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ABC of Sexual Health

  • Verlag: BMJ Books
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ABC of Sexual Health

ABC of Sexual Health provides a comprehensive overview of this important, but difficult subject and includes reading resources as well as information on professional societies, patient groups and online resources. Fully revised and expanded to cover a range of new content and topics including psychological, urological, gynaecological, endocrinological and psychiatric aspects of sexual health, the effects of medication, sexual dysfunction, sexual orientation, gender identity, paraphilias, forensic sexology, dermatoses, and psychosexual therapy and education. ABC of Sexual Health is a practical guide for all general practitioners, family physicians, trainees and medical students wanting to improve communicating, examining and managing patients with sexual health problems. Kevan R. Wylie, Consultant in Sexual Medicine, NHS, Sheffield, UK; Honorary Professor, University of Sheffield and Visiting Professor, Sheffield Hallam University, UK; President, World Association for Sexual Health


    Format: ePUB
    Kopierschutz: AdobeDRM
    Seitenzahl: 144
    Sprache: Englisch
    ISBN: 9781118665619
    Verlag: BMJ Books
    Größe: 11372 kBytes
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ABC of Sexual Health

Chapter 1
Psychosexual Development

Brian Daines

University of Sheffield, Sheffield, UK

Psychosexual development is not limited to childhood and adolescence but extends through adult life
Early psychoanalytic views of the process are still influential but more recent ideas such as consumerist and feminist perspectives offer a more societal emphasis
It is important to consider the impact of the aspects of law and culture that relate to psychosexual development
Clinicians need to be aware of the implications of these issues and the various factors impacting on development in their consultations with patients. Introduction

Interest in psychosexual development has tended to focus around managing problems, particularly those associated with risks and their management. These areas include sexual abuse in childhood and early adolescence, unwanted pregnancy and sexually transmitted diseases (STDs) in adolescence and early adulthood and functional sexual difficulties in adults. In contrast, the interest, for example of adolescents has been shown to be more in the rite of passage and recreational aspects of sexual activity. There has also been a concentration on childhood and adolescence, with adult psychosexual development being a poor relation and any emphasis for older people being on dysfunctions and disorders rather than the expected course of development. Development through the life cycle involves important areas such as sexual identity, couple relationship issues, fertility and ageing.
Psychoanalytic views

Probably, the most familiar schema of sexual development in childhood and adolescence is that proposed by Freud ( Table 1.1 ). This still has currency in many modern textbooks despite having long been superseded, not only outside of the world of psychoanalysis, but also generally among psychotherapists. A primary criticism is that it pathologizes variations in sexual development, in particular gay and lesbian relationships. With the passage of time, Freud's emphasis on instinct and drive was replaced by highlighting the importance of relating and relationship and then broadened to recognize the importance of learning and culture. Freud's theories assume that children are caught in hidden conflicts between their fears and their desires, whereas the environmental learning view is of identification through observation and imitation. Modern psychoanalytic views include a wide range of innovative ideas such as that the various dynamics in childhood produce a psychosexual core which is unstable, elusive and never felt to be really owned.

Table 1.1 Freud on psychosexual development
Oral stage 0-2 years
Desires are focussed on the lips and mouth. The mother becomes the first love-object, a displacement from the earliest object of desire, the breast Anal stage 2-4 years of age
In this stage, the anus is the new auto-erotic object with pleasure being obtained from controlling bladder and bowel movement Phallic stage 4-7 years of age
In this third stage, awareness of and touching the genitals is the primary source of pleasure Latency period 7-12 years of age
During this time, sexual development is more or less suspended and sexual urges are repressed Genital phase 13 years + (or from puberty on)
In this final phase, sexual urges are direct onto opposite sex peers with the primary focus of pleasure of the genitals Consumerist view

At the other end of the spectrum are ideas that take a

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