Sigmund Freud remains one of the most creative, dramatic and
significant contributor to the field of modern psychiatry especially through
his famous theory of psychoanalysis in explaining varied forms of abnormal
behavior. Of particular relevance to this discourse is the dual – drive theory
in relationship to human sexuality. He described sexual drive as the ultimate
premise of biological motivation for human behavior just as instincts serve
similar purpose for animals. Under the dominance of the sexual drive and guided
by the primary process thinking; the libido exerts an ongoing pressure towards
gratification operating in accordance with the pleasure principle. The aggressive or ‘death’ drive which is profoundly
self-destructive is responsible for the development of depression and suicide
and runs counter the pleasure principle of the libido. A basic inference from
this theory is that the sexual drive is the energy of life and when it is
frustrated could result in unconscious self- destructive psychological
strategies that may end up in depression and suicide. This explains the central
role that mental health experts play in sexual dysfunction. Men and women have
always been curious about sexual life; its inherent mysteries, drives,
intentions, oddities and common sexual problems. Treatment rituals, folk
remedies, advice, and sex manuals have been discovered among the writings of
the ancient Greek physicians, Islamic and Talmudic scholars, and Chinese and Hindu
practitioners. Even today the public’s insatiable curiosity about sexual life,
especially how to enhance, improve, restore or cure problems, is the focus of
every monthly women’s magazine, television and radio programmes, books and
videos.
Biographers have observed that most of our great leaders and
inventors have been peculiarly endowed with enormous libidinal energy
creatively harnessed and plugged into their particular creative outlets rather
than wasteful dissipation in consonance with the concept of sexual
transmutation. For the love of a woman, a man can perform essentially animated
by the energy of the libido.
I think it is in
agreement with Freud’s theory of libido that guided our culture to define
manhood among other qualities in the context of sexual agility. The African society is essentially patriarchal
and sexual agility is considered a resource for man to take full control of his
emotional and psychological territory just as the women are expected to derive
security in the enjoyment of this facility. However changes in the dynamics of
the modern marriage with the attendant psychological challenges may explain an
apparent increase in incidence of sexual dysfunction among men especially
erectile dysfunction and their patronage of local culturally compliant
remedies. The women because of the cultural and religious inhibitions may never
admit to their sexual dysfunction.
From basic psychology, the sexual response cycle can be divided
into 4 phases of functioning: desire, arousal, orgasm and satisfaction. Sexual
dysfunction in clinical practice follows this theoretical model including the
sexual pain disorders. Erectile dysfunction is a disorder of sexual arousal
characterized by persistent or recurrent inability to attain or to maintain erection
until completion of the sexual activity. The dysfunction may occur as full
erection occurs in the early stages of love -making but declines when
intercourse is attempted; or erection does occur, but only when intercourse is
not being considered; or partial erection, insufficient for intercourse occurs
but not full erection. And for women; there is the persistent inability to
attain or sustain adequate lubrication-swelling response of sexual excitement
Significant enough to cause distress and interpersonal difficulty. Couples or
individuals who discover that they do not have optimum sexual satisfaction
should seek medical advice since some
medical conditions like diabetes, hypertension, some surgical conditions and some medications like
the antihypertensive, Depressive illness presenting with reduced libido, antipsychotics and some drugs of abuse may be
cause erectile dysfunction.
However, strong cognitive and emotional factors may be responsible
for the majority of cases. Until
recently; clinicians used to consider performance anxiety responsible for the
development and maintenance of life long and acquired erectile dysfunction. However,
recent findings are showing that the cognitive processes interacting with
anxiety are responsible for sexual dysfunction.
The challenge for the mental health expert is to elicit deep
seated psychological and relational barriers usually fed by faulty cultural and
religious paradigms and defective communication patterns. The African man’s
definition of manhood as sexual conquest of his partner readily makes him
vulnerable to sexual dysfunction especially when his partner demands to be
treated with respect rather than conquered. The quality of the couple’s non-
sexual relationship is examined such as conflicts emanating from work,
finances, partner’s health, and difficulties with parents and children.
Partners could provide useful information that the client is concealing like
bereavement, indebtedness, not getting promotion or a son’s drug problem. The goal of therapy is to assist couples to
accept changes in their lives such as menopause, disability, and other life
stresses.
Dr. Adeoye Oyewole
adeoyewole2000@yahoo.com
+234 803 490 5808 (WhatsApp Only)
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