Sex therapy

Berry, Michael and Barker, Meg John (2015). Sex therapy. In: Richards, Christina and Barker, Meg John eds. Handbook of the Psychology of Sexuality and Gender. Basingstoke: Palgrave MacMillan, pp. 353–373.



It is difficult to pinpoint an exact moment when sex therapy began. While the use of psychology and psychotherapy, as they are currently understood, in treating sexual issues is a relatively recent phenomenon, human interest in sexual satisfaction is a timeless issue and ancient civilizations had a wide variety of strategies for dealing with sexual problems. Historical research suggests that the ancient Greeks and Romans, for instance, used a panoply of herbal remedies, magical devices such as amulets and charms, and prayer to gods, as means of dealing with sexual difficulties (McLaren, 2007). During the middle ages, Western Europeans used similar methods (Taberner, 1985) as well as attributing sexual problems to suspected ‘witches’: usually poor, eccentric, or socially marginal women who were thought to have robbed people of their sexual ‘potency’ (Rider, 2006). Clearly, while our interest in sexual health and functioning can be traced back through the millennia, accepted treatment methods have changed dramatically since the days of witch-burning and Spanish fly . Nevertheless, our understanding of sexual therapies can still benefit greatly from being considered within a sociohistorical context, given that accepted treatments continue to reflect and perpetuate prevailing cultural understandings of sex, gender and selfhood.

In this chapter, we take account of key sociocultural factors as we outline some of the core principles of sex therapy and illustrate the key psychological bases of current concepts and debates. First, we describe the recent history of sex therapy, tracing the trajectory of the discipline from Freud to the present day, and identifying some of the principal psychological theories and psychotherapeutic models used in the field. We then present a number of the current debates in sex therapy, describing the critical views of psychologists and therapists who have challenged traditional notions of sexual behaviour, gender roles, and diagnostic categories. Finally, we identify some of the implications that sex therapy research and practice—especially critical approaches to these—have for applied psychology and psychotherapy, and indicate future directions for clinical practice and for research.

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