Sexual Problems

I do not think most of us in the psychoanalytic community would agree with Dr. Arnold I. Gilberg’s opinion (letter, Feb. 22) that it is the labeling of difficulties in a person’s sexual function that causes low self-