Sexual Problems That Can Arise in Long-Term and Commited Relationships Sexual issues arising in long-term relationships as they present The cycle of limerence is not the only factor contributing both sexual touch (stroking genitals, penetrative sex, oral sex) can often alleviate feelings of disappointment and improve self- in the therapeutic setting are examined in this paper. These to waning desire in long-term relationships. Individual clients and non-sexual touch (cuddling, holding hands, spooning). esteem while also restoring confidence in the couple’s ability to include the role of sexual desire and its relationship to the cycle may report additional factors: long working days, exhaustion, Communication can either increase or decrease intimacy have penetrative sex. of limerence, therapeutic treatments of sexual problems, sexual children, lack of privacy in the family home, relationship Hence it is important that the therapist understand the role Women often present for counselling when recovering from and non-sexual communication and the impact illness can problems such as anger at the other partner, or a significant life communication plays in the dynamic of the relationship in mastectomies, or during the course of other chronic conditions play, both as a contributing factor to sexual problems and in event. Mansell, Salinas and Sanchez (2011) cite other factors order to best facilitate the clients’ work.
like chronic fatigue syndrome, depression, and cancers of the including communication problems, substance abuse, anxiety It is common that clients lack the skills and attitudes female reproductive system: breast, ovarian, uterine or cervical.
Permanent injury or disability and chronic conditions Sexual Desire in Long-Term Relationships
and depression, certain medications, prior sexual abuse, required for discussing sensitive issues such as the specifics of significantly impact a client’s ability to function sexually. Clinical experience shows that clients in committed, long-term gynaecological problems, or even a primary medical problem their sexual relationship with their partners (Bienvenu 1980). The therapist will need to work with the couple in exploring relationships often present with complaints relating to reduced, such as Hypoactive Sexual Desire Disorder (HSDD). It is Furthermore, research has shown a positive relationship alternative ways to achieve sexual intimacy, which may require low or non-existent sexual desire. Multiple physiological, therefore crucial that the health practitioner take a full sexual between the frequency and quality of a couple’s talk about sex the couple to broaden their sexual repertoire. psychological, emotional and social factors may contribute and relationship history of both partners in order to fully (both men and women) and their level of sexual satisfaction In good case management, the therapist liaises in a to this phenomenon. Unresolved problems relating to sexual identify and understand all the factors contributing to sexual (Timm & Keiley 2011, Baus, 1987, Metts & Cupach 1989, collaborative effort with the clients’ other health practitioners, desire can prove catastrophic to both the sexual and non-sexual desire problems.
Sprecher & McKinney 1993). This highlights the need for increasing the possibility of achieving a lasting resolution to aspects of a relationship. It is not uncommon that clients seek Clients may experience the distancer/pursuer pattern in their counsellors to address and facilitate communication in the both the individual’s sexual difficulties (McCabe, et al. 2010) counselling only after years of conflict regarding one partner’s relationship. This occurs when one partner, the pursuer, seeks and laying the foundation for the couple to resume their pre- sexual intercourse with the other, the distancer, who avoids or refuses the sexual interaction (Betchen, 1991). The more the The Link Between Relationship Issues
Sexual Desire Defined
pursuer pursues, the more the distancer distances and so on. It and Sexual Difficulties
There is no consensus on a definition of sexual desire. DeLamater is important that the counsellor works with the couple on the It is important to remember that working with sexual issues also Albaugh, JA and Kellogg-Spadt, S 2002, ‘Sensate Focus and its Role in Treating Sexual Dysfunction (Intimacy Issues)’, Urologic Nursing 22(6): 402 and Sill (2005) discuss two main frameworks in the literature. The causes of this pattern.
involves working with relationships. Sexual and relationship Baus, PD 1987, ‘Indicators of Relationship Satisfaction in Sexually Intimate first and most common framework suggests that sexual desire is issues can exist independently of one another, but relationship Relationships’, paper presented at the Iowa Conference on Personal Relationships, an innate biological drive that motivates individuals to seek out Treatment of Sexual Desire Issues
problems can cause sexual problems and sexual problems can Betchen, SJ 1991, ‘Male Masturbation as a Vehicle for the Pursuer/Distancer sexual stimuli or activity. The second framework sees sexual desire A number of techniques can be used to address sexual desire Relationship in Marriage’, Journal of Sex & Marital Therapy 17(4): 269-78 as an external force that manifests in the potential partner rather issues. General education incorporating the anatomy and Links between relationship and sexual problems are not Bienvenu, MJ 1980, Counselor’s and Teacher’s Manual for the Sexual Communication Inventory, Saluda, NC: Family Life Publications than from an internal need within the desiring self (Verhulst physiology of the body and sexual techniques can be very helpful always easy to identify, hence the importance of taking detailed Brotto, LA, Petkau, AJ, Labrie, F and Basson, R 2011, ‘Predictors of Sexual Desire & Heiman, 1979). Clinical experience has shown that clients for couples who have limited or no knowledge of lovemaking histories of both individuals and couples. Disorders in Women’, The Journal of Sexual Medicine 8: 742-753 can exhibit both innate and external desire, which may occur (DeLamater & Sill 2005; Mansell, et al. 2011; Brotto, et al. DeLamater, J and Sill, M 2005, ‘Sexual Desire in Later Life’, Journal of Sex Research, lllness and Sexual Rehabilitation in
interchangeably within their relationships.
