The article presents a clinical case with a 25-year-old female patient A., who has been married for 1 year, but before she was in a commonlaw marriage during 5 years with her present spouse, who is 30. They have not got any children. When she sought medical advice the patient informed that during 1.5 years she had been feeling sexual aversion to her husband (when he tried to take her in his arms, she had creeping sensations on her arms and back, a feeling of lump in her throat, and a desire to cry). She attributed it to the fact that her husband “does not pay enough attention to me”, he did not defend her against accusations from the side of his relatives and stood with his mother, faulting the patient for causing conflictual relations between the women. She did not feel any sexual desire toward her husband. Their sexual life was once a week. She let her husband loose with her only after she drank alcohol. A month before it was the end of their 8-month period, when she did not let her husband loose with her at all. Her husband put up with restrictions in their sexual life; he did not have any lover. Four months before she parted with her lover, with whom she was going 3-4 months. She did not feel any aversion to him. With time, by means of long conversations she succeeded in making her husband completely take her part in the conflict with his parents, and the spouses even severed any contacts with them.
Our additional examination succeeded in revealing a number of the patient’s characterological peculiarities, particularly histrionic personality disorder, this fact confirming our clinical observations. The following diagnosis was made: sexual aversion, absence of sexual desire (selective variants) with development by the conversion (hysterical) mechanism. Treatment was provided with help of cognitive effects and hypnosuggestive therapy (its seven sessions were given). The cognitive effects were targeted at the patient’s complete acceptance of the belief that her husband fully supported her at that time and was entirely reliable. It was explained that in some cases disorders might base on the mechanism of conditioned pleasantness/desirability (conversion mechanism). But it was done in a very nuanced and kind way, since a straight-line explanation of this mechanism (“it is in your interests”) may cause a negative response and the treatment may be discontinued by patients.
It was pointed out that sexual dysfunctions could result from influence of psychological factors: her bad relationships with her husband’s parents and with him. Suggestion in the hypnotic state was particularly targeted at elimination of sexual aversion, appearance of sexual desire toward her husband, generation of pleasant sensations during his caresses and kisses, presence of voluptuous (lascivious) sensations in frictions during coitus. Sexual intercourses were modeled too. It was also suggested that her husband was her defender, he stood with her and was entirely reliable. As the result of the given treatment, sexual aversion to the patient’s husband was nullified and her sexual desire toward him was completely restored.
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Опросник Леонгарда-Шмишека. – URL: http://psychojоurnal.ru/ schniieschek.html (дата обращения: 26.09.2016).