ABSTRACT
It is not surprising that the land that gave us Tolstoy, Dostoyevsksy, and Chekhov, Tchaikovsky, and Rachmaninoff, as well as Pavlova, Nureyev, and Baryshnikov, would give us a romantic view of sexuality. It is in this chapter, and no other, that the idea of love is discussed in connection with sex. Fate also makes an appearance in the discussion of the existence of a hard-wired sexual constitution. According to some Russian sexologists, all men and women have a sexual constitution, which is a relatively fixed and stable level of sexual desire (strong, medium, or weak). If a person happens to marry someone with a different sexual constitution, therapy is geared toward helping that person, or the couple, understand that this is “just the way it is.” This stands in stark contrast to the time and energy many American couples devote to trying to change or increase the level of sexual desire in the partner with less desire. While the notion of a sexual constitution may be foreign to many readers, challenging couples to find happiness together despite sexual differences is a treatment option that may be revisited upon reading this chapter.
Sexual dysfunctions in Russia are, however, often the focus of aggressive and multidisciplinary treatment including talk therapy, medication, and mechanical devices. The latter treatment is primarily geared toward resolving male sexual dysfunction, specifically erectile dysfunction. Awareness of the importance of helping women experience orgasm is a more recent phenomenon in Russian sex therapy and in Russian culture.
The authors of this chapter interviewed eight sex therapists (physicians and psychologists), reviewed the vast treatment literature, and present two case studies in order to show a view of Russian sexuality and sex therapy with the history, politics, culture, and religion of the country providing the contextual but ever changing backdrop.
