A number of recent clinical trials have suggested that mindfulness-based therapy may be an efficacious treatment for sexual dysfunction. However, little is known regarding the mechanisms of action for these treatments or whether these mechanisms are unique to mindfulness-based therapies. Such knowledge would aid in maximizing the impact and dissemination of these interventions. This article provides a review of potential mechanisms utilizing empirically supported theoretical models of sexual dysfunction and mindfulness meditation. These mechanisms include (a) shifting locus/quality of attention during sex, (b) decreasing negative sexual schemas, (c) altering negative expectancies/goals for sex, (d) reducing behavioral/experiential avoidance, (e) lessening engagement with negative sex-related cognitions, and (f) improving the relational context. Current evidence for the importance of each potential mechanism is summarized and recommendations regarding future directions of research are provided.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Adam, F., Heeren, A., Day, J., & de Sutter, P. (2015a). Development of the sexual Five-Facet Mindfulness Questionnaire (FFMQ-S): validation among a community sample of French-speaking women. Journal of Sex Research, 52, 617–626.
Adam, F., Géonet, M., Day, J., & de Sutter, P. (2015b). Mindfulness skills are associated with female orgasm? Sexual and Relationship Therapy, 30, 256–267.
Andersen, B. L. (1981). A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females. Journal of Consulting and Clinical Psychology, 49, 568–570.
Andersen, B. L., & Cyranowski, J. M. (1994). Women’s sexual self-schema. Journal of Personality and Social Psychology, 67, 1079–1100.
Andersen, B. L., Cyranowski, J. M., & Espindle, D. (1999). Men’s sexual self-schema. Journal of Personality and Social Psychology, 76, 645–661.
American Psychiatric Association (APA) (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.) (2013). Arlington, VA, US: American Psychiatric Publishing, Inc.
Arch, J. J., & Craske, M. G. (2008). Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: different treatments, similar mechanisms? Clinical Psychology: Science and Practice, 15, 263–279.
Atlantis, E., & Sullivan, T. (2012). Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. The Journal of Sexual Medicine, 9, 1497–1507.
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., & Williams, J. G. (2008). Construct validity of the Five Facet Mindfulness Questionnaire in meditating and nonmeditating samples. Assessment, 15, 329–342.
Bancroft, J., Loftus, J., & Long, J. S. (2003). Distress about sex: a national survey of women in heterosexual relationships. Archives of Sexual Behavior, 32, 193–208.
Banks, K., Newman, E., & Saleem, J. (2015). An overview of the research on mindfulness-based interventions for treating symptoms of posttraumatic stress disorder: a systematic review. Journal of Clinical Psychology, 71, 935–963.
Barber, J. P., & DeRubeis, R. J. (1989). On second thought: where the action is in cognitive therapy for depression. Cognitive Therapy and Research, 13, 441–457.
Barlow, D. H. (1986). Causes of sexual dysfunction: the role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54, 140–148.
Barlow, D. H., Sakheim, D. K., & Beck, J. G. (1983). Anxiety increases sexual arousal. Journal of Abnormal Psychology, 92, 49–54.
Barnes, S., Brown, K. W., Krusemark, E., Campbell, W. K., & Rogge, R. D. (2007). The role of mindfulness in romantic relationship satisfaction and responses to relationship stress. Journal of Marital and Family Therapy, 33, 482–500.
Basson, R. (2000). The female sexual response: a different model. Journal of Sex & Marital Therapy, 26, 51–65.
Baucom, B. R., Sheng, E., Christensen, A., Georgiou, P. G., Narayanan, S. S., & Atkins, D. C. (2015). Behaviorally-based couple therapies reduce emotional arousal during couple conflict. Behaviour Research and Therapy, 72, 49–55.
Bavelas, J. B., Coates, L., & Johnson, T. (2000). Listeners as co-narrators. Journal of Personality and Social Psychology, 79, 941–952.
Beck, A. T. (1963). Thinking and depression. Archives of General Psychiatry, 9, 324–333.
Benson, L. A., McGinn, M. M., & Christensen, A. (2012). Common principles of couple therapy. Behavior Therapy, 43, 25–35.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & Devins, G. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241.
Bober, S. L., Recklitis, C. J., Bakan, J., Garber, J. E., & Patenaude, A. F. (2015). Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention. The Journal of Sexual Medicine, 12, 189–197.
