Mindfulness in Sex Therapy: A comprehensive Review.

Abstract

Objective: The aim of this study is to provide an exhaustive exploration of the possible benefits that Mindfulness practices have in clients with sexual difficulties.

Material and Method: We have carried out a bibliographic review through Ebsco (which includes Pubmed, Psycinfo and Google Scholar). We used the key words “Mindfulness AND (Sexual Difficulties OR Sexuality OR Sexual Dysfunctions OR Sexual Problems OR Hypersexuality)”.

Results: We found 75 articles from 2007 to 2017 about the efficacy and utility of mindfulness practice in the treatment of sexual problems. We finally selected 57 to elaborate this work. 27 of them were empirical researches with real patients experiencing different sexual pathologies, 29 were bibliographic reviews and there was 1 meta-analysis.

Conclusions: There are different interventions based on Mindfulness used in sex therapy: 1) First Generation Mindfulness interventions (i.e.: Mindfulness Based Stress Reduction or Mindfulness-Bases Cognitive Therapy Intervention). 2) Second Generation Mindfulness Interventions (i.e.: Mindfulness Awareness Training). In our review, all of these interventions proved to be useful in: reducing sexual difficulties as sexual stress and pain; improving sexual desire, excitation, lubrication, orgasm and sexual satisfaction. As well, Mindfulness interventions are useful in patients suffering hypersexual disorder.

Others studies have found that Mindfulness practices can provide better self-body consciousness, better attention to sexual sensations, and improve pleasant sexual sensations. Finally, training in Mindfulness has shown to reduce other associated symptoms as sexual shame, negative cognitive distortions, depression, anxiety. Some medical pathologies which derive in genital problems of desire and pain can also be reduced by the practice of mindfulness, specially in women arousal disorder with gynecological cancer.

In the light of the results, there is evidence that mindfulness can be a choice of treatment for different sexual pathologies. Therefore, based on the research we have reviewed, Mindfulness can be recommended as a useful tool for sexual treatments. It is necessary to continue with this line of research in order to create specific programs aligned to the needs of each sexual dysfunction.

