The doctor, when addressing a patient, considers it his duty, which is quite natural, to help him in eliminating a sexual disorder buy generic viagra online. However, on this way, the most unforeseen consequences may lie in wait for him. In most cases, it is possible to observe the quite understandable joy of the couple, connected with the achievement of positive results. However, it is seldom that in the process of treatment one can encounter the patient’s unconscious resistance in achieving positive therapeutic results. So, for example, in the application (with the aim of eliminating the syndrome of anxious anticipation of sexual failure) of the new psychotherapeutic method developed by us, which is known in the literature under the name “method of correction of behavioral programs,” the patient was noted resistance to the ongoing treatment, the presence of which was confirmed during a hypnosuggestive Therapy.
In the psychoanalytic literature, there is the term “negative therapeutic response” (STR). It is noted that this concept is widely used in clinical psychoanalysis and it is expressed bewilderment that the term scientific and technological revolution was not widely used outside the sphere of clinical psychoanalysis, since it would seem to be easy to apply to a wide range of clinical situations. The scientific and technological revolution occupies an important place in the history of psychoanalysis, since it represents a phenomenon chosen by S. Freud (1923) with the aim of demonstrating the “unconscious sense of guilt” and for proving the existence of the “Super-I”. In the psychoanalytic literature this concept was first formulated by him as follows:
“There is a category of people behaving very specifically during the analytical process. When someone expresses the hope of a successful course of treatment or satisfaction about the progress made in their treatment, they show signs of discontent, and their condition is constantly deteriorating. At first glance, this can be perceived as a challenge, as an attempt to prove its superiority over the attending physician, but with a deeper and impartial analysis, the conclusions change – we have to admit that such people not only can not tolerate some praise in their address or a positive assessment of their actions, but also reverse reaction to the progress in treatment. Any decision made specifically in the course of treatment and in other people giving an improvement (or, at least, leading to a temporary disappearance of the symptoms) in these patients increases the morbid state, instead of improving, it worsens. “
Also, in connection with the scientific and technological revolution, it is necessary to recall the idea in psychoanalysis of the primary and secondary benefits of the disease. Under the benefit of the disease, all kinds of indirect or direct satisfaction received from her by the patient are understood. In this case, the primary and secondary benefits are distinguished. Primary benefit is one of the motives for the onset of a neurosis, along with satisfaction from a symptom, flight into a disease favorable to the subject by changing attitudes with the environment. The secondary benefit becomes possible only in hindsight, that is, in fact, is an additional profit from an already existing disease. It is only externally connected with the root cause of the disease and the meaning of its symptoms. Freud distinguished between the “inner aspect of primary profit” and “external” or “accidental”. If the “internal aspect” is to reduce the tension that is generated by the symptoms (the goal of the symptom, even painful, is to help the subject avoid more painful conflicts, this is the mechanism of flight into the disease), the “external aspect” is associated with those changes that A symptom generates in the interpersonal relations of the subject. Thus, a woman “oppressed by a husband” can achieve thanks to her neurosis greater tenderness and attention, as well as the opportunity to avenge her mistreatment. The benefits that the disease gives can be demonstrated by examples of interest to specialists in the field of sexual pathology.
Premature ejaculation and erectile dysfunction alone can be conditionally pleasant. Thus, VD Kochetkov reports that Ferenczi (1912) described premature ejaculation in men for whom sexual acts are undesirable for one reason or another. Therefore, they are interested in their rapid completion. The author also notes that such observations are led by L.Ya. Jacobson (1918) and N.V. Ivanov (1961). He states that his clinical and pathogenetic analysis of sexual disorders has allowed to reveal development of sexual frustration under the mechanism named above.
In this connection V.D. Kochetkov calls the sexual disorders of men who entered into an “accidental” or “forced” marriage. The sexual weakness that arose after the conclusion of such marriages, expressed in “inhibition of the erection function,” was for them a relatively pleasant desirable symptom, since, in the end, it was the reason for the dissolution of a painful marriage for them. The quoted author points out that, under certain circumstances, a man tries to perform sexual intercourse contrary to his moral conviction and views. This, according to the mechanism of conditional pleasantness and the desirability of failure leads in such cases to inhibition of sexual desire, erection and orgasm. As an example of the development of “impotence” according to the mechanism named V.D. Kochetkov gives the following observation.
“Patient K., 25 years old, a student of the fifth year. He complained about the lack of adequate adequate erections. Do not smoke, do not drink alcohol. Masturbation denies. Sexual life from 21 years. He had several normal sexual acts, including “with the unloved student of the same course.” However, after she became pregnant, the patient, for a number of reasons, was forced to marry her. All attempts at intimacy with his wife were in vain because of the lack of adequate erections. The inhibition of the erection function was a “conventionally pleasant or desirable symptom”, which ultimately led to the dissolution of a painful marriage. From the side of internal and genito-urinary organs, as well as the nervous system, there are no deviations from the norm “
Sexual disorders in men, which develop by the mechanism of conditional pleasantness / desirability, are very rarely diagnosed. This is associated with the high prestige of normal potency in everyday ideas and the fact that the mechanism of conditional pleasantness of the disease does not affect unconditionally pleasant sexual relations. At the same time, sexual disorders arising from this mechanism can occur if a man does not want to have sex with his wife (partner), for example, because of violations in their relationships.
Recall that the mechanism of conditional pleasantness / desirability, underlying the development of symptoms, is typical for hysterical (dissociative / conversion in ICD-10) neurotic disorders, which are much more likely to occur in persons with hysteroid traits character. It can be assumed with considerable probability that sexual dysfunctions developing according to the mentioned mechanism exist more often than are diagnosed. This is due to some difficulties in identifying them.
Nevertheless, the point of view presented below, apparently, should be considered only as a significant, untrue exaggeration. According to her, the most common type of personality of a man with a psychogenic erectile dysfunction is a type with hysterical abnormalities. Such individuals are often immature, require attention. Their behavior is easy to manage. Violation of potency in these cases is considered as a consequence of the “punitive” style of behavior adopted between spouses. In women, sexual dysfunctions, conditioned by the mechanism of conditional pleasure / desirability, are diagnosed more often than in men. Among them, in particular, vaginismus and dyspareunia (genitalia) of inorganic nature.
The benefit of a sexual disorder for women can also be in the way of attempts to normalize their orgasm. Suppressed orgasm orgasm can be useful to her, as it serves as a tool of manipulation aimed at achieving non-sexual goals. Blaming the man for his sexual dissatisfaction, she, in fact, induces him compensatory behavior. S.S. Liebig, V.I. Friedkin notes that “in such cases, an orgasm is sometimes possible for a woman, but as an encouragement for the behavior necessary for the wife (for submission in the struggle for leadership, for confirmation of the husband’s love and care, for the alcoholic” corrected and stopped drinking, Etc.). ” We have previously noted that the lack of orgasm in a woman can be beneficial to her for the simple reason that, reproaching her husband for not being able to satisfy her sexually, she thereby justifies her need for sexual non-family contacts and justifies them. Therefore, her behavior can lead to the appearance of a husband’s sexual frustration. Here is our clinical observation, which demonstrates this idea.