Bohlmeijer, E., ten Klooster, P. M., Fledderus, M., Veehof, M., & Baer, R. (2011). Psychometric properties of the Five Facet Mindfulness Questionnaire in depressed adults and development of a short form. Assessment, 18, 308–320.
Brake, C., Sauer-Zavala, S., Boswell, J. F., Gallagher, M. W., Farchione, T. J., & Barlow, D. H. (2016). Mindfulness-based exposure strategies as a transdiagnostic mechanism of change: an exploratory alternating treatment design. Behavior Therapy, 47, 225–238.
Brauer, M., Lakeman, M., van Lunsen, R., & Laan, E. (2014). Predictors of task-persistent and fear-avoiding behaviors in women with sexual pain disorders. The Journal of Sexual Medicine, 11, 3051–3063.
Brotto, L. A. (2013). Mindful sex. Canadian Journal of Human Sexuality, 22, 63–68.
Brotto, L. A., & Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy, 57, 43–54.
Brotto, L. A., & Goldmeier, D. (2015). Mindfulness interventions for treating sexual dysfunctions: the gentle science of finding focus in a multitask world. The Journal of Sexual Medicine, 12, 1687–1689.
Brotto, L.A., & Smith, K. B. (2014). Applications of mindfulness in the treatment of women’s sexual dysfunction. In A. le, C. T. Ngnoumen, E.J. Langer (Eds.), The Wiley Blackwell handbook of mindfulness (vols I and II) (pp. 864–880). Wiley-Blackwell.
Brotto, L. A., Basson, R., & Luria, M. (2008a). A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. The Journal of Sexual Medicine, 5, 1646–1659.
Brotto, L. A., Heiman, J. R., Goff, B., Greer, B., Lentz, G. M., Swisher, E., & Van Blaricom, A. (2008b). A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Archives of Sexual Behavior, 37, 317–329.
Brotto, L. A., Seal, B. N., & Rellini, A. (2012). Pilot study of a brief cognitive behavioral versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse. Journal of Sex & Marital Therapy, 38, 1–27.
Brotto, L. A., Basson, R., Carlson, M., & Zhu, C. (2013). Impact of an integrated mindfulness and cognitive behavioural treatment for Provoked Vestibulodynia (IMPROVED): a qualitative study. Sexual and Relationship Therapy, 28, 3–19.
Brotto, L. A., Basson, R., Smith, K. B., Driscoll, M., & Sadownik, L. (2015). Mindfulness-based group therapy for women with provoked vestibulodynia. Mindfulness, 6, 417–432.
Brown, D. B., Bravo, A. J., Roos, C. R., & Pearson, M. R. (2015). Five facets of mindfulness and psychological health: evaluating a psychological model of the mechanisms of mindfulness. Mindfulness, 6, 1021–1032.
Byers, E. S. (2005). Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long-term relationships. Journal of Sex Research, 42, 113–118.
Cahn, B. R., & Polich, J. (2006). Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychological Bulletin, 132, 180–211.
Carmody, J. (2015). Reconceptualizing mindfulness: The psychological principles of attending in mindfulness practice and their role in well-being. In K. W. Brown, J. D. Creswell, R. M. Ryan, K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 62–78). New York: Guilford Press.
Carrère, S., & Gottman, J. M. (1999). Predicting the future of marriages. In E. M. Hetherington (Ed.), Coping with divorce, single parenting, and remarriage: A risk and resiliency perspective (pp. 3–22). Hillsdale, NJ: Lawrence Erlbaum Associates.
Carson, J. W., Carson, K. M., Gil, K. M., & Baucom, D. H. (2004). Mindfulness-based relationship enhancement. Behavior Therapy, 35, 471–494.
Catalan, J., Hawton, K., & Day, A. (1991). Individuals presenting without partners at a sexual dysfunction clinic: psychological and physical morbidity and treatment offered. Sexual & Marital Therapy, 6, 15–23.
Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Research, 187, 441–453.
Christensen, A., Atkins, D. C., Berns, S., Wheeler, J., Baucom, D. H., & Simpson, L. E. (2004). Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples. Journal of Consulting and Clinical Psychology, 72, 176–191.
Christensen, A., Atkins, D. C., Yi, J., Baucom, D. H., & George, W. H. (2006). Couple and individual adjustment for 2 years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology, 74, 1180–1191.
