Anxiety and Anger, ...all of which interfere with sexual arousal in men and women.
There are other, less complex sources of anxiety and anger, all of which interfere with sexual arousal in men and women. A woman may fear that she will not reach orgasm. A woman may feel helpless or exploited. Some men and women may feel shame and guilt, or they may believe that sex is a sin; they may have grown up in situations where sex was seen as dirty and bad, and they may have trouble ridding themselves offeelings of shame and guilt even in the shelter of marriage. Some women may expect physical pain in intercourse and therefore dread it. Many men fear rejection and become self-conscious, thereby inhibiting an otherwise normal physiological potential. And often there is the fear of pregnancy.
Negative emotions arising in relationships must not be overlooked either. Relationships do not always progress well. People change, sometimes developing different living habits and preferences. Their partner may not change accordingly, and conflict may then ensue, bringing about negative feelings between the couple. Understandably, it is often difficult to discard these feelings when the couple enters the bedroom. In such cases, one or both partners might develop a sexual dysfunction, probably specific in nature.
The behavioral school offers an explanation of the causes of sexual dysfunction based on learning theory. For men, erectile dysfunction may result from an early sexual experience. A particularly traumatic first sexual experience will condition strong fear to sexual encounters. Recall Sheldon's first and formative sexual encounter. Heterosexual activity was the conditioned stimulus (CS), which resulted in a humiliating, public failure to have an erection (US) and an unconditioned response (UR) of ensuing shame and anxiety. Future exposures to the CS of sexual encounters produced the conditioned response (CR) of anxiety, which in tum blocked erection. This formulation fits many of the instances in which there is an early traumatic experience, and it also fits the success of direct sexual therapy with erectile dysfunction. It fails to account for those cases in which no traumatic experience can be discovered, and it also does not account for why certain individuals are more susceptible to sexual traumatic experiences than others. For every individual who undergoes an initial sexual experience that is a failure (such as Sheldon's) and develops erectile dysfunctions, there are many who encounter similar initial failures but do not.
In addition to psychodynamic and behavioral accounts of sexual dysfunctions, the cognitive view suggests other important considerations as well. We saw that for both the orgasmic and the arousal dysfunctions, what an individual thinks can greatly interfere with performance. Men and women with orgasm difficulties become "orgasm watchers." They may say to themselves, "I wonder ifI'll climax this time." "This is taking much too long; he must think I'm frigid." Men and women who have arousal dysfunctions may say to themselves, "If I don't get an erection, she'll laugh at me." "I'm not going to get aroused this time either." These thoughts produce anxiety, which in tum blocks the parasympathetic responding that is the basis of the human sexual response. Such thoughts get in the way of abandoning oneself to erotic feelings. Complete therapy for the sexual dysfunctions must deal with problems at four levels: physical, behavioral, psychodynamic, and cognitive, for difficulties at any ofthese levels can produce human sexual dysfunction.