Psychotherapies and Sex therapy

The most peculiar symptom of PSSD, the one that is most likely to lead one to rule out a psychogenic nature of at least the symptom itself, is hypoesthesia, that is, the loss of erogenous and/or tactile sensation in the genital area following intake of serotonergics (and not previously present). Another sign that very little may have to do with the psyche is the change in the consistency and quantity of semen.

Sexual reflexes fail. If it used to be normal, resting a finger on or lightly stimulating, even without sexual thought, the most erogenous and sensitive spot, glans or clitoris, to have an unconditioned response, such as a contraction followed perhaps by a small blood/nervous "response", this kind of autonomous responsiveness with PSSD may have been completely lost. Many people with PSSD explain that now touching their genitals is like touching an arm or other non-erogenous body part. In severe cases of anesthesia, one no longer even feels touching a towel or whether the water is cold or hot.

PSSD itself is not psychogenic in origin and cannot be treated with psychotherapy, and so far we are there. However, PSSD is a very burdensome problem that compromises many aspects of life, from one's sense of identity, to one's relational life, to expectations for one's future, and more. Often the symptomatology is not just sexual dysfunction, but a more complex and sometimes disabling post-SSRI syndrome. It is a condition that triggers severe malaise in the sufferer, even to the point of despair, sometimes to levels one had never known before taking the antidepressant that caused it all.

So what can psychotherapy or sex therapy be useful for?

Not to treat PSSD in the strict sense, but the possible negative consequences resulting from PSSD, which can even worsen the symptoms with very unfavorable vicious circles.

Some people who are confused about whether or not to have PSSD, who perhaps have a mild case and suffer from easy suggestion, may really have a psychogenic component that is causing or at least worsening the symptoms they are concerned about.

Short-strategy psychotherapy when dealing with sexual dysfunction targets certain dynamics that gravitate around autosuggestion: "The more you think about it, the more you focus on that thing, the more what you fear comes true/what you want doesn't happen", "The more you read on the Internet that PSSD is a problem that can be permanent, the more you convince yourself that you will never get better, and the more you will never get better".

These phrases are complete nonsense to those who have clear cases of PSSD. In these cases, psychotherapists who insist and maybe even dare to tell you "You don't want to heal" when you reject their explanations are really off the mark, as are the proposed strategies that are really useless for PSSD in the strict sense.

But even in these cases, certain psychological strategies could benefit on the psychological consequences of PSSD, such as obsessive focuses on dysfunction, paranoia, hypochondria, anxiety, performance anxiety, etc., which could really worsen the symptoms, especially erectile dysfunction and involvement in intimacy. Assess for yourself whether psyche may play a role in your case. Feeling very confused about this could be a telltale sign that it might as well.

If you, on the other hand, see clear as day that the symptoms are not psychogenic and the therapist insists that they are, it's time to drop it! It would only lead to further stress and frustration, anger, and a sense of misunderstanding and incommunicability.

If you are in a romantic relationship, individual or couples sex therapy, provided it is with a therapist aware of PSSD, might be supportive, with suggestions, strategies, allowing you to vent, find acceptable compromises with your partner, explore new possibilities.

In addition, PSSD may have thrown you into a depression you had never experienced before, and the symptom of decreased libido may have been made worse by that affliction, as is the case for many depressed people. But let's remember: not for everyone! Many with PSSD say that even at the peak of their depressive distress, before PSSD, their sexuality functioned great-they could even be hypersexual. Depressed people who have no libido often find it hard to believe and retort that "it was not real depression"!

Psychotherapy with a PSSD-conscious therapist could help you reflect and find support about how to cope, to deal with the grief that PSSD entails, to limit its disastrous effects, to compromise even with yourself struggling with a condition that is very difficult to cope with and endure, to focus your attention on positive goals that are still attainable. This might include being patient and keeping hope alive, keeping abreast of scientific research and doing activism, and in the meantime taking care of yourself and carrying on with your life as best you can.

There are quite different psychotherapy orientations: brief strategic therapy, cognitive-behavioral, systemic-relational, psychodynamic, etc. Before starting one, get informed and try to get an idea of what is best for you.