Christensen, A., Dimidjian, S., & Martell, C. R. (2015). Integrative behavioral couple therapy. In A. S. Gurman, J. L. Lebow, D. K. Snyder, A. S. Gurman, J. L. Lebow, & D. K. Snyder (Eds.), Clinical handbook of couple therapy (5th ed., pp. 61–94). New York: Guilford Press.
Cranston-Cuebas, M., Barlow, D. H., Mitchell, W., & Athanasiou, R. (1993). Differential effects of misattribution on sexually functional and dysfunctional men. Journal of Abnormal Psychology, 102, 525–533.
Cyranowski, J. M., & Andersen, B. L. (1998). Schemas, sexuality, and romantic attachment. Journal of Personality and Social Psychology, 74, 1364–1379.
Cyranowski, J. M., & Andersen, B. L. (2000). Evidence of self-schematic cognitive processing in women with differing sexual self-views. Journal of Social and Clinical Psychology, 19, 519–543.
Davis, J. M., Manley, A. R., Goldberg, S. B., Smith, S. S., & Jorenby, D. E. (2014). Randomized trial comparing mindfulness training for smokers to a matched control. Journal of Substance Abuse Treatment, 47, 213–221.
Davis, S. P., Bergeron, S., Bois, K., Sadikaj, G., Binik, Y. M., & Steben, M. (2015). A prospective 2-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes. The Clinical Journal of Pain, 31, 333–341.
de Jong, D. C. (2009). The role of attention in sexual arousal: implications for treatment of sexual dysfunction. Journal of Sex Research, 46, 237–248.
Desrochers, G., Bergeron, S., Khalifé, S., Dupuis, M., & Jodoin, M. (2009). Fear avoidance and self-efficacy in relation to pain and sexual impairment in women with provoked vestibulodynia. The Clinical Journal of Pain, 25, 520–527.
Desrochers, G., Bergeron, S., Khalifé, S., Dupuis, M., & Jodoin, M. (2010). Provoked vestibulodynia: psychological predictors of topical and cognitive-behavioral treatment outcome. Behaviour Research and Therapy, 48, 106–115.
Dickson, K. S., Ciesla, J. A., & Reilly, L. C. (2012). Rumination, worry, cognitive avoidance, and behavioral avoidance: examination of temporal effects. Behavior Therapy, 43, 629–640.
Doss, B. D., Thum, Y. M., Sevier, M., Atkins, D. C., & Christensen, A. (2005). Improving relationships: mechanisms of change in couple therapy. Journal of Consulting and Clinical Psychology, 73, 624–633.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.
Fisher, W. A., Donahue, K. L., Long, J. S., Heiman, J. R., Rosen, R. C., & Sand, M. S. (2015). Individual and partner correlates of sexual satisfaction and relationship happiness in midlife couples: dyadic analysis of the international survey of relationships. Archives of Sexual Behavior, 44, 1609–1620.
Fjorback, L. O., Arendt, M., Ørnbøl, E., Fink, P., & Walach, H. (2011). Mindfulness-based stress reduction and mindfulness-based cognitive therapy—a systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124, 102–119.
Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: exposure to corrective information. Psychological Bulletin, 99, 20–35.
Follette, V. M., & Pistorello, J. (1995). Couples therapy. In C. Classen, I. D. Yalom, C. Classen, & I. D. Yalom (Eds.), Treating women molested in childhood (pp. 129–161). San Francisco: Jossey-Bass.
Forbes, M.K., Baillie, A.J., & Schniering, C.A. (2015). Where do sexual dysfunctions fit into the meta-structure of psychopathology? A factor mixture analysis. Archives of Sexual Behavior.
Fox, K. R., Nijeboer, S., Dixon, M. L., Floman, J. L., Ellamil, M., Rumak, S. P., & Christoff, K. (2014). Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neuroscience and Biobehavioral Reviews, 43, 48–73.
Frühauf, S., Gerger, H., Schmidt, H. M., Munder, T., & Barth, J. (2013). Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Archives of Sexual Behavior, 42, 915–933.
Grabovac, A. D., Lau, M. A., & Willett, B. R. (2011). Mechanisms of mindfulness: a Buddhist psychological model. Mindfulness, 2, 154–166.
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37, 1–12.
