Sexual dysfunction and interpersonal stress: The significance of the presenting complaint in seeking and engaging help

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Abstract
This paper examines the extent to which sexual problems featured in one year's applications to a specialist marital agency and the degree of match between client and agency in the way these problems were understood. Sexual dysfunction is seen as having a functional aspect, capable of drawing attention to sensitive areas in marriage and yet of deflecting away from them when attention begins to constitute a threat. The nature of the threat is examined from a psychodynamic perspective in relation to a case example, and implications are drawn for the therapist in managing both the presenting symptom and the transference.

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