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Dr Chess Denman, psychiatrist, Jungian analyst and cognitive analytical therapist, observes that, ‘sex remains a difficult subject to discuss with any sense of balance’ (p. 1). She offers a biopsychosocial approach to counteract the prejudices that she detects in existing approaches to sexuality, to inform therapists about sex and to encourage them to interrogate their unexamined assumptions. She provides composite clinical examples to illustrate her approach.
Denman explores sexuality from three angles. Beginning with a comprehensive and informative biological account she considers chromosomes, hormones, internal and external sex organs, brain differences, sexual response cycles, medical matters and evolutionary processes. Biology limits our sexuality: ‘Sex is a biological business. Large parts of what we do, how we wish to do it and how we have difficulty in doing it are strongly conditioned by biological factors’ (p. 36). The social/cultural dimension allows greater latitude for sexual variation: ‘It is the fact of sexual diversity across time, and across and within cultures, which undercuts easy claims of sexual universality and any easy standard of sexual normality’ (p. 37). Sexual health is gauged according to social standards, collective aims and values. At the psychological level individuals shape their personal sexuality from their socio-biological possibilities. Sexuality is ‘an intensely personal experience’, and scope for individual variation is greatest psychologically. She acknowledges psychoanalysis as the foremost contributor to the psychology of sexuality. She credits psychoanalysis with recognizing the importance of sexuality in human development and providing fertile soil for the erotic imagination. However, her even-handed and impressive coverage of the range of psychoanalytic theories is peppered by her negative evaluation of the social conservatism and prejudice she detects in privileging heterosexuality and monogamy and a tendency to ‘pathologi