Treating Sexual Disorders

Treating Sexual Disorders is an excellent, multi-authored work. It describes sex and couples therapy in a comprehensive manner that will be especially useful to the beginning sex therapist. I have one major concern, however, and that is the last chapter (treating paraphilia). The psychodynamic orientation of the author makes him regard paraphilia as inherently pathological, and not just as a result of learning history that gives us all different "turn ons." Charlton speaks, for example, on page 309 of how "working closely with the paphiliacs involves a confrontation with the nature of evil" and later mentions the "evil inherent in perverse sexuality." To be fair, perhaps he was only referring to victimizing or to the DSM IV caveat that the behavior has to cause upset to the person engaging in it or to a victim. The tone of the entire chapter, however, seems to pathologize paraphilia more than the literature supports. In my own practice (I am a licensed psychologist), I see many clients who have been told that any form of unusual sexuality makes them evil or dirty. They don't need any more help to feel that way. More could have been written regarding mutually consensual play between couples that is just a little (or a lot) "kinky" without the heavy judgement. This chapter aside, there is a great deal of value in this volume.

As a therapist who sees patients with sexual problems I found this book extremely helpful. The various chapters gave me the tools I needed to understand sexual difficulties from a psychological and physical perspective. I've even referred my patients to selected chapters of the book, and they have reported that they were able to understand the concepts without having a professional education. I would recommend this book to seasoned and novice therapists to add to their library. It addresses areas that therapists tend to avoid.