Clinical sexology: modern concepts and paradigms of therapeutic support

The author’s concepts dealing with clinical sexology are described: 1. Symptom-formation, according to which we should isolate primary symptoms, those of development and derivative ones, as well as principal and derivative symptoms, thereby making it possible to reveal target symptoms and work out a program of adequate symptomatic therapy. 2. The concept of erogenous sensory systems (ESS), within whose framework we should accept existence of the visual, auditory, olfactory, vomeronasal, tactile and intracerebral ESS, as well as intrasystemic and intersystemic cooperation. Also, paradigms of therapeutic maintenance for patients with sexual dysfunctions are characterized: 1. Erection-centric, according to which medical aid is based on the approach aimed at normalization of erection with a resultant ability to accomplish coitus. 2. Orgasm-centric, according to which orgasm is the main index of qualitative coitus. 3. Pleasure-centric, suggested by the author. On the basis of his experience in giving aid to patients with sexual dysfunctions the author has drawn a conclusion that it is this paradigm that most completely satisfies demands for the above help; in compliance with it the main thing during intimacy consists in pleasure, which should be sought, while complete erection and orgasm are achieved not always. The pleasure-centric approach during psychotherapeutic maintenance of patients with sexual dysfunctions is the most humanistic one and has a strong psycho protective potential. But the work in this approach by no means excludes measures for normalization of sexual functions (including erection and orgasm) in those cases when it is possible.