Status of Sexuality in Contemporary Psychoanalytic Psychotherapy as Reported by Therapists

Contemporary psychoanalytic literature places less emphasis than its classical counterpart on sexuality in explaining human motivation. However, up until now no methodical research has been done on the status of sexuality in clinical work. We report on a qualitative interview study that examined the status of sexuality in psychoanalytically oriented psychotherapy (n = 10). We studied the extent to which therapists used sexual factors to explain patient behavior: To what extent were sexual themes dominant in the treatment, what importance did therapists attach to them, and what factors affected their place in therapy? The data gathered from the investigation were related to theoretical thinking on the marginalization of sexuality in psychoanalytic theory and practice. On the basis of the investigation, we describe four factors that affect the status of sexual themes in therapy: the extent of the belief in the centrality of sexuality in human motivation, the level of expressiveness of therapy, the narrowing of the concept of sexuality and the separation between sexuality and intimacy, and the tendency to avoid sexual issues because of the discomfort their discussion causes to patient or therapist.