2011). Sensate focus exercises can be given as homework to help McCabe, M, Althof, SE, Assalian, P, Chevret-Measson, M, Leiblum, SR, Simonelli, recapture intimacy between partners (Albaugh & Kellogg- Long-Term and Committed Relationships
C and Wylie, K 2010, ‘Psychological and Interpersonal Dimensions of Sexual Sexual Desire and Limerence
Spadt 2002). These involve touching, caressing and non- A number of il nesses can affect a client’s physical, mental and Function and Dysfunction’, The Journal of Sexual Medicine, 7: 327–336 Clients often cite a reduction in sexual desire for their partners Mansell, D, Salinas, GD, Sanchez, A, Abdolrasulnia, M 2011, ‘Attitudes Toward coital massage—a powerful tool for couples working towards emotional health. It is important to understand that a diagnosis Management of Decreased Sexual Desire in Premenopausal Women—National after the relationship has passed from the initial phase (as early rebuilding their physical connection, which may have been of il ness can disrupt both emotional intimacy and physical Survey of Nurse Practitioners and Physician Assistants’, Journal of Allied Health, as three months) into the committed and long-term phase neglected due to the distancer/pursuer relationship and/or other sexual function. Many couples experience relationship stress Martínez-Jabaloyas, JM, Moncada, I, Rodríguez-Vela, L, Gutiérrez, PR, Chaves, (up to two years and beyond). A common complaint, it can relationship problems. Developing clients’ communication from a diagnosis of il ness and, general y, couples who were J 2010, ‘Evaluation of Self-Esteem in Males with Erectile Dysfunction Treated nevertheless be a baffling and unsettling change within a with Viagra. Analysis of a Spanish Patients Group Selected from a Multicenter, skills to improve their ability to negotiate their needs and wants experiencing relationship problems before a diagnosis are more International Study’, Actas Urol Esp., 34(8): 699-707 relationship. The cycle of limerence explains the initial wave of more generally within the context of the relationship as well likely to continue to have problems afterwards. Relationship Metts, S and Cupach, WR 1989, ‘The Role of Communication in Human Sexuality’, relationship euphoria and ensuing dissatisfaction experienced in K McKinney and S Sprecher (Eds.) Human Sexuality: The Societal and as in the sexual relationship is also an important influencing support should ideal y begin at the onset of diagnosis, and should Interpersonal Context, Norwood, NJ: Ablex Publishing (139-161) factor in increasing sexual desire (Mansell et al. 2011). These occur alongside conventional medical support. Disappointment, Reynolds, S 1983, ‘“Limerence”: A New Word and Concept’, Psychotherapy: Theory, ‘Limerence’ attempts to describe the enigmatic state of ‘being Research and Practice, 20(1): 107-111 suggestions are by no means exhaustive, and each couple will no isolation and poor quality of life can result if sexual issues are not in love’. Individuals in the state of limerence may experience Sprecher, S and McKinney, K 1993, Sexuality, Newbury Park, CA: Sage doubt benefit from individualised and client-centered therapy.
identified, understood and counselled.
Tennov, D 1979, Love and Limerence: The Experience of Being in Love, New York: Stein feelings of joy—happiness accompanied by an emotional Men can present with conditions—including cardiovascular high—and have a heightened focus on and longing for the The Role of Communication in
disease, diabetes, depression, prostate cancer and post Timm, TM and Keiley, MK 2011, ‘The Effects of Differentiation of Self, Adult Attachment, and Sexual Communication on Sexual and Marital Satisfaction: A other person that may, at times, be obsessive and include Long-Term and Committed Relationships
prostatectomy conditions—that can directly affect the Path Analysis’, Journal of Sex & Marital Therapy, 37(3): 206–223 intrusive thoughts and fantasies about that person. They feel a Clients often present in the moment of crisis when communication physiological functioning of the male genitalia, namely erectile Verhulst, J and Heiman, J 1979, ‘An Interactional Approach to Sexual Dysfunctions’, American Journal of Family Therapy longing for reciprocation of these feelings by the object of their on all levels has broken down. Sexual as well as non-sexual dysfunction (ED), and may cause distress to both the individual desire. A physical manifestation may be felt as pain in the chest communication can be regarded as crucial to many relationships. and the relationship. A number of therapies can be used in order area. At the height of limerence, the individual is unconcerned When communication fails, the relationship is at risk. The ability to improve erectile function, depending on the severity of the with any defects in the other; rather, he or she can see only the to communicate about issues in long-term relationships is a key client’s condition. Common therapies used include the use of Christina Spaccavento, MSc (Health Science), is a qualified and
positive aspects of her or his partner (Tenor 1979). When the skill that all clients can benefit from learning. PDE5 Inhibitors—more commonly known as Viagra, Levitra experienced sex therapist and relationship counsellor, educator process of limerence is explained to clients, their relationship Communication is not only verbal. Couples can also and Cialis (Martínez-Jabaloyas 2010)—vacuum pumps, and supervisor. She runs her own clinical practice in Surry Hills experience is normalised, and any feelings of guilt related to communicate through body language and touch. In long-term intracavernosal injection therapy (ICI) and, in extreme cases, and Potts Point and has made various expert contributions to media publications and television in the area of sexology. relationships, non-verbal intimate communication can involve penile implants. When used properly, these physical therapies, [email protected]


Tropeninstitut_krankheiten_auf_reisen Gesund reisen gesund heimkehren Krankheitserreger und oft schlechtere Hygienebedingungen erwarten. Das gesundheitliche Risiko hängt unter anderem von der Art der Reise (z.B. Hotelaufenthalt oder Trekkingreise), der Reisezeit (z.B. Sommer oder Regenzeit), der Krankheitserregern) und auch dem Alter des Reisenden (Kind oder Erwachsener) ab. Beruflich Reisende sollten

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