Treatment of Sexual Dysfunction by William E. Hartman, PhD. and Marilyn A. Fithian is an important contribution to the field of Sexology.  The book relays the unique and pioneering 2 week, in-person intensive sex therapy program of Hartman and Fithian in their clinic for couple’s sexual dysfunctions.  

The team of Hartman and Fithian were brave pioneers in the world of touch based sexuality research and what today might be called somatic sex therapy.  Hartman and Fithian worked with heterosexual, married couples who were experiencing “sexual dysfunction” including lack of intimacy, erectile dysfunction, inability to orgasm, mismatched libido and the sexless marriage. They chose to work solely with heterosexual couples and the language of the text reflects that. However, despite the fact that this book was written for and about heterosexual couples most of the exercises and methodologies used are applicable to all sexualities, genders and couples with some adjustments to reflect the specific needs of the individuals, relationships and sexual identities.

Treatment of Sexual Dysfunction was written in 1972 to describe the intensive 2 week couple’s body based sex therapy process of research and methods. The work of Hartman & Fithian as outlined in their book continues to give enormous benefit both to the field of sexology and sex therapy as well as to sexuality professionals who are desiring to or currently working with couples. Their system and methods, well grounded in research, gives permission and credibility to the benefits of body based sex therapy methods for couples.

As outlined in the Introduction, “Our program for treatment of human sexual dysfunction includes a series of steps, activities, and exercises moving the individual and the couple toward becoming more intimately in touch with their own feelings and the feelings of the significant other”. This healing journey for the couple is described as one which elicits a myriad of emotions, uncovers sensations, determines where there can be a lack of sensation and offers an opportunity to do go into those places where sexual repression and lack of permission around pleasure can be highlighted and healed for a deeper connection between couples.

Hartman and Fithian describe their system as a “biopsychosocial approach to the treatment of human sexual dysfunction”. (Pg. 1) Their process includes: psychological testing, the taking of a sex history for each individual, physical examination, sexological examination, body imagery, caress exercises, homework assignments, and the use of audio and video aids.

Hartman and Fithian used a dual-sex team approach as they believe that the, “importance of a dual-sex therapy team is evident when one considers the socialization process involved in taking on a sexual identity, male or female”… “It is, therefore, essential that representatives of both sexes, with their unique cultural conditioning be represented in a therapeutic situation involving two individuals with similar cultural experiences” (pg 3). It is evident that they wanted to create a highly specialized, safe space and container where their clients could feel absolutely comfortable and trusting when working with them. By using this dual-sex team approach they created such a container especially involving the use of touch by themselves towards their clients. “Touch between clients and therapists can take place much more readily and comfortably in such a situation”. (Pg. 4)

Hartman and Fithian ask each couple to begin by defining their goals for treatment and ask the question, “If we are successful in helping you, what will you be able to do that you cannot do now”?. This is an important question and asks the couples to take a deep look into their expectations and willingness to commit to the process. Hartman and Fithian make sure that it is known from the start that, “Resolution of sexual problems does not resolve all problems in a relationship”. (pg. 23). This allows the couple to view their sex life as one portion of their lives together and as an important part of their intimacy but not the totality of it.

By going through the 2 week intensive process the couple will discover many aspects of their intimacy they have previously not, just by doing the work of improving their sex lives. At the end of the 2 weeks Hartman and Fithian have a process in which to say Goodbye and to safely and with love close the container of the intense work they have all done with each other. With the the willingness to do the work and the effort to which the couple has engaged in they acknowledge the work that has been done and offer way in which the couple can stay connected through follow up calls and by staying in close contact during the month of so after the treatment has concluded.

I loved this book and would recommend it to someone studying couples sex therapy, touch based sex therapy, how to create an intensive program for couples and how to design curriculum as a systematic approach to somatic sex therapy that shows results.  My belief is that the work of William Hartman, PhD and Marilyn Fithian will continue to inspire people in the sexology professions to be better therapists and practitioners creating a modern as well as historical space in which we can excel at our profession.  The importance of touch based sex therapy can not be stressed enough.  It is through the practical application of any therapy that true change will take place.

Categories: Sex Education


Anya de Montigny, DHS is a sexuality expert with over 20 years experience working with individuals, couples, and groups. Dr. Anya has a Doctor of Human Sexuality (DHS) degree, is a certified sex educator and certified sex coach and was the host of the popular radio show The O Word Sex Talk Radio. Dr. Anya has a private practice in the San Francisco Bay Area working with individuals and couples and invites straight and LGBTQ people into her practice. She also teaches adult sex education classes as well as consent & boundaries workshops at Universities and Colleges.

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