Halford, W. K., Saunders, M. R., & Behrens, B. C. (1993). A comparison of the generalization of behavioral marital therapy and enhanced behavioral marital therapy. Journal of Consulting and Clinical Psychology, 61, 51–60.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168.
Heiman, J. R. (2002). Psychologic treatments for female sexual dysfunction: are they effective and do we need them? Archives of Sexual Behavior, 31, 445–450.
Hocaloski, S., Elliott, S., Brotto, L. A., Breckon, E., & McBride, K. (2016). A mindfulness psychoeducational group intervention targeting sexual adjustment for women with multiple sclerosis and spinal cord injury: a pilot study. Sexuality and Disability, 34, 183–198.
Hooper, N., Villatte, M., Neofotistou, E., & McHugh, L. (2010). The effects of mindfulness versus thought suppression on implicit and explicit measures of experiential avoidance. International Journal of Behavioral Consultation and Therapy, 6, 233–244.
Hucker, A., & McCabe, M. P. (2014). An online, mindfulness-based, cognitive-behavioral therapy for female sexual difficulties: impact on relationship functioning. Journal of Sex & Marital Therapy, 40, 561–576.
Jodoin, M., Bergeron, S., Khalifé, S., Dupuis, M., Desrochers, G., & Leclerc, B. (2011). Attributions about pain as predictors of psychological symptomatology, sexual function, and dyadic adjustment in women with vestibulodynia. Archives of Sexual Behavior, 40, 87–97.
Jones, L. M., & McCabe, M. P. (2011). The effectiveness of an Internet-based psychological treatment program for female sexual dysfunction. The Journal of Sexual Medicine, 8, 2781–2792.
Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.
Kabat-Zinn, J. (2005). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness (15th anniversary ed.). New York: Delta Trade Paperback/Bantam Dell.
Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27.
Khoury, B., Sharma, M., Rush, S. E., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy individuals: a meta-analysis. Journal of Psychosomatic Research, 78, 519–528.
Kinder, B. N., & Curtiss, G. (1988). Specific components in the etiology, assessment, and treatment of male sexual dysfunctions: controlled outcome studies. Journal of Sex & Marital Therapy, 14, 40–48.
Kuffel, S. W., & Heiman, J. R. (2006). Effects of depressive symptoms and experimentally adopted schemas on sexual arousal and affect in sexually healthy women. Archives of Sexual Behavior, 35, 163–177.
Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., & Dalgleish, T. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: an individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73, 565–574.
Laumann, E. O., West, S., Glasser, D., Carson, C., Rosen, R., & Kang, J. (2007). Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: from the male attitudes regarding sexual health survey. The Journal of Sexual Medicine, 4, 57–65.
Laurent, H., Laurent, S., Hertz, R., Egan-Wright, D., & Granger, D. A. (2013). Sex-specific effects of mindfulness on romantic partners’ cortisol responses to conflict and relations with psychological adjustment. Psychoneuroendocrinology, 38, 2905–2913.
Leonard, L. M., & Follette, V. M. (2002). Sexual functioning in women reporting ahistory of child sexual abuse: review of the empirical literature and clinical implications. Annual Review of Sex Research, 13, 346–388.
Levant, R. F., Hall, R. J., Williams, C. M., & Hasan, N. T. (2009). Gender differences in alexithymia. Psychology of Men & Masculinity, 10, 190–203.
Linehan, M. M., & Wilks, C. R. (2015). The course and evolution of dialectical behavior therapy. American Journal of Psychotherapy, 69, 97–110.
Lorenz, T. A., Harte, C. B., Hamilton, L. D., & Meston, C. M. (2012). Evidence for a curvilinear relationship between sympathetic nervous system activation and women’s physiological sexual arousal. Psychophysiology, 49, 111–117.
Mark, K. P., & Jozkowski, K. N. (2013). The mediating role of sexual and nonsexual communication between relationship and sexual satisfaction in a sample of college-age heterosexual couples. Journal of Sex & Marital Therapy, 39, 410–427.
Mark, K. P., & Murray, S. H. (2012). Gender differences in desire discrepancy as a predictor of sexual and relationship satisfaction in a college sample of heterosexual romantic relationships. Journal of Sex & Marital Therapy, 38, 198–215.
