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However, when sexual touches are wanted, oral and manual genital stimulation or the use of a vibrator can be considered. Given possible problems with mobility, dyspareunia, and erection, exploring non- penetrative genital sexual stimulation may be particularly important. Ultimately, the act of intercourse or vaginal penetration with dildo may be included but is not the major focus. For some couples intercourse may prove to be less enjoyable, e. Focusing away from intercourse can alleviate performance anxiety, and decrease self-monitoring and cognitive distractions, with benefit to all phases of sexual response. Men and women with spinal cord injury can explore their pleasure—pain continuum, as the skin near their injury is hypersensitive to touch.

Often painful and intensely aversive when touched, these sensations can become pleasant when stimulated the right way with a wanted partner. Sensate focus can explore the hypersensitive areas, and find how to create a pleasuring touch. The emotions and thoughts elicited by the sensate focus experience can clarify conscious and unconscious conflicts that may be part of the sexual problem. Working with this information and addressing the underlying issues brought out by the sensate focus exercises can be the most powerful part of treatment. Therefore, it is important that the therapist links sensate focus exercises with regular psychosexual sessions, where couples can process, communicate, and understand these experiences.

Systemic desensitization Systemic desensitization is used when severe anxiety or phobic response to sexual stimulus is evident, e.

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