Sexual Desire Disorders: Dysfunctional Regulation of Sexual Motivation

Almost three decades ago, Dr. Helen Kalan was the first to identify the disorders of sexual desire as distinct entities, thus showing the way to more effective treatment of all the sexual disorders. Now, in this volume, drawing upon her systematic recording of the treatment experience and outcome of over 6000 patients whom she has treated - and by recognizing and studying not just the successes but the treatment failures as well - Dr. Kaplan has brought the art of science of sex therapy to new levels of clarity and effectiveness. In this hardcover, Dr. Kaplan applies her comprehensive, integrated, psychodynamically oriented approach to arrive at an individualized treatment attuned to the specific diagnosis and unique circumstances of each patient. In addition, the author examines psychiatric disorders that can lead to loss of sexual desire, as well as organic causes, including medical conditions, drugs and aging. Throughout the volume, more than 30 case studies illuminated the varied clinical approaches to the various disorders of sexual desire. This book provides a remarkable synthesis of trailblazing theory, painstaking research, and highly focused clinical treatment that will make this volume an indispensable guide for many years to come.

Helen Singer Kaplan does an excellent job of separating out the psychological from the physical elements that contribute to having reduced sexual desire. Beginning with a distinction between genital dysfunctions and the arousal disorders, Dr. Kaplan proceeds through the importance of getting a complete and accurate picture of the patient's past and present experience that contribute to reduced or absent desire. After evaluation and a full understanding of the patient's goals for treatment, Dr. Kaplan moves into treatment strategies, using homework and other behavioral suggestions. She uses the exploration of underlying psychoanalytic causes only when the shorter-term solution-focused, behavioral treatments fail to make significant changes. The very readable case histories are a cross section of problems in this area and of Dr. Kaplan's innovative and individualized techniques for offering help. Her comfort with all areas of sexual behavior, anatomy, and individual preferences comes through in every sentence.I was especially impressed by Dr. Kaplan's consideration of some people's lack of motivation in having insights into their personality patterns and behavior. She demonstrates admirable respect for people whose religious beliefs or ethnic norms prevent them from following some of her suggestions to fantasize, share fantasies, masturbate, or use erotica. In each case, she reframed the suggestion so that it was in keeping with the patient's values or she changed the assignment so that it was acceptable to the patient. Her understanding and respect that many couples have successful relationships that they want to maintain but that we, as therapists, might not want for ourselves, provided excellent role modeling for those who read her book. She also doesn't claim 100% success and is willing to discuss some of her treatment failures and why she thought she was ineffective-the mark of a true scientist.~~Joan Mazza, author of Dream Back Your Life; Dreaming Your Real Self; Things That Tick Me Off; Who's Crazy, Anyway? and Exploring Your Sexual Self.