Sexual Medicine and Medical Collaboration · Neurological Triage

What Still Works

Seven effects of neurological conditions, each classified twice: by mechanism, and then by where the work belongs. Three of the seven do not resolve cleanly to one discipline.

What this exercise practises

Applying the primary, secondary and tertiary framework to presentations as clients actually describe them, and deciding what is medically managed, what is sex therapy, and what has to be both at once.

One item on the list is a medical urgency presenting as a relational problem. One is a question about a spinal cord injury that cannot be answered from the injury level.

Estimated time to complete this exercise: 25 minutes

1Seven effects
2The injury
3Close

Before you begin

How this one works

Seven effects, one at a time. Each one gets two decisions: the mechanism, using the primary, secondary and tertiary framework, and then where the work belongs.
The second decision only appears once you have made the first, and both are revealed together. You cannot change an answer once it is in.
Three of the seven do not resolve cleanly to one discipline, and one of them is a medical urgency dressed as a relational problem.
Nothing is graded and nothing is recorded. Reloading starts it again.

Sex therapy addresses secondary and tertiary effects. Primary neurological dysfunction requires medical management. That sentence is easy to agree with and harder to apply, because the client does not present with a mechanism. She presents with the fact that sex has stopped happening, and the mechanism is something you have to work out.

References

  1. Bronner, G., Royter, V., Korczyn, A. D., & Giladi, N. (2004). Sexual dysfunction in Parkinson's disease. Journal of Sex & Marital Therapy, 30(2), 95–105. https://doi.org/10.1080/00926230490258893
  2. Fedele, D., Bortolotti, A., Coscelli, C., Santeusanio, F., Chatenoud, L., Colli, E., Lavezzari, M., Landoni, M., & Parazzini, F. (2000). Erectile dysfunction in type 1 and type 2 diabetics in Italy. International Journal of Epidemiology, 29(3), 524–531. https://doi.org/10.1093/ije/29.3.524
  3. Lew-Starowicz, M., & Rola, R. (2013). Prevalence of sexual dysfunctions among women with multiple sclerosis. Sexuality and Disability, 31(2), 141–153. https://doi.org/10.1007/s11195-013-9293-9
  4. Sipski, M. L. (1997). Sexual functioning in the spinal cord injured. International Journal of Impotence Research, 9(2), 111–116. https://doi.org/10.1038/sj.ijir.3900270