Mental Health and Low Sexual Arousal Disorder
Published in NCCA Newsletter, Summer 2021
Sexuality has been associated with the longevity of intimate relationships (Lesier et al., 2007) and appears to be an important factor that many people consider when determining their level of relationship satisfaction (Byers, 2005; Mernard et al., 2015). The consideration of sexuality upon relationship satisfaction makes sense considering previous literature discussing how positive sexual experiences increase the closeness and intimacy with another’s partner
(Ellens, 2009). Conversely, when there are negative experiences in sexual activity, relationship satisfaction appears to decrease and mental health problems arise (Yehuda et al., 2015).
Mental health issues play a role in the development of Low Sexual Arousal Disorder (LSAD). A few of the most common mental health issues linked to LSAD are post-traumatic stress disorder (PTSD), anxiety, and depression. Individuals who have anxiety (Basson & Gilks, 2018), depression (Bodenmann & Ledermann, 2008), or go through trauma and develop PTSD (Yehuda et al., 2015) are at a higher risk for developing LSAD. PTSD resulting from sexual trauma either as a child or an adult is a common issue related to LSAD (O’Driscoll & Flanagan, 2016). Another mental health issue connected to LSAD is anxiety. Anxiety can make the symptoms of LSAD worse when an individual has trouble experiencing the sensations of physical arousal (Basson & Gilks, 2018). Lastly, depression has a way of numbing individuals and this can affect their libido (Yehuda et al., 2015). Treating depression aids in producing symptoms of LSAD because antidepressants can create symptoms of LSAD (Yehuda et al., 2015; Bodenmann & Ledermann, 2008). This creates a conflicting pattern of trying to treat depression and LSAD when experienced simultaneously.
Minimal research explores the constructs occurring with LSAD and how attention to each construct is important to treat the overall person. Some researchers suggest the use of mindfulness in treatment can help the client with awareness during the sexual experience, decreasing the negative symptoms, and supporting the overall sexual connection. For example, Brotto and Basson (2014) found four sessions of group Mindfulness-Based Therapy (MBT) significantly decreased symptoms of LSAD in an individual, utilizing a self-accepting approach. While Paterson et al. (2016) found a MBT program significantly improved sexual desire by using mindfulness to help ground people to the current moment that they are experiencing.
Even with all the research utilizing MBT to treat LSAD, these authors noted how further research would be useful to increase the significance of treating LSAD. One way this can occur is by integrating Cognitive Behavioral Therapy (CBT) with MBT, creating Mindfulness-Based Cognitive Therapy (MBCT). Since MBT uses the techniques of meditation and staying in the moment, and CBT uses the techniques of reframing distorted thoughts and changing negative behavior patterns, future research is needed to identify if MBCT would be a way to treat the different constructs seen in the symptoms of LSAD. For example, a client with low self-esteem and anxiety may also have LSAD.
A counselor could apply MBCT by using cognitive behavioral therapy techniques such as reframing the negative thoughts about herself. The counselor could integrate mindfulness based therapy by helping the client learn techniques to keep her mind from wandering during sexual intercourse. Most individuals who have LSAD suffer because of an underlying issue. Some mental health issues, physical issues, and medications have been linked to individuals having symptoms of LSAD. Past research has focused on using MBT to treat LSAD. According to research, a better alternative to treating LSAD would be MBCT which is an integration of MBT and CBT. Further research is needed to observe the effects of MBCT on individuals with LSAD.
Selected References
Basson, R., & Gilks, T. (2018). Women’s sexual dysfunction associated with psychiatric disorders and their treatment. Women’s Health, 14, 1-16. https://doi.org/10.1177/1745506518762664
Bodenmann, G., & Ledermann, T. (2008). Depressed mood and sexual functioning. International Journal of Sexual Health, 19(4). 63-73. https://doi.org/10.1300/J514v19n04_07
Brotto, L. A., & Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy, 57, 43-54. https://doi.org/10.1016/j.brat.2014.04.001
O’Driscoll, C., & Flanagan, E. (2016). Sexual problems and post-traumatic stress disorder following sexual trauma: A meta-analytic review. Psychology and Psychotherapy: Theory, Research and Practice, 89(3), 351-357. https://doi.org/10.1111/papt.12077
Paterson, L. Q. P., Handy, A. B., & Brotto, L. A. (2016). A pilot study of eight-session mindfulness-based cognitive therapy adapted for women’s sexual interest/arousal disorder. The Journal of Sex Research, 54(7), 850-861. https://doi.org/10.1080/00224499.2016.1208800
Yehuda, R., Lehrner, A., Rosenbaum, T. Y. (2015). PTSD and sexual dysfunction in men and women. The Journal of Sexual Medicine, 12(5), 1107-1119. https://doi.org/10.1111/jsm.12856