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On the whole traumatic birth thing again...
From http://www.psychnet-uk.com/dsm_iv/female_orgasmic_disorder.htm :
Female Orgasmic Disorder occurs when there is a significant delay or total absence of orgasm associated with the sexual activity.
That bit's ok.
This condition must cause a problem in the relationship with the sexual partner in order to be defined as a disorder.
THAT BIT ENRAGES ME BEYOND BELIEF.
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Musing: I wonder if they mean to imply "as a [psychological] disorder" and might be meaning that if the sexual relationship is fine, then they assume it's a medical problem. I mean, not like women EVER have orgasms when ALONE, on no no no never!
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It's not even part of the actual *clinical* definition, it's just their guidance paragraph before the full text of the diagnosis. Mind you, the clinical definition isn't much better.
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I keep looking at that & trying to find a better reading of it (e.g. it's an incompetent way of saying that it's a disorder only if the woman herself feels that it upsets her sex life), but a) yeah, right, that's not how sex & women is treated, medically; & b) even then it explicitly includes an extensive range of 'sex life'.
Actually I think I will have that pickaxe back to seek targets myself. THIS KIND OF SHIT IS WHY I NO LONGER WANT TO GO INTO PSYCHOLOGY.
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http://www.behavenet.com/capsules/disorders/forgdis.htm
Diagnostic criteria for 302.73 Female Orgasmic Disorder
A. Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The diagnosis of Female Orgasmic Disorder should be based on the clinician's judgment that the woman's orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives.
B. The disturbance causes marked distress or interpersonal difficulty.
C. The orgasmic dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
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http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=172
Only major difference I can see is that it takes out the comment about "clinician's judgement" and replaces it with a more objective benchmark of problems that affect >75% of sexual experiences over >6 months.
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The problem is that once you try to draw that line, you're essentially asking the patient to diagnose themselves - how distressed is "enough"? You end up not treating the people that put up and shut up, and (perhaps) wasting resources on people who have less severe problems but just complain louder. Also, even though the diagnostic criteria are drafted in as non-sexist a manner as possible, with identical wording, it ends up institutionalising society's sexism.
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Unless I send Rob in with a big MY WIFE IS DEFECTIVE I WILL DIVORCE HER rant on, but I can't see him managing it convincingly. He's a lousy liar.
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The boxes they'll want ticked appear to be:
1) How long it's been going on (to catch DSM-V proposed criteria)
2) Whether it happens every time you have sex (likewise)
3) Whether it's a problem when masturbating as well as having sex (the "is Rob just crap" test)
... worth pointing out here that there wasn't a problem (so far as I know) prior to L being born.
4) Does it cause you or Rob distress (may be best if you can go in as a joint appointment and say it causes you both distress?).
They'll want to rule out physical causes (do you have some communication from the obs/gynae people to say there's no physical reason for problems?) and any drug interactions (antidepressants etc.)
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The problem here is that you're British, and the DSM criteria are written largely by Americans.
When you read "distress", imagine the AMERICAN definition of "distress", not the BRITISH one.
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http://www.behavenet.com/capsules/disorders/morgdis.htm
Diagnostic criteria for 302.74 Male Orgasmic Disorder
A. Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person's age, judges to be adequate in focus, intensity, and duration.
B. The disturbance causes marked distress or interpersonal difficulty.
C. The orgasmic dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
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http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=173
I'm not sure why psychnet-uk.com put such a misleading preface to its article: I think they were trying to avoid stigmatising people with a "disorder" in cases where it's not causing them or their partner any distress, but they worded it remarkably badly if so. However, the crap bit isn't actually part of DSM-IV.
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"This condition must be considered a problem by the person who has it in order to be defined as a disorder"
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The part where I screamed and nearly went into shock from the pain may have convinced him that I was serious about the pain. But FFS.
Ailbhe is right, I get better treatment when I use my energy to overcome my reserve and cry, than when I keep it for communicating.
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I don't have any issues externalising my emotions, but I used to think that when speaking to someone with scientific training it was better to be rational and stick to facts, measurables and testable hypotheses. WRONG! Breaking down in floods of tears earn you contempt, but also gets you treatment.
I do have to make the observation that this is a very English/British Catch-22, by the way. I think it's something to do with the very fact of having/admitting to a mental problem being seen as so shameful and flawed that there is no "right" way to about being that patient...
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