Mark, K. P., Milhausen, R. R., & Maitland, S. B. (2013). The impact of sexual compatibility on sexual and relationship satisfaction in a sample of young adult heterosexual couples. Sexual and Relationship Therapy, 28, 201–214.
Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Boston: Little Brown.
McCabe, M. P. (1991). The development and maintenance of sexual dysfunction: an explanation based on cognitive theory. Sexual & Marital Therapy, 6, 245–260.
McCabe, M. P., & Goldhammer, D. L. (2013). Prevalence of women’s sexual desire problems: what criteria do we use? Archives of Sexual Behavior, 42, 1073–1078.
McCarthy, B., & Wald, L. M. (2013). Mindfulness and good enough sex. Sexual and Relationship Therapy, 28, 39–47.
McNulty, J. K., Wenner, C. A., & Fisher, T. D. (2016). Longitudinal associations among relationship satisfaction, sexual satisfaction, and frequency of sex in early marriage. Archives of Sexual Behavior, 45, 85–97.
Meston, C. M. (2006). The effects of state and trait self-focused attention on sexual arousal in sexually functional and dysfunctional women. Behaviour Research and Therapy, 44, 515–532.
Meston, C. M., Lorenz, T. K., & Stephenson, K. R. (2013). Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial. The Journal of Sexual Medicine, 10, 2177–2189.
Mogg, K., & Bradley, B. P. (1999). Selective attention and anxiety: A cognitive-motivational perspective. In T. Dalgleish & M. J. Power (Eds.), Handbook of cognition and emotion (pp. 145–170). New York: Wiley.
Muise, A., Giang, E., & Impett, E. A. (2014). Post sex affectionate exchanges promote sexual and relationship satisfaction. Archives of Sexual Behavior, 43, 1391–1402.
Nelson, A. L., & Purdon, C. (2011). Non-erotic thoughts, attentional focus, and sexual problems in a community sample. Archives of Sexual Behavior, 40, 395–406.
Nobre, P. J., & Pinto-Gouveia, J. (2008a). Cognitions, emotions, and sexual response: analysis of the relationship among automatic thoughts, emotional responses, and sexual arousal. Archives of Sexual Behavior, 37, 652–661.
Nobre, P. J., & Pinto-Gouveia, J. (2008b). Cognitive and emotional predictors of female sexual dysfunctions: preliminary findings. Journal of Sex & Marital Therapy, 34, 325–342.
Norton, A. R., Abbott, M. J., Norberg, M. M., & Hunt, C. (2015). A systematic review of mindfulness and acceptance-based treatments for social anxiety disorder. Journal of Clinical Psychology, 71, 283–301.
Owens, G. P., Walter, K. H., Chard, K. M., & Davis, P. A. (2012). Changes in mindfulness skills and treatment response among veterans in residential PTSD treatment. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 221–228.
Purdon, C., & Holdaway, L. (2006). Non-erotic thoughts: content and relation to sexual functioning and sexual satisfaction. Journal of Sex Research, 43, 154–162.
Pyke, R. E., & Clayton, A. H. (2015). Psychological treatment trials for hypoactive sexual desire disorder: a sexual medicine critique and perspective. The Journal of Sexual Medicine, 12, 2451–2458.
Quinta Gomes, A. L., & Nobre, P. (2012). Early maladaptive schemas and sexual dysfunction in men. Archives of Sexual Behavior, 41, 311–320.
Ravart, M., Trudel, G., Marchand, A., & Turgeon, L. (1996). The efficacy of a cognitive behavioural treatment model for hypoactive sexual desire disorder: an outcome study. Canadian Journal of Human Sexuality, 5, 279–293.
Regev, L., & Schmidt, J. (2009). Sensate focus. In W. T. O’Donohue, J. E. Fisher, W. T. O’Donohue, & J. E. Fisher (Eds.), General principles and empirically supported techniques of cognitive behavior therapy (pp. 584–590). Hoboken: Wiley.
Roemer, L., & Orsillo, S. M. (2007). An open trial of an acceptance-based behavior therapy for generalized anxiety disorder. Behavior Therapy, 38, 72–85.
Rosen, N. O., Muise, A., Bergeron, S., Delisle, I., & Baxter, M. L. (2015). Daily associations between partner responses and sexual and relationship satisfaction in couples coping with provoked vestibulodynia. The Journal of Sexual Medicine, 12, 1028–1039.
