Dr. Silbert provides sex therapy for sexual problems related to libido, arousal, performance and orgasm, sexual identity, sexual abuse, and non-normative sexual practices; sexual, couple and marital counseling for individuals to overcome sex problems to achieve sexual enhancement; psychotherapy and hypnosis for sex addiction, depression, grief, stress, loss, medical illness, death anxiety and sexual issues; and telephone advice for sexual education, sexual problems and mental health problems.
Seventy to eighty percent of all adult males and females experience sexual problems in their lives. These include lack of interest, decreased libido, performance anxiety, achieving orgasm, problems maintaining arousal, erectile dysfunction (impotence), premature ejaculation, vaginal pain and general sexual dissatisfaction. These problems can be caused by anxiety, stress, fear, lack of sexual knowledge and experience, childhood physical and sexual trauma, relationship difficulties, physical disabilities and medical problems.
The Sexuality Clinic of San Diego provides sexual counseling and therapy for individuals and couples to achieve sexual satisfaction. Emphasis is placed on educating clients about the sexual system for the individual and within the matrix of a couple. Treatment issues encompass sexual orientation, gender identity, sexual role behavior, extramarital affairs, communication skills, enhancing creativity, coping with non-normative sexual practices, sexual addiction, sexual compulsion, masturbation, pelvic pain disorders, menopause, infertility, medical illness, sexual desire discrepancy, emotional distress, depression, anxiety, stress, low self-esteem, and body image.
Sex therapy is tailored to individual needs. For some, this will include enhancing sexual knowledge, decreasing performance anxiety or improving sexual communication, performance and creativity. For others, therapy will focus on more effectively dealing with issues of fear, anger, trust and the vulnerability of intimacy, hence becoming more comfortable with ones self, emotionally and physically.
A holistic approach to treatment is paramount. Sexual activity is a combination of psychological, physiological and sociological influences. Therefore, consultation with physicians to evaluate physical functioning may be included as part of the evaluation process. Generally sexual disorders may be considered situational or generalized, (i.e. certain activities or specific partner verses all activities); lifelong or acquired; causative factors either physical or psychological, or a combination of both.
Categories of Male and Female Dysfunction:
Orgasmic Disorder (anorgasmia) - Persistent or recurrent difficulty, delay in or absence of attaining orgasm following sufficient sexual stimulation and arousal, which causes personal distress. (for males nocturnal emission may occur).
Hypoactive Sexual Desire Disorders - Persistent or recurrent deficiency and/or absence of sexual fantasies, thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress.
Hypoactive Sexual Arousal Disorder - Persistent or recurrent inability to attain or maintain sufficient sexual excitement, causing personal distress. It may be expressed as a lack of subjective excitement, or lack of genital lubrication or swelling in women, erection in males, or other physical responses.
Sexual Aversion Disorder - Aversion to and active avoidance of genital sexual contact with a sexual partner causing marked distress. The individual may experience anxiety, fear and/or disgust.
Pelvic Pain Disorders - syndromes with various symptoms which often include pain and dysfunction related to urination (including interstitial cystitis), defecation and sexual activity.
Dyspareunia - Recurrent or consistent genital pain associated with genital intercourse and sexual activity.
Categories of Female Dysfunction:
Vaginismus - Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration which causes personal distress.
Vulvodynia (Vulvar Vestibulitis) – is a syndrome that is marked by pain at the opening of the vagina when touched often associated with pain during intercourse.
Vulvodynia (Dysesthetic Vulvodynia) – is a syndrome associated with chronic pain and a sense of burning in the vulva whether the vulva is touched or not.
Categories of Male Dysfunction:
Erectile Dysfunction - Consistent or recurrent inability to attain and/or maintain a penile erection sufficient for sexual performance (impotence).
Early Ejaculation - Persistent or recurrent occurrence of ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it (premature ejaculation).
Delayed Ejaculation - Undue delay in reaching ejaculation during sexual activity.
DR. DENISE T SILBERT
RN, CNS, PhD, FAACS
Dr. Silbert combines her education and experience with her sense of compassion, sensitivity and intuition to create an atmosphere of understanding and trust which promotes a therapeutic alliance for success!