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Old Mar 31, 2008, 02:12 AM
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I don't think you are being a freak about your personal space. Everyone who has responded to you here has said that they would similarly feel uncomfortable about being asked such specific and detailed questions and the majority of people here (myself included) did indeed wonder about the ethics of that.

Part of it was that you told him that impulsive sexual behavior was one of the things that you wanted to work on. So I'd imagine that he was conducting an assessment of the problem.

If you told him that traumatic memories of sexual abuse was one of the things that you wanted to work on I'd imagine that an assessment of the problem would involve asking about when you had those memories (how frequent, how debilitating) and perhaps a little about the content, yeah.

Makes some difference to treatment whether you are allowing guys to sleep with you if they want to and taking a passive role kind of lying back and thinking of England... Compared to whether you are actively seducing guys and taking a very active role in the behaviors you are engaged in. Makes some difference to treatment if there are S and M themes and which of those themes tends to predominate for you. Makes a great deal of difference for treatment whether you enjoy the sexual act or whether you experience it more as a kind of compulsion that you can't resist. Makes a great deal of difference whether you are fixated on oral acts (for example) or %#@&#! themes or whatever...

Now of course I wasn't there. All I'm meaning to say is that one can't know whether he is an unprofessional crank or not on the basis of one initial meeting like that.

From Kaplan and Saddock:

SEXUAL HISTORY: ... The psychiatrist should ask how the patient learned about sex and what he or she felt were the parents' attitudes about sexual development. Also inquire whether the patient was sexually abused in childhood... The onset of puberty and the patients feelings about this milestone are important. Adolescent masturbatory history, including the nature of the patient's fantasies and feelings about them, is of significance. Attitudes towards sex should be described in detail. Is the patient shy, timid, agressive? Does the patient need to impress others and boast of sexual conquests? Did the patient experience anxiety in the sexual setting? Was there promiscuity? What is the patient's sexual orientation?

The sexual history shuold include any sexual symptoms, such as anorgasmia, vaginismus, erectile disorder, premature or retarded ejaculation, lack of sexual desire, and paraphilias (e.g., sexual sadism, fetishism, voyeurism). Attitudes towards fellatio, cunnilingus, and coital techniques may be discussed. The topic of sexual adjustment should include a description of how sexual activity is usually initiated, the frequency of sexual relations, and sexual preferences, variations, and techniques...

And that is in the context of a general history and not within the context of assessing symptoms of a sexual disorder well enough to treat it...