November 6th 2012LI: Limited information- Some people doing couples therapy added a step to the beginning: SEXOLOGICAL EXAMINATIONo Supposed to provide info on how everything works with actual hands on demonstration. o Hartman and phithia were first to do this. o Involves some touching from the therapist. o This is a preliminary and preparation for later homework exercises, reduces tension that couple had about touching. - Helen found they were making great progress with premature ejaculation, but then she started getting on to patients for not doing homework. o He having this problem would give a reason for her to hang on to him. If he gets cured, then he might go to find another lady.- The market has changed, in the beginning clients were only concerned with improving sex, but now markets deals with improving the whole relationship in general. Masters and Johnson paradigm is a LEARNING PARADIGM. - Hypnosis: 2 major people working with hypnosis is Theodore Barber and Martin Orne. - Ornes research has found that hypnosis and trance lies entirely within the hypnotic subject. The hypnotist is not important. It is a self induced program, a guide. They worked on susceptibility to trance and compared 3 conditions.- Actual trance state: - Simulated trance state: - Progressive Relaxation: object is to simply get the subject to relax and feel. Used to treat vaginismus. <<makes penetration painful if not impossible.- also used in treating phobias because once u can get the client to experience the event withoutpain and danger, the disorder is not repeated.- Another principle that is used is called Desensitization followed by Resensitization.- an offshoot of this type of therapy is called aversion.- this therapy is used for sexual objects are inappropriate (PEDOPHILES) - Readings on a penile straingage. A ring put around the penis which can expand and sends data that can be recorded on the measure of arousal. The idea is to change the object which will produce arousal. They will use “fade out, fade in” where the client looks at pictures of naked children or whatever aroused them before, and then they fade out that picture and fade in the picture of an adult woman. Over time, the object of arousal will change. - Aversion occurs when they try to speed it up by giving electric shocks upon arousal to the inappropriate object (punishment). Controversial because doesn’t work in fade out fade in technique. - Aversion is more for punishment for people who get aroused from little naked kids. Moral factor involved. Learning Paradigm: Intercourse is not permitted (last step). The client needs to respond to pleasurable stimulation without an object in mind. No touching of genitalia either. Touching of body (toes, fingertips,massage) and slowly work your way inward. When he begins to have erection that will last, then youmove on to more sensitive areas. This is called Sensate Focus (one partner is donor, other is receiver) <<used with all problems of arousal. Also used in treating females who are unable to achieve orgasm. Sensate focus works pretty well. - Once erection is stable and genitalia is stimulated, then you can move on to intercourse. But intercourse always starts with female on top. For masters and Johnson, an orgasm is an orgasm no matter how it is produced. GO OVER DIFFERENT TYPES IF THERAPYGroup Therapy: Homework done in private by each couple, but couples are together with therapist in allother sessions. You get cross couple communication which seems to help. The group acts as a disciplinary board to keep them on track. Cost is less. Females rarely have disorders of arousal. Vaginismus. Some will insist if the women has male partner, then some say male should insert cylinders to make him a part of it. Success rate is over 90% ans relapse rate is low.3 levels of orgasm:1. Pre orgasmia: women has never had an orgasm yet. a. Masturbation is best indicator of being able to have orgasmb. Sensate focus is used. 2. Anorgasmia:Males Disorder of orgasm:1. Premature ejaculation2. Retarded ejaculation: erection is achieved, but the orgasm doesn’t