Sigmund Freud remains one of the most
creative, dramatic and significant contributors to the field of modern
psychiatry, especially through his famous theory of psychoanalysis in
explaining varied forms of abnormal behaviour.
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 it runs counter to 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.
Continue reading after the cut...
This explains the central role that
mental health experts play in sexual dysfunction. Men and women have
always been curious about sex — 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,
as well as Chinese and Hindu practitioners.
Even today, the public’s insatiable
curiosity about sexuality, especially how to enhance, improve, restore,
or cure sexual 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 women are expected to derive security in the enjoyment of this
facility.
However, changes in the dynamics of
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 cultural and
religious inhibitions, may never admit to their sexual dysfunction.
From basic psychology, the sexual
response cycle can be divided into four 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 characterised by persistent or recurrent inability to
attain or 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 may
be at play. Again, depressive illness presenting with reduced libido,
antipsychotics and some drugs of abuse may be the cause of erectile
dysfunction.
However, strong cognitive and emotional
factors may be responsible for the majority of cases. Until recently,
clinicians used to consider performance anxiety as being responsible for
the development and maintenance of lifelong 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 eliminate 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- Adeoye Oyewole/Punch
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