Archives of Sexual Behavior

, Volume 32, Issue 3, pp 279–285 | Cite as

The Nature of Sexual Desire: A Clinician's Perspective

  • Stephen B. Levine

Abstract

Sexual desire is the sum of the forces that lean us toward and away from sexual behavior. The ordinary spectrum of sexual desire's intensity ranges between aversion, disinclination, indifference, interest, need, and passion. Although many individuals have a characteristic pattern of desire throughout their adult lives, this spectrum evolves considerably over the life cycle. It is clinically useful to think of desire as consisting of drive (biological), motive (individual and relationship psychology), and wish (cultural) components. Four master variables—age, gender, social situation, and health—affect sexual desire so basically that many remain blind to their presence. Five dark paradoxes of desire envelop most people at some time in their privacy: (1) Drive and motive are not in sync; (2) Behavioral fidelity is often associated with longing for infidelity; (3) Despite moral proscriptions, lust is possible; (4) Familiarity diminishes sexual interest; and (5) Derogation enhances sexual expression. Clinicians cannot afford to simplify desire's inherent contradictions. Researchers must simplify desire in order to measure it. In both the clinician's and the researcher's hands, sexual desire is a slippery concept.

desire drive sexual motivation sexual desire disorders 

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REFERENCES

  1. Basson, R. (2000). The female sexual response: A different model. Journal of Sex and Marital Therapy, 26, 51­65.Google Scholar
  2. Basson, R. (2003). Women's desire deficiencies and avoidance. In S. B. Levine, C. B. Risen, & S. E. Althof (Eds.), Handbook of clinical sexuality for mental health professionals (pp. 111­130). New York: Brunner/Routledge.Google Scholar
  3. Basson, R., McInnes, R., Smith, M. D., Hodgson, G., & Koppiker, N. (2002). Efficacy and safety of sildenafil citrate with sexual dysfunction associated with female sexual arousal disorder. Journal of Women's Health and Gender­Based Medicine 11, 367­377.Google Scholar
  4. Butler, R. N. (1975). Psychiatry and the elderly: An overview. American Journal of Psychiatry, 132, 893­900.Google Scholar
  5. Clement, U. (2002). Sex in long­term relationships: A systemic approach to sexual desire problems. Archives of Sexual Behavior, 31, 241­246.Google Scholar
  6. Everaerd, W., Laan, E. T. M., Both, S., & Van Der Velde, J. (2000). Female sexuality. In L. T. Szuchman & F. Muscarella (Eds.), Psychological perspectives on human sexuality (pp. 101­146). New York: Wiley.Google Scholar
  7. Freud, S. (1905). Three essays on the theory of sexuality. In The standard edition of the complete psychological works of Sigmund Freud (Vol. 7, pp. 123­245). London: Hogarth Press.Google Scholar
  8. Goldstein, I., Lue, T. F., Padma­Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998). Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. New England Journal of Medicine, 338, 1397­1404.Google Scholar
  9. Herdt, G., & McClintock, M. (2000). The magical age of 10. Archives of Sexual Behavior, 29, 587­606.Google Scholar
  10. Kafka, M. P. (1997). Hypersexual desire in males: An operational definition and clinical implications for males with paraphilias and paraphilia­related disorders. Archives of Sexual Behavior, 26, 505­526.Google Scholar
  11. Kandel, E. R. (1999). Biology and the future of psychoanalysis: A new intellectual framework for psychiatry revisited. American Journal of Psychiatry, 156, 505­524.Google Scholar
  12. Laumann, E. O., & Michael, R. T. (Eds.). (2001). Sex, love, and health in America: Private choices and public policies. Chicago: University of Chicago Press.Google Scholar
  13. Leiblum, S. R., & Rosen, R. C. (Eds.). (1988). Sexual desire disorders. New York: Guilford Press.Google Scholar
  14. Levine, S. B. (1987). More on the nature of sexual desire. Journal of Sex and Marital Therapy, 13, 35­44.Google Scholar
  15. Levine, S. B. (1988). Individual and intrapsychic factors in sexual desire. In S. R. Leiblum & R. C. Rosen (Eds.), Clinical perspectives on sexual desire disorders (pp. 21­44). New York: Guilford Press.Google Scholar
  16. Levine, S. B. (1989). Sex is not simple. Columbus: Ohio Psychology Publications.Google Scholar
  17. Levine, S. B. (1992). Sexual life: A clinician's guide. New York: Plenum.Google Scholar
  18. Levine, S. B. (1984). Essay on the nature of sexual desire. Journal of Sex and Marital Therapy, 10, 83­96.Google Scholar
  19. Levine, S. B. (1995). The vagaries of sexual desire. In S. R. Leiblum & R. C. Rosen (Eds.), Case studies in sex therapy (pp. 96­109). New York: Guilford Press.Google Scholar
  20. Levine, S. B. (1997). Solving common sexual problems. Livingston, NJ: Jason Aronson.Google Scholar
  21. Levine, S. B. (1998). Sexuality in midlife. New York: Plenum.Google Scholar
  22. Levine, S. B. (1999). Male heterosexuality. In R. C. Friedman & J. I. Downey (Eds.), Masculinity and sexuality: Selected topics in the psychology of men (pp. 29­54). Washington DC: American Psychiatric Press.Google Scholar
  23. Masters, W. H., & Johnson, V. (1970). Human sexual inadequacy. Boston: Little Brown.Google Scholar
  24. Meston, C. M., & Frohlich, P. F. (2000). The neurobiology of sexual function. Archives of General Psychiatry, 57, 1012­1030.Google Scholar
  25. Person, E. S., Terestman, N., Myers, W. A., Goldberg, E. L., & Salvadori, C. (1989). Gender differences in sexual behavior and fantasies in a college population. Journal of Sex and Marital Therapy, 15, 187­198.Google Scholar
  26. Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The International Index of Erectile Dysfunction (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822­830.Google Scholar
  27. Rothstein, E. (2001, March 10). Eros and its dizzying masks. The New York Times, p. B11.Google Scholar
  28. Schiavi, R. C., & Segraves, R. T. (1995). The biology of sexual function. Psychiatric Clinics of North America, 18, 17­23.Google Scholar
  29. Schnarch, D. M. (2000). Desire problems: A systemic perspective. In S. R. Lieblum & R. C. Rosen (Eds.), Principles and practice of sex therapy (3rd ed., pp. 17­56). New York: Guilford Press.Google Scholar
  30. Shifren, J. L., Braunstein, G. D., Siman, J. A., Casson, P. R., Buster, J. E., Redmond, G. P., et al. (2000). Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. New England Journal of Medicine, 343, 682­688.Google Scholar
  31. Simon, W. (2002). Desire is a fuzzy matrix. Zeitschrift für Sexualforschung, 15, 150­160.Google Scholar
  32. Stoller, R. J. (1975). Perversion: The erotic form of hatred. New York: Pantheon Books.Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Stephen B. Levine
    • 1
  1. 1.Center for Marital and Sexual HealthBeachwood

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