Issues and dilemmas in sexual treatment

Five concrete issues and dilemmas typically confronted in the practice of treatment of sexual problems are discussed. These are: (a) the issue of therapeutic values and conflict in values that may arise for the therapist; (b) the phenomenon of the desperation of the impotent male and its relationship to coping techniques and cultural expectations; (c) masturbation as a development stage in sexual responsiveness, based on evidence from historical, cross-cultural, human, and animal studies and clinical practice; (d) the positive aspects of the self-concept of nonorgasmic women that may serve as resistance to sexual responsiveness; and (e) a specific value conflict for women therapists that is a reflection of the change in values promoted by the women's movement.