Ruiz, F. J. (2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: a systematic review and meta-analysis of current empirical evidence. International Journal of Psychology and Psychological Therapy, 12, 333–357.
Sarwer, D. B., & Durlak, J. A. (1997). A field trial of the effectiveness of behavioral treatment for sexual dysfunctions. Journal of Sex & Marital Therapy, 23, 87–97.
Sbrocco, T., & Barlow, D. H. (1996). Conceptualizing the cognitive component of sexual arousal: Implications for sexuality research and treatment. In P. M. Salkovskis (Ed.), Frontiers of cognitive therapy (pp. 419–449). New York: Guilford Press.
Scepkowski, L. A., Wiegel, M., Bach, A. K., Weisberg, R. B., Brown, T. A., & Barlow, D. H. (2004). Attributions for sexual situations in men with and without erectile disorder: evidence from a sex-specific attributional style measure. Archives of Sexual Behavior, 33, 559–569.
Schmiedeberg, C., & Schröder, J. (2016). Does sexual satisfaction change with relationship duration? Archives of Sexual Behavior, 45, 99–107.
Schover, L. R., & LoPiccolo, J. (1982). Treatment effectiveness for dysfunctions of sexual desire. Journal of Sex & Marital Therapy, 8, 179–197.
Sedlmeier, P., Eberth, J., Schwarz, M., Zimmermann, D., Haarig, F., Jaeger, S., & Kunze, S. (2012). The psychological effects of meditation: a meta-analysis. Psychological Bulletin, 138, 1139–1171.
Segal, Z. V., Williams, J. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York: Guilford Press.
Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62, 373–386.
Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in United States women: prevalence and correlates. Obstetrics and Gynecology, 112, 970–978.
Shorey, R. C., Brasfield, H., Anderson, S., & Stuart, G. L. (2015). The relation between trait mindfulness and early maladaptive schemas in men seeking substance use treatment. Mindfulness, 6, 348–355.
Silberstein, L. R., Tirch, D., Leahy, R. L., & McGinn, L. (2012). Mindfulness, psychological flexibility and emotional schemas. International Journal of Cognitive Therapy, 5, 406–419.
Silverstein, R. G., Brown, A. H., Roth, H. D., & Britton, W. B. (2011). Effects of mindfulness training on body awareness to sexual stimuli implications for female sexual dysfunction. Psychosomatic Medicine, 73, 817–825.
Snippe, E., Nyklíček, I., Schroevers, M. J., & Bos, E. H. (2015). The temporal order of change in daily mindfulness and affect during mindfulness-based stress reduction. Journal of Counseling Psychology, 62, 106–114.
Staples, J., Rellini, A. H., & Roberts, S. P. (2012). Avoiding experiences: sexual dysfunction in women with a history of sexual abuse in childhood and adolescence. Archives of Sexual Behavior, 41, 341–350.
Stappenbeck, C. A., Luterek, J. A., Kaysen, D., Rosenthal, C. F., Gurrad, B., & Simpson, T. L. (2015). A controlled examination of two coping skills for daily alcohol use and PTSD symptom severity among dually diagnosed individuals. Behaviour Research and Therapy, 66, 8–17.
Stephenson, K.R. & Kerth, J. (under review). Effects of mindfulness-based therapies for female sexual dysfunction: a meta-analytic review.
Stephenson, K. R., & Meston, C. M. (2015a). The conditional importance of sex: exploring the association between sexual well-being and life satisfaction. Journal of Sex & Marital Therapy, 41, 25–38.
Stephenson, K. R., & Meston, C. M. (2015b). Why is impaired sexual function distressing for women? The primacy of pleasure in female sexual dysfunction. The Journal of Sexual Medicine, 12, 728–737.
Stephenson, K. R., & Meston, C. M. (2016). Heterosexual women’s causal attributions regarding impairment in sexual function: factor structure and associations with well-being. Archives of Sexual Behavior, 45, 1989–2002.
Stephenson, K. R., Pallatto, C. A., & Meston, C. M. (2012). Childhood sexual abuse moderates the association between sexual functioning and sexual distress in women. Journal of Child Abuse & Neglect, 36, 180–189.
Stephenson, K. R., Rellini, A. H., & Meston, C. M. (2013). Relationship satisfaction as a predictor of treatment response during cognitive behavioral sex therapy. Archives of Sexual Behavior, 42, 143–152.
