Clinicians theorize that strong negative emotions (anger, dysthymia, guilt, shame) result in diminished sexual desire; however, empirical studies supporting these ideas are generally lacking. One exception is Schreiner-Engel and Schiavi's report(24) that men and women with generalized hypoactive sexual desire had higher lifetime prevalences of depressive disorder which had preceded the development of the sexual disorder. Many clinicians also believe that situational sexual desire disorders may have their origin in the deterioration of a couple's non-sexual relationship. Stuart et al.'(25> found that hypoactive sexual desire was associated with lower levels of marital satisfaction and lower feelings of romantic love toward the partner. Finally, a history of childhood sexual abuse or gender identity conflict has been associated with generalized hypoactive sexual desire in some women. (26,2Z>

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