فانتزی های جنسی و میل جنسی در زنان

SummaryIn the clinical experience of sexual disease, we often have to investigate sexual fantasies of patients. Our group has felt the need to class the sexual fantasies as modern clinical rules, beginning from a retrospective examination of cases treated by medical sexual service. Then we tried to make uniform the ways to collect sexual reveries. We examined 326 clinical cases. Sixteen of them were rejected because of the absence or insufficiency in the medical history of sexual fantasies. By means of the analysis of 308 cases, we made a classification of fantasies according to various criteria: depending on time, depending to the type of sexual activity represented in them, the relationship established by partners and their ability to share individual fantasies, the role represented by him/herself within his/her imagination. Afterward we suggested a possible use of sexual fantasies, in the therapy of hypoactive sexual desire disease in women. The goal of treatment is therefore to enhance the sexual sphere, using the fantasies to bring back the erotism in the partner and in the relationship. To perform this, anticipatory fantasies can be created using in them the partner's itself. The aim of the therapy to overcome the decline of desire is to bring back arousal in the relationship, in the person involved and in the situation in order to obtain an improved sexual response. We analyzed 52 cases, four of them gave up the therapy after a few meetings, while the others ended it. Only nine of these 48 obtained a small improvement, whereas the others returned to the whole normality, tested also with FSFI. We are currently starting research on sexual fantasies in Italy. This for both an updated finding survey and to build a clinical tool like a repertoire of fantasies in order to facilitate the collection of sexual fantasies.

We can define sexual imagination as the faculty that man has to mentally eroticize himself through the creation of conscious mental representations with erotic charge. It is capable of activating a desire, a general and genital arousal to the point that for much fantasy is the real engine of sexual activity (Pasini et al., 1987). Sexual fantasies are particularly important because they constitute the expression of our sexual “habitus” free from hesitation, personal conflicts and unencumbered by the rules imposed by the environment. Certainly, they are sensitive to the cultural context of reference and vary according to sexual identity and age (Fossi and Mascari, 2001). These fantasies generally derive their strength from more or less explicit sexual content, although sexual contents may not possess erotic charge. They can take the form of a single image, a representation of more rapid images (plurisegmental fantasies) or a structured setting (Pasini et al., 1987). In general, the sexual fantasy serves to fill a sexual-emotional specific need and is therefore more likely to be present at the time when the need becomes more pressing, with the aim to restore, temporarily, the intrapsychic homeostasis that satisfies basic psycho-emotional needs such as the need to be valued, the need for fusion and the need for security (Pasini et al., 1987).

Our group was recently interested in sexual imagery. We have debated and proposed a classification and used it as a tool for diagnosis and sex therapy. In particular, it appeared very useful in cases of hypoactive desire. Certainly the use of imagination in clinical practice requires good collaboration with the patient and a capacity of the subject to easily contact his/her erotic imagination. In addition, the sensibility of the treated field requires a careful analysis of the psychological, cultural, and sociological characteristics of the individual. This is to prevent a paradoxical effect, where instead of getting an increase in sexual desire, there is a worsening of rigidity and a therapeutic escape, which may be associated with traumatic experiences (Friday, 2000). We are currently starting research on sexual fantasies in Italy. This for both an updated finding survey and to build a clinical tool like a repertoire of fantasies in order to facilitate the collection of sexual fantasies.