Masters and Johnson’s model of sex therapy

Sexual dysfunctions are characterized by the existence of some type of alteration given in some of the phases of the sexual response; which we will explain later. To treat this type of dysfunction, there are several therapy models, including the one developed by William Masters and Virginia Johnson.

In Masters and Johnson’s sex therapy model, which was developed around the 1970s, the human sexual response was divided into 4 main phases: arousal phase, plateau phase, orgasmic phase, and resolution phase.

In this article we will see what is the sex therapy model of Masters and Johnson and we will also talk about each of the phases of the sexual response.

    What is the Masters and Johnson model of sex therapy?

    Masters and Johnson’s model of sex therapy was an unprecedented revolution in the treatment of sexual problems; Note the 4 phases proposed by these sexologists to distinguish between different physiological changes that people experience.

    In developing this sex therapy model, a number of fundamental considerations were taken into account, including the following:

    • Human sexuality is natural, because it is controlled by a series of reflexive responses.
    • In sex therapy, it is important to try to facilitate the response of these key reflexes.
    • They rejected the hypothesis that the sexual dysfunction was the result of a mental disorder.
    • The couple must be made to understand that sexuality is not the only important thing in a relationship.
    • One member of a couple should never be blamed for sexual dysfunction.
    • They considered sexual dysfunction to be the result of behavior learned through experience.

    Moreover, in carrying out the Masters and Johnson model of sex therapy, these sexologists took into account a number of basic requirementsbeing these that we will enumerate next:

    • Therapy should begin with an individualized and thorough assessment of each couple.
    • Treatment focuses on the couple’s relationship, taking into account all related factors.
    • This model of sex therapy follows a brief and intensive 15-day internal approach.
    • It is an integrative therapy model where social, biological and psychological factors are taken into account.
    • For the treatment to work, the collaboration of both members of the couple is necessary.

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      The phases of the Masters and Johnson sex therapy model

      Now that we have seen the basic considerations and requirements that must be kept in mind when applying this model of sex therapy, it is appropriate that we continue by briefly explaining the different phases into which this therapy is divided. .

      1. Assessment and diagnosis phase

      The first phase of the Masters and Johnson sex therapy model is done during the first 3 days of treatmentduring which the following tasks are mainly carried out:

      • Individual interview with each member of the couple separately and also jointly.
      • Medical examination and examination.

      It is important to emphasize that during this first phase the couple must be clarified on the basics of the therapy and also address the aspects of training and education related to sex that may be necessary and will not be allowed to have sexual relations beyond those authorized by the therapist, as they may interfere with the therapeutic process.

      The assessment phase will end with an analysis, diagnosis and discussion with both members of the couple regarding the diagnosis of the problem that led them to consult a professional and the therapy guidelines for future sessions will also be specified.

        2. Sensory focus phase

        The second phase of this model would be in which the sensory focus is carried out, where each of the members of the couple participating in the therapy must try to know more deeply and to locate as precisely as possible the areas of the body that please each member the most when stimulated in order to encourage an adequate sexual response so that they can have a successful sexual relationship for both of them.

        In addition, in this phase we must work to improve or increase, if necessary, the communication between the members of the couple so that they develop the habit of expressing with the other desire and affection.

        3. Specific phase

        Finally, when applying the Masters and Johnson’s sex therapy model, once the assessment and diagnosis was properly done, the sensory focus phase was also properly worked on, allowing both limbs to have a more fluid communication and to know perfectly how to stimulate the other to obtain a better sexual response, it is then that a specific program will be carried out with a series of concrete techniques focused on treating the sexual dysfunction of each specific couple.

        Please note that the program that will be carried out in this sex therapy will vary greatly depending on each partner and the sexual dysfunction that led him to the therapy (eg premature ejaculation, erectile dysfunction, hypoactive sexual desire disorder, organic disorder, vaginismus, dyspareunia, etc.).

          Phases of sexual response according to Masters and Johnson

          After seeing the different phases of Masters and Johnson’s model of sex therapy, it’s time to see what the different phases of human sexual response consist of according to these sexologists.

