Sex Therapy – The PLISSIT Model

Sex therapy is the treatment of male and female sexual dysfunction.  Male sexual dysfunction may include erectile dysfunction, premature ejaculation, delay orgasm, delay ejaculation, or persistent sexual arousal disorder.  Female sexual dysfunction may include hypoactive sexual desire disorder (HSSD), sexual arousal disorder, orgasmic disorder, painful intercourse, or persistent sexual arousal disorder.

Sex therapy can also help to treat people with sexual addiction, sexual inhibitions, sexual dissatisfaction, unwanted sexual fetishism, sexual assault, sexual abuse, gender identity issues, sexual orientation issues, performance anxiety issues, sexual difficulties, or intimate relationship issues.

Many people with sexual problems do not seek professional help because it is a private matter and most people are not comfortable talking to stranger about their sexual problems.  Sexual dysfunction can affect anyone and sex therapy can help to treat people regardless if you are heterosexual, gay, lesbian, bisexual, or transsexual.

Each therapist works differently taking different approaches depending on the types and complexity of sexual problems.  Most therapists follow the PLISSIT model of sex therapy developed by American psychologist Jack Annon.  The PLISSIT model is a four levels program which acronym as permission, limited information, specific suggestion, and intensive therapy.

Permission

This is the first level of sex therapy that serves to give clients permission to talk about their sexual problems.  The therapist will attempt to identify root cause by asking series of questions to determine how and when the problem was first developed.  The therapist will attempt to gather information on medical history, personal history, sexual history, and relationship history to determine best type of treatment approach.

The therapist will attempt to identify negative emotions that may be associated with sexual problems.  Some people may experience negative emotions such as guilt, anxiety, or embarrassment towards sexual fantasies, sexual desires, sexual feelings, or sexual behaviors. 

The therapist will attempt to comfort clients by assuring them that sexual fantasies, sexual desires, sexual feelings, or sexual behaviors are normal as long as the experiences do not lead to negative outcomes.  The clients are given permission to engage in these sexual experiences that may help to enhance their sexual satisfaction.

Limited Information

Limited information is the second level of therapy that may involve providing sex education to clients about male and female sexual anatomy and physiology.  Once the therapist has identified the root cause, the therapist will work together with clients to achieve goals as part of the therapy treatment program. 

The therapist help clients overcome problem by providing information fact specific to their sexual problem.   The information serves to educate clients about what is normal and help to eliminate false beliefs that the clients may have developed in the past.  The therapist may provide clients with books, magazines, or videos as part of the therapy treatment.

Specific Suggestion

Specific suggestion is the third level of therapy that involves exercises or assignments given clients to do at home.  As part of the therapy program to help clients achieve goals, the therapist often assigned specific exercises for clients to do between therapy sessions.

The assignment may include self masturbation, senate focus exercises, or stop-start technique.  The purpose of the assignment is to help client reduce performance anxiety, improve communication between partners, and to enhance sexual pleasure.

Intensive Therapy

Intensive therapy is the fourth level of therapy that is used when the first three levels of sex therapy failed to treat client’s specific sexual problems.  Intensive therapy may help to treat cases that are more complex such as sexual addiction, sexual abuse, or relationship issues.  Depending on the complexity and types of sexual problems intensive therapy may include psychosexual therapy, systems therapy, or EMDR.

• Psychosexual therapy is treatment that focuses on helping clients to become aware of their unconscious thoughts or feelings that causes their sexual problems. 

• Systems therapy is treatment that focuses on dealing with relationships issues by identifying sexual problems in current relationship.

• Eye Movement Desensitization and Reprocessing (EMDR) are treatment that involve eye movement back and forth and thinking about the problem at the same time in an attempt to treat sexual problems.

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