ABSTRACT

This chapter explains the clinical evolution of family therapy as the context for sex therapy and continues with the context in which sexual issues are presented in family therapy. The earliest understanding of sexual dysfunction was as 'moral degeneracy', with abstinence and moderation as therapy, and stemmed from the work of Krafft-Ebing. The second understanding of sexual dysfunction focused on 'psychosexual immaturity' with psychoanalysis as the treatment, as reflected in the work of Freud and Havelock Ellis. When couples can relate their therapy to their marital contract and are experiencing moderate, rather than severe, marital stress, the sex therapy often facilitates resolving other marriage problems. During many of their sexual developmental years, people are 'single'. The hormone androgen can increase the sexual drive without altering consciousness; it increases the libido and performance of both men and women. Fears and anxiety about sexual activity often are found in heart-attack patients, but studies show that these fears are not substantiated.