Full text

Mindfulness in sex therapy: A
comprehensive review.
Villena, A.; Gimeno, E.; G.; Blazquez, M.; Zavala, L.; García-Lanzas, E.; llarraza, F. & Chiclana, C.
Grupo de Trabajo, Estudio e Investigación en Sexualidad.
Consulta Dr. Carlos Chiclana, Madrid, España.
INTRODUCTION
Treatments for sexual dysfunctions have changed radically from the influence
of psychoanalysis, through the more behavioral orientation centered on Masters and
Johnson's abilities, to the humanistic sexology coming from the work of Mashlo,
Hartman, Lopiccolo, Dodson and others, and finally by the power of Viagra's
influence, of the medical model from the 90s to the present day.
Much of the research on sexuality is now beginning to focus on the application
of meditation practices for the treatment of sexual problems. In this sense, one of the
most hopeful perspectives is the Mindfulness, which has been described as an
awareness of the present, here and now, in a non-judgmental way.It has its roots in
Buddhist meditation, which has been practicing for millennia. Different types of
meditation have also been practiced for decades in other cultures.
AIMS AND METHODOLOGY
The aim of this study is to provide an exhaustive exploration of the possible
benefits that Mindfulness practices have in clients with sexual difficulties.
We have carried out a bibliographic review through Ebsco (which includes
Pubmed, Psycinfo and Google Scholar). We used the key words “Mindfulness AND
(Sexual Difficulties OR Sexuality OR Sexual Dysfunctions OR Sexual Problems OR
Hypersexuality)”.
We found 75 articles from 2007 to 2017 about the efficacy and utility of
mindfulness practice in the treatment of sexual problems. We finally selected 57 to
elaborate this work. 27 of them were empirical researches with real patients
experiencing different sexual pathologies, 29 were bibliographic reviews and there
was 1meta-analysis.
RESULTS
CONCLUSIONS
Mindfulness has been proven to enhance the concordance between the physical and the sexual reply, paying attention to the sexual sensation that is emerging. Mindfulness
proves to be useful in:reducing sexual difficulties as sexual stress and pain, improving sexual desire, excitation, lubrication, orgasm and sexual satisfaction, as well
mindfulness is useful in patients suffering hypersexual disorder. There is evidence that mindfulness can be a choice of treatment for different sexual pathologies.
Therefore, based on the research we have reviewed, mindfulness can be recommended as a useful tool for sexual treatments. It is necessary to continue with this line of
research in order to create specific programs aligned to the needs of each sexual dysfunction.
REFERENCES
[1] Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York, NY: Hyperion.
[2] Brotto, L. A., Krychman, M., & Jacobson, P. (2008). Eastern approaches for enhancing women's sexuality: Mindfulness, acupuncture, and yoga (CME). The journal of sexual medicine,5(12), 2741-2748.
[3] Van Gordon, W., Shonin, E., & Griffiths, M. (2015). Towards a second-generation of mindfulness-based interventions. Australia and New Zealand Journal of Psychiatry, 49, 591–592.
[4] Mize, S. J. (2015). A review of mindfulness-based sex therapy interventions for sexual desire and arousal difficulties: From research to practice. Current Sexual Health Reports,7(2), 89-97.
[5] Silverstein, R. G., Brown, A. C. H., Roth, H. D., & Britton, W. B. (2011). Effects of mindfulness training on body awareness to sexual stimuli: implications for female.
[6] Rosenbaum, T. Y. (2013). An integrated mindfulness-based approach to the treatment of women with sexual pain and anxiety: promoting autonomy and mind/body connection. Sexual and Relationship Therapy,28(1-2), 20-28.
[7] Reid, R. C., Bramen, J. E., Anderson, A., & Cohen, M. S. (2014). Mindfulness, emotional dysregulation, impulsivity, and stress proneness among hypersexual patients. Journal of Clinical Psychology,70(4), 313-321.
[8] Brotto, L. A., & Heiman, J. R. (2007). Mindfulness in sex therapy: Applications for women with sexual difficulties following gynecologic cancer. Sexual and relationship therapy,22(1), 3-11. sexual dysfunction. Psychosomatic medicine,73(9), 817.
[9] Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2017). Dispositional mindfulness, shame, and compulsive sexual behaviors among men in residential treatment for substance use disorders. Mindfulness,8(6), 1552-1558.
[10] Mize, S. J. S. & Iantaffi, A. (2013). The place of mindfulness in a sensorimotor psychotherapy intervention to improve women’s sexual health. Sexual and Relationship Therapy, 28, 63-76.Doi: 10.1080/14681994.2013.770144
[11] Matlack, J. (2008). BETTER SEX? THINK ON IT. Prevention Emmaus 60 (12), 108
[12] Paterson, L. Q., Handy, A. B., & Brotto, L. A. (2017). A pilot study of eight-session mindfulness-based cognitive therapy adapted for women’s sexual interest/arousal disorder. The Journal of Sex Research,54(7), 850-861.
[13] Brotto, L. A., & Goldmeier, D. (2015). Mindfulness interventions for treating sexual dysfunctions: the gentle science of finding focus in a multitask world.The journal of sexual medicine,12(8), 1687-1689.
Traditionally, sexual problems have been treated with the techniques of sensory
focusing proposed by Masters and Johnsons, however, these techniques present
notorious conceptual similarities with the practice of meditation and mindfulness. It is
not, therefore, surprising that mindfulness can be used to treat these pathologies.
However, it can sometimes be difficult to maintain a mindful attitude during
sexual experiences when the society in which we live seems to push both men and
women to feel anxious or ashamed of their desires or even suspicious to share them in
order to fit into the collective vision of what is considered "sexually normative".
There are different interventions based on Mindfulness used in sex therapy:
1) First Generation Mindfulness interventions (FG-MBIs).
These interventions include Mindfulness Based Stress Reduction or
Mindfulness-Based Cognitive Therapy Intervention. They are based on the
conceptualization of mindfulness as “a way of intentionally paying attention to the
present moment in a non-judgmental way”. [1]
FG-MBIs have proven their ability to improve several aspects of sexual
response and reduce sexual distress in women with sexual desire and arousal
disorders . [2]
2) Second Generation Mindfulness Interventions (SG-MBIs).
Within these interventions it is Mindfulness awareness Training.SG-MBIs
integrate a greater range of meditation techniques and they are developed on the
basis of a more traditional Buddhist conceptualization in which mindfulness is
considered as “the process of engaging a full direct, and active awareness of
experienced phenomena that is spiritual in aspect, and maintained from one moment
to the next”. [3]
The SG-MBI are especially recommended for the treatment of behavioral
addictions since they facilitate those who practice them to be more conscious from
an ethical point of view of the short and long term consequences of their behavior.
In addition, the SG-MBI defends the usefulness of Mindfulness as away of life,
more than as a therapeutic technique to resort only in case of difficulties. [3]
In our review, all of these interventions proved to be useful in:reducing
sexual difficulties as sexual stress and pain; improving sexual desire,
excitation, lubrication, orgasm and sexual satisfaction .[4, 5, 6]
As well, Mindfulness interventions are useful in patients suffering
hypersexual disorder. [7] Others studies have found that Mindfulness practices
can provide better self-body consciousness, better attention to sexual
sensations, and improve pleasant sexual sensations. [8, 2, 5]
Finally, training in Mindfulness has shown to reduce other associated
symptoms as sexual shame, negative cognitive distortions, depression and
anxiety [9] and better sexual function. Some medical pathologies which derive
in genital problems of desire and pain can also be reduced by the practice of
mindfulness, specially in women arousal disorder with gynecological cancer. [8]
ØThe practice of mindfulness can change the cerebral processing
related to excitation, increasing the sexual desire and the reply
velocity. [11]
ØMajorities of studies are on women.
ØInterventions based on mindfulness in group improve significantly the
sexual desire in women. [12]
ØThere is another study in which the effective increase (sexual
excitement, satisfaction, lubrication, sexual functioning, orgasmic
difficulties and psychological symptoms) when mindfulness is
combined with motor sensorial intervention, also with cognitive
therapy and psychoeducation. [10]
ØCorporal images may influence our intrusive thinking and block us.[12]
ØRecommendation to practice mindfulness: 45 minutes daily (6 days a
week). [13]
Other Results
Contact:alejandrovillena@doctorcarloschiclana.com
MINDFULNESS AS AN INTERVENTION TECHNIQUE IN SEXUAL PROBLEMS