International Handbook of Clinical Hypnosis - E-Lib FK UWKS

TREATMENT OF SEXUAL DYSFUNCTIONS 241
HYPOACTIVE SEXUAL DESIRE DISORDER
The treatment of reduced sexual desire may focus on anxiety reduction with respect
to emotional intimacy or sexual involvement or the resolution of relationship
dif®culties. Hammond 1990) provides a script for using the `master control room'
metaphor to step-wise increase sexual functioning. Negotiation and the use of posthypnotic
suggestions in association with the control room analogy also offer ways
of improving sexual responsiveness and overcoming patient resistance.
Hypnosis offers good opportunities to become absorbed in fantasy, and since a
hypnotized subject may respond to fantasy as if it were reality, hypnotic techniques
provide good opportunities for rehearsal of effective sexual functioning. The use of
revivi®cation of previous sexual arousal successes if appropriate, has been reported.
Where anger is the inhibitory emotion metaphoric suggestions of extinguishing a
powerful force may be used, such as putting out the inner ®re of anger with water
or sand; the volcano may collapse back in on itself and cease to be an active force;
the violent earthquake may pass its peak and settle to a period of quiescence
Araoz, 1982).
SEXUAL AVERSION DISORDER
Sexual aversions are most commonly found to be equivalent to phobic responses,
with both anxiety and avoidance being major components of the dif®culties.
Hypnosis can be used to facilitate systematic desensitization in fantasy and in
reality in much the same way as it would be used with other phobic disorders.
Facilitation of anxiety control through the use of cued relaxation while thinking of,
fantasizing about, or actually involved in sexual activity, is a very useful component
of the use of hypnosis. The use of imaginal exposure to the sexual situation using
hypnosis also facilitates the desensitization process. Both uses of hypnosis in effect
also assist in curtailing avoidance behaviors.
Gilmore 1987) illustrated the use of indirect/metaphorical techniques to assist a
woman who was experiencing panic in relation to sexual arousal. The aim of the
embedded metaphors was to assist the patient in dissociating the feeling of pain
and panic associated with past sexual trauma from contemporary sexual arousal.
The ®rst sexual metaphor of a walk in the sun was designed to activate relaxation
and encourage letting herself go into a sensuous experience. The second metaphor
alluded to overcoming apparent failure and therefore regaining a sense of control.
The third metaphor indicated ways to learn to forget pain and guilt.
Hammond 1990) provides many suggestions to overcome sexual aversion.
While the approach to what is essentially a sexual phobia can include a formalized
desensitization paradigm, permissive approaches are likely to be more successful in
representing sexual activity as an emotional and sensuous process. Araoz 1982)
presents a technique in which the patient can become the director of their own
internal sexually explicit movie which they can change and control at will. Sexual