Human Sexual Inadequacy

 
 
 
 
Masters' and Johnson's Human Sexual Inadequacy is a cumulative descriptive account of the operation of the clinic for the treatment of human sexual dysfunction at the Washington University School of Medicine since 1959 and its continuation at the Reproductive Biology Research Foundation after 1964. The authors report in detail on the development of their therapeutic format and then discuss the evolution of therapeutic approaches to a dozen of the major types of sexual dysfunction presented by patients. Both parts of the book are written in a direct, clinical--but forcefully clear--manner that is free of therapeutic jargon. This makes the volume as much an invaluable handbook as an introductory text. It is also, however, an important historical document since it is a record of the emergence of the original, and the most influential, model for therapeutic approaches to sexual dysfunction.

The therapeutic format established by Masters and Johnson became an enduring standard. They had studied interactions among partners and began to establish certain therapeutic principles very early in their work on the anatomy and physiology of sexual response. That work had also been driven by the assumption that scientific knowledge was required as a basis for therapeutic intervention and they expected, therefore, to be able to deal with sexual dysfunction at every level. Interpersonal problems, psychological problems, physical dysfunction, and inadequacies of performance in terms o


     
 
 
 
    

 

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ons can assist communication between the partners. Thus two therapists can manage to ensure that confusions, lack of information, and numerous problems that might sidetrack therapy are not allowed to develop. And, as the authors' point out, the dual-therapist approach eliminates some of the effects of clinical transference, familiar from other kinds of therapy, that might interfere with a therapeutic procedure. As Masters and Johnson note, though transference is not discouraged entirely, "every effort is made in the brief two-week acute phase of the therapy program to avoid the development of a special affinity between either patient and either cotherapist" (7). In the arrangement they devised, one therapist serves as the silent observer and coach of the team. The observer looks on and evaluates "levels of patient receptivity to therapeutic concept and to the educative and directive material presented by the cotherapist," while defining degrees of understanding and identifying areas of immediate concern for the team (9). At any point where a clarification is needed, the pace needs to be altered, or the specific gender-oriented knowledge of the silent therapist is needed, the cotherapists change positions and continue with a

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