Institute for Contemporary Psychotherapy and Psychoanalysis, New York City, USA.
Fam Process. 2010 Sep;49(3):291-308. doi: 10.1111/j.1545-5300.2010.01324.x.
Psychotherapists often believe if couples improve their communication and emotional dynamics, good sex follows. In practice we often find otherwise and have many questions about how to proceed to work with sexuality issues more directly. This paper presents the many challenges working with sex including the following: the fluidity and multidimensionality of sex and gender, the incongruities and paradoxes in sexual behavior, thoughts, attractions, feelings, and sensations, and the powerful feelings, impasses, surprises, and confusion therapists often experience doing the work. In essence, what is queer about sex? Using the couple as client, expansive ways of thinking and working with sexuality are presented including the development of inclusive models of sex, gender, and sexual response, as well as new approaches to standard sex therapy techniques such as sexual history-taking, redefining sex, and sensate focus. Techniques are presented with an emphasis on the therapist's use of self as sexual change agent including integrating multiple theoretical perspectives (psychodynamic, systemic, and cognitive-behavioral), co-creating a safe treatment frame, and how to intervene within the cognitive, affective, behavioral, somatic, and discursive realms.
心理治疗师通常认为，如果夫妻改善沟通和情感动态，良好的性生活就会随之而来。但在实践中，我们经常发现并非如此，并且对于如何更直接地处理性行为问题有很多疑问。本文介绍了在处理性问题时所面临的诸多挑战，包括以下内容：性和性别具有流动性和多维性、性行为、思想、吸引力、感觉和感觉之间存在不和谐和矛盾、治疗师在进行这项工作时经常会产生强烈的感觉、僵局、惊喜和困惑。本质上，性有什么奇怪的地方？本文以夫妻为客户，提出了一些扩展性的思考和处理性行为的方法，包括发展包容性的性、性别和性反应模式，以及对标准性治疗技术（如性史采集、重新定义性和感觉集中）的新方法。本文重点介绍了治疗师作为性改变代理人的自我使用，包括整合多种理论视角（心理动力学、系统和认知行为）、共同创建安全的治疗框架，以及如何在认知、情感、行为、躯体和话语领域进行干预。
