5. Clinical Significance of Differentiating Between a Model of Mental Health and a Model of Sexual Health

Although the arousal function is the foundation of our sexuality, and stands in direct causal connection with more than 50 percent of the sexual problems of our clients, it is our least understood and evaluated function. Clinical experiences show quite clearly that disorders of the arousal function (rapid ejaculation, anorgasmy, erectile dysfunction, etc.), of sexual desire and, in part, of our experience of gender identity are connected to learning steps at the level of the arousal function.
One basic problem inherent in many so-called sex therapies is the failure to evaluate the direct causalities i.e. the sexual learning steps. Lack of awareness of their direct causal effects leads to the search for indirect causes – like relationship problems, emotional conflicts, a “difficult childhood”, or sexual abuse – which are then connected to the sexual disorder via some hypothetical construct. In this “naturalistic” concept of sexuality, after removing the “obstacles”, sexuality is supposed to develop spontaneously. Our clinical experience shows, however, that when the arousal function is not taken into consideration, this is often not the case. Of course, indirect causes are evaluated in the Sexocorporel, as well, because they can certainly hinder sexual learning steps or may call for specialized treatment.
Lack of sexological knowledge has led to the unnecessary “psychopathologizing” (analogous to “medicalization”) of many clients with sexual problems. However, the majority of clients that seek therapeutic help for sexual problems are psychologically healthy. Long-standing clinical experiences by other authors, such as Helen Kaplan, also confirm these findings.
That in mind, sexual dysfunction occurs frequently in people with mental illnesses, and on the other hand, sexual dysfunction can significantly impair a person’s mental health or a couple’s relationship.
A standalone model of sexual health is required for accurate and independent evaluations of mental and sexual health. This distinction helps facilitate precise diagnostics prerequisite for the therapeutic project and helps prevent unnecessary confusion posed by unclear causal interrelations.