All of this is true for love-making as well. Yet we often believe that good love-making should "come naturally," without education. We covet beliefs that somehow people should know how to make love together and should not have to talk about it or practice with the intent of improving our style so that it is mutually satisfying. Clearly, if your dance partner continuously stepped on your toes and was unwilling to discuss the matter, it would not take long before you either stop dancing or find a different partner. Yet the majority of couples do not communicate about their love-making and are not open to exploring their sexuality with one another. Even the most experienced lovers often practice poor love-making strategies. People, especially men, become defensive when their partner wants to discuss their sex life as if they were about to be criticized.

Communication between dance partners and lovers is essential for having a satisfying experience. The partners must frequently communicate verbally and non-verbally with one another in order to learn to anticipate each other's moves. With sufficient practice, the dance of love seems effortless. Lovemaking should be fun, playful, affectionate, intimate, and fulfilling. When something goes awry, either because of faulty communication, inappropriate attitudes, or antiquated beliefs, a sexual dysfunction may emerge.

Remember: most sex goes on between your ears, not between your legs! Good sex starts with a healthy attitude about sex.

The cardinal rules for good sex are:

• respect your partner
• adopt a healthy attitude
• share your thoughts and feelings with your partner
• talk about what you like and don't like
• be honest
• experiment
• have fun and relax
• practice.

Sexuality and Sex Therapy: Part 2 When There Is Sexual Dysfunction

Bob became increasingly embarrassed as he talked about his problem with premature ejaculation. He claimed that can only 'last' for two minutes and felt that he was not much of a man. His 'problem' has kept him from dating.

Sally was beside herself with fear as she harshly castigated herself for not being able to achieve orgasm. She feared she would lose her husband because of her 'condition.'

Most sexual dysfunction occurs because of faulty beliefs and attitudes about sexuality, poor habits, ignorance, and early experiences. There are some sexual dysfunctions that are precipitated by physiological, biological, or chemical factors. However, all physiological dysfunctions have a psychological component. When men are unable to obtain or maintain an erection, whether from physiological or psychological causes, they feel inferior, less manly. When a woman is unable to reach orgasm she feels less feminine. Therefore, in all cases of sexual dysfunction it is necessary to attend to the psychological aspects of the difficulty and what it means to the individual.

Physiological factors. Some of the more common non-psychological precipitants of sexual dysfunction include hormonal imbalance, medications, neurological impairment, substance abuse (even nicotine dependence can cause erectile dysfunction), alcohol dependency, physiological disorders, and even vitamin deficiency. Certain illnesses and medications can have side effects that affect sexual functioning including impotence and increased or decreased libido.

Many people prefer to think of only a medical approach to sexual dysfunction, since it is more acceptable to one's self-image to believe that there is an organic basis for the dysfunction. Even in those instances when there is a recognizable medical condition affecting sexual functioning, the psychological component cannot be overlooked. We all have varying psychological reactions to physical illness or impairment. This psychological reaction can exacerbate the physical problem. This is especially true for infertility problems. Most people who have difficulty conceiving a child choose to investigate the medical aspects to the exclusion of the psychological aspects. Yet we all know of many cases where a couple after years of frequenting the fertility clinics to no avail, finally decide to adopt a child only to conceive a few months afterward. This can suggest that psychological factors were at play.

Psychological factors. Most sexual dysfunctions have a psychosocial etiology. Dr. Helen Singer Kaplan states, "In a general sense we see the immediate causes of the sexual dysfunctions as arising from an anti-erotic environment created by the couple which is destructive to the sexuality of one or both. An ambiance of openness and trust allows the partners to abandon themselves fully to the erotic experience."

She lists four specific sources of anxiety and defenses against full sexual enjoyment: 1) Avoidance of or failure to engage in sexual behavior which is exciting and stimulating to both partners. 2) Fear of failure, exacerbated by pressure to perform, and overconcern about pleasing one's partner rooted in fears of rejection. 3) A tendency to erect defenses against erotic pleasure. 4) Failure to communicate openly and without guilt and defensiveness about feelings, wishes and responses. Psychological reactions to traumatic events also affect sexual functioning. For example, child molestation, rape, abuse all can contribute to later sexual dysfunction.