Cognitive Hypnotherapy with Sexual Disorders

Research has found that in psychogenic sexual disorders, cognitive processes are more important than physiological ones. Negativistic "thinking" about one's sexual activity aggravates the symptom and perpetuates it. Therefore, as vital as a differential diagnosis of sexual dysfunction is, the uncovering of Negative Self-Hypnosis (NSH) becomes essential for the successful resolution of the sexual problem. NSH constitutes the "hidden symptom" in all psychogenic sexual dysfunctions. After explicating NSH, the paper offers specific hypnotic techniques for different sexual disorders. TRADITIONAL HYPNOSEX THERAPY Early applications of hypnosis for the treatment of sexual dysfunctions can be seen in the work of Erickson (1935). His indirect imagination techniques focused the clinical attention upon the symptoms, which were viewed as an expression of some personality problem. Somewhat later, van Pelt (1958) focused his approach upon helping the patient uncover past traumatic events which he believed were producing anxiety and consequent dysfunction. Through direct suggestion of "new ideas" he believed he could eliminate the anxiety producing dysfunction. He reinforced these "ideas" through mental imagery and mental rehearsal. Once again the focus of the therapy was upon the individual who manifested the symptom. Beigel (1972) was one of the first hypnoclinicians to incorporate the dysfunctioning individual's partner, engaging him/her as an ad hoc cotherapist. Beigel's primary approach was mental rehearsal (Beigel 1963), with the focus of the therapy being placed upon the symptom and the individual who manifested it. Although some authors pointed out the importance of treating the interrelationship between partners and not only the symptom, in many cases the focus of treatment still consisted of suggestion and directive hypnotherapy (Kroger & Fezler, 1976). THE NEW HYPNOSEX THERAPY More recently two important developments have begun to come to the forefront of hypnotic treatment of sexual dysfunction. The first important change was to place the focus of treatment upon the "hidden symptoms." In so doing the emphasis of therapy is upon the cognitive functions such as negativistic imagery and self-talk (LoPiccolo, 1980). Similarly, Walen (1980) presents her eight links of the sexual cycle, recognizing the close connection between cognition and human sexuality. The second important development in hypnotic treatment of sexual dysfunction is the focus upon the systemic aspects of the dysfunction. Borrowing from the family systems model, Araoz (1982) focused upon the cognitive interactive process between partners, examining how one partner or the other may be involuntarily perpetuating the problem. The current article focuses upon those aspects of the "hidden symptoms" that are the cognitive process, discussing their role within both the individual and systems models. Among the earlier works in defining human sexual response Masters and Johnson (1966) established the four stages of sexual response. By defining the anatomical and physiological differences between the stages of excitement, plateau, orgasm, and resolution, they laid an initial groundwork for future researchers. The primarily directive, educational, and behavioristic techniques that followed, however, offered no direction for the cognitive processing occurring during these phases. In so doing the techniques placed an increased pressure on the individual"s overt actions, while perhaps actually creating negative self-definitions for the individual. Walen's (1980) eight-link model, which was to follow, emphasized the cognitive elements in human sexuality. The eight links are (1) perception of the sexual stimulus, (2) evaluation of the stimulus, (3) physiological arousal, (4) perception of the arousal (5) assessment of the arousal, (6) sexual behavior, (7) perception of that behavior, and (8) evaluation of the sexual behavior. …