CURRENT CONCEPTS OF
Helen Singer Kaplan
THE LAST DECADE has witnessed intense activity and rapid development in the area of human sexuality. The intellectual and moral climate regarding sex has become increasingly rational, humane, and nonjudgmental to the point where the human sexual response has become a legitimate topic for scientific study. As evidence, people all over the world are openly seeking help for their sexual difficulties. This has led to the accumulation of extensive clinical experience, substantially changing traditional concepts about sexuality and sexual disorders. At the same time, clinical techniques have been greatly improved and extended.
of Human Sexuality and
In the past, it was believed that human sexual response was a single entity beginning with lust and ending with a climax. But this monistic view is wrong and has hampered the quest for theoretical clarity and for the effective treatment of sexual problems.
Probably the single most important recent theoretical advance in this field has been the emergence of the triphasic concept of the sexual response, which is based on the discovery that the male and female sexual response is made up of three interlocking, but neurophysiologically separate, phases: desire, excitement, and orgasm. This separation of the three phases, in addition to its theoretical importance, is also of great practical significance. Each of the phases can be impaired separately, and inhibitions of the specific phases produce the clinical dysfunction syndromes of orgasm phase, excitement phase, and desire phase dysfunction. Each of these phase dysfunctions is associated with related, but distinct and different, psychopathological patterns, and each responds to related, but specific treatment strategies. 10 The new classification of sexual disorders as described in the DSM-III is organized according to this concept. 5