          1. The excitement phase

          The first phase of human sexual response following the Masters and Johnson sex therapy model would be the arousal phase, where a series of physiological changes in both members of the couple that indicate their response to sexual stimulationwhether physical and/or psychological.

          At this point the female reproductive organ will begin to lubricate and also at the top there will be an increase in the size of what is called the clitoris. On the other hand, a woman’s breast size will also increase because vasocongestion will occur when she receives more blood flow.

          Instead, the man will begin to have an erection in his reproductive organ when he also receives more blood flow, when vasocongestion occurs. Besides, there will be testicular elevation and the rectum will experience a series of irregular contractions.

          On the other hand, it should be mentioned that both women and men, at the beginning of this first phase, will suffer from the so-called sexual redness, due to the increase in blood circulation and the temperature of the skin, as well as an increase in blood pressure and heart rate.

            2. The plateau or the maintenance phase

            The second phase would be the maintenance or plateau, where there will be a considerable increase in sexual tension levels and therefore also an increase in vasocongestion.

            In man, it is in this second phase of the sexual response that the penis will reach a maximum level of erection. The testicles will increase in size and the contractions of the rectum, which started in the previous phase, will continue to occur.

            In women, it will happen a series of contractions in the vaginal walls and in addition the clitoris will withdraw inwards. Also, the uterus at this stage will increase in size. It is also characteristic of this phase that in women it is when contractions begin to occur involuntarily in the rectum.

            On the other hand, in both members of the couple, it is worth mentioning that the vasomotor flushes will continue and, in addition, in this phase, the blood pressure and the heart rate will increase, arriving to accelerate the breathing of both.

            3. The Orgasmic Phase

            Third, we can find the orgasmic phase, where it will occur an explosive and involuntary discharge of neuromuscular tension when the sexual stimulation has increased to its maximum intensity, being this the moment that produces the greatest pleasure, being considered the moment of climax.

            In women, orgasm occurs when the orgasmic platform begins to contract 5 to 12 times at intervals of approximately 0.8 seconds. As well, there will be involuntary contractions in other muscle groupsamong which is the anal sphincter.

            In contrast, in men, the penis will experience a series of contractions which will cause ejaculation due to contractions of the pelvic muscles and urethra, also accompanied by contractions of the rectum.

            It should be noted that in both members of the couple during the orgasmic phase they continue to experience increases in blood pressureheart rate and respiratory rate.

            4. The resolution phase

            The fourth phase of sexual response according to Masters and Johnson’s sex therapy model would be resolution, where there will be a gradual loss of sexual tensionthus returning both limbs to the previous state they were in before the arousal phase took place.

            In men, after orgasm, this is when the refractory period occurs, during which it would no longer be possible to develop a full sexual response again, the duration of which varies according to each person (usually lasts between 15 and 30 minutes, increasing to as the person ages).

            On the other hand, in women, after orgasm, the signs of vasodilation that we mentioned above will gradually disappear, noting that in the case of women there is no refractory period, so they have the ability to experience multiple or repeated orgasms for a shorter period of time.

            Bibliographic references

            • PIR Preparation Academy (2019). Manual of psychological treatment: 3rd edition. Madrid: APIR.
            • PIR Preparation Academy (2021). Handbook of Clinical Psychology (Volume II): 3rd Revised Edition. Madrid: APIR.
            • Ballester-Arnal, R. (2020). Sexual dysfunction, paraphilic disorders and gender dysphoria. In A. Belloch, B. Sandin and F. Ramos (eds.). Handbook of Psychopathology: Volume I (pp. 441-483). Madrid: McGraw Hill.
            • Carey, MP (2007). Cognitive-behavioral treatment of sexual dysfunctions. In VE Horse (coord.). Handbook for the cognitive-behavioral treatment of psychological disorders (vol. 1): anxiety, sexual, affective and psychotic disorders (pp. 267-298). Madrid: Spanish Publishers of the 21st Century.
            • Masters, WH & Johnson, VE (1970). Human sexual inadequacy. Boston: Little Brown.
            • Masters, WH & Johnson, VE (1985). human sexuality. Boston: Little Brown.
            • Musso, JR (1985). Sexual therapies and behavioral therapies: epistemological reflections Revista Latinoamericana de Psicología, 17 (1), pp. 113-119.

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