1. Introduction to Psychosexual Medicine
Doctor Gillian Vanhegan
Member of the Institute of Psychosexual Medicine

2. Course Objectives To understand psychosexual problems
To be familiar with different treatment methods for psychosexual problems
To be able to use the practitioner/patient relationship therapeutically and the psychosomatic examination of the genitalia
To have confidence to manage psychosexual problems in your normal practice

3. Session One
Background to the Institute of Psychosexual Medicine method of treatment
Psychosexual Problems
The Practitioner/Patient Relationship
Psychosomatic examination of the genitalia

4. Session Two Analysis of the events before the consultation
What happens in the consultation
Interpretation of the conscious and unconscious feelings in the room
Basic psychoanalytical principles

5. Session Three Psychosomatic examination of the genitalia
When to examine the patient, trigger events
When not to examine the patient, interpretation of this to the patient
Preparation for the examination
What happens on the couch
Other Therapies

6. Session Four Male problems Medical treatment Surgical treatment
Psychotherapeutic treatment

7. Session Five
Female problems
Pain with sex
Vulvodynia
Vaginismus

8. Session Six Reflection on the course Evaluation of the sessions
What happens next?
Summing up

9. Dr Michael Balint The study of the pharmacology of the drug ‘doctor’
Restrict to a minimum the use of written material in the discussion groups
A frank account of the doctor-patient relationship, the discussion should be free enough to enable the doctor to speak spontaneously

10. Dr Tom Main Training for skill rather than knowledge
Doctors are required to think for themselves
To investigate the patient’s and doctor’s feelings during each clinical encounter
Knowledge can be taught by a scholar to a pupil, skill must be acquired

11. Dr Tom Main The strength of the patient’s defences
Reasons for the psychosomatic examination of the genitalia
Fantasies and how we deal with them
The doctor/patient relationship

12. Psychosexual Problems
Lack of libido and anorgasmia occur in both sexes
Female problems are deep and superficial dyspareunia (vulvodynia) and vaginismus
Male problems are ED, premature or retarded ejaculation

13. The patient and the psychosexual problem
Presentation of problem
Practitioner/patient relationship
Interpretation of the relationship
The patient’s response
The practitioner’s and patient’s defences
Subconscious feelings in the consultation

14. The patient and the psychosexual problem
The psychosomatic examination of the genitalia
How the feelings reflect other relationships in the patient’s life
Ongoing clinical plans

15. Case Presentation Develop free floating attention
Think about what the patient was like
What was said and how was it said
How did you feel and what were the feelings in the room
What happened during the examination
Reflections on the case

16. Case Discussion
Listen carefully to the presentation, noticing what you are feeling about the patient
In the discussion express your thoughts and feelings about the case, try not to ask too many questions
Think about how the practitioner/patient relationship might relate to the patient’s problem

17. Websites and contact details