Stephenson, K. R., Sullivan, K. T., & Christensen, A. (2016). Couples Therapy. In: H. Friedman (Ed.), Encyclopedia of mental health, 2nd edn (pp. 368–376). Elsevier.
Stinson, R. D. (2009). The behavioral and cognitive-behavioral treatment of female sexual dysfunction: how far we have come and the path left to go. Sexual and Relationship Therapy, 24, 271–285.
Tang, Y., Hölzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature Reviews Neuroscience, 16, 213–225.
Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33, 25–39.
Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002). Metacognitive awareness and prevention of relapse in depression: empirical evidence. Journal of Consulting and Clinical Psychology, 70, 275–287.
ter Kuile, M., van Lankveld, J. M., de Groot, E., Melles, R., Neffs, J., & Zandbergen, M. (2007). Cognitive-behavioral therapy for women with lifelong vaginismus: process and prognostic factors. Behaviour Research and Therapy, 45, 359–373.
Tolin, D. F., McKay, D., Forman, E. M., Klonsky, E. D., & Thombs, B. D. (2015). Empirically supported treatment: recommendations for a new model. Clinical Psychology: Science and Practice, 22, 317–338.
Treanor, M. (2011). The potential impact of mindfulness on exposure and extinction learning in anxiety disorders. Clinical Psychology Review, 31, 617–625.
van Lankveld, J. M., ter Kuile, M. M., de Groot, H. E., Melles, R., Nefs, J., & Zandbergen, M. (2006). Cognitive-behavioral therapy for women with lifelong vaginismus: a randomized waiting-list controlled trial of efficacy. Journal of Consulting and Clinical Psychology, 74, 168–178.
van Lankveld, J. M., Leusink, P., van Diest, S., Gijs, L., & Slob, A. K. (2009). Internet-based brief sex therapy for heterosexual men with sexual dysfunctions: a randomized controlled pilot trial. The Journal of Sexual Medicine, 6, 2224–2236.
Vujanovic, A. A., Youngwirth, N. E., Johnson, K. A., & Zvolensky, M. J. (2009). Mindfulness-based acceptance and posttraumatic stress symptoms among trauma-exposed adults without Axis I psychopathology. Journal of Anxiety Disorders, 23, 297–303.
Wahbeh, H., Lu, M., & Oken, B. (2011). Mindful awareness and non-judging in relation to posttraumatic stress disorder symptoms. Mindfulness, 2, 219–227.
Weiner, L., & Avery-Clark, C. (2014). Sensate focus: clarifying the Masters and Johnson’s model. Sexual and Relationship Therapy, 29, 307–319.
Weisberg, R. B., Brown, T. A., Wincze, J. P., & Barlow, D. H. (2001). Causal attributions and male sexual arousal: the impact of attributions for a bogus erectile difficulty on sexual arousal, cognitions, and affect. Journal of Abnormal Psychology, 110, 324–334.
Westerlund, E. (1992). Women’s sexuality after childhood incest. New York: W W Norton & Co.
Wiegel, M., Scepkowski, L. A., & Barlow, D. A. (2005). Cognitive and affective processes in female sexual dysfunctions. In I. Goldstein, C. M. Meston, S. L. Davis, & A. M. Traish (Eds.), Women’s sexual function and dysfunction: Study, diagnosis, and treatment. New York: Informa Healthcare.
Wilamowska, Z. A., Thompson-Hollands, J., Fairholme, C. P., Ellard, K. K., Farchione, T. J., & Barlow, D. H. (2010). Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depression and Anxiety, 27, 882–890.
Williams, J. G., Crane, C., Barnhofer, T., Brennan, K., Duggan, D. S., Fennell, M. V., & Russell, I. T. (2014). Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial. Journal of Consulting and Clinical Psychology, 82, 275–286.
This article does not contain any studies with human participants performed by the authors.
Conflict of Interest
The author declares that he has no conflict of interest.
About this article
Cite this article
Stephenson, K.R. Mindfulness-Based Therapies for Sexual Dysfunction: a Review of Potential Theory-Based Mechanisms of Change. Mindfulness 8, 527–543 (2017). https://doi.org/10.1007/s12671-016-0652-3
- Sexual dysfunction