typical sexual interactions, beliefs and values that may be the result of cultural learning and experience more or less positive about sex, can undermine the performance of the complete sexual response.


Psychotherapy, often associated with pharmacological support, is the treatment of excellence for sexual disorders with an important psychological component. The cognitive-behavioral therapy approach is one that has been shown to have the highest expectations of effectiveness in this area. It is a type of brief intervention, focused to the symptom, and it can be individual or couple, but as sexual dysfunction manifest their disturbance in the relationship with the partner, is in the couple therapy that gets maximum results , also going to act on the report. The therapist tries to resolve the vicious cycle that feeds the problem and that leads the person to increase levels of emotional activation (tension, anxiety, fear, anger, shame, sadness ...) losing, in most cases, the pleasure in sexual activities and leave space to worry that such symptoms cause. The therapist uses cognitive and behavioral techniques, non-drug, that are able to reorganize the body's natural processes in a functional sense. It is expected therefore an active role from the couple, who will be implement in their intimacy erotic-educational exercises, with according to a precise protocol, that will be assigned to them during the course of treatment. The goal is to create a climate of cooperation in a context in where performance is not important and to remove the emotions associated with dysfunctional sexuality, thereby restoring a dimension of pleasure.

By Doctor Helen Casale
Member of Psychologist of Tuscany Order n. 4972.
The Doctor receives:
- Centro di Cognitivismo Clinico, via delle Porte Nuove n.10, Florence, Italy.

For informations call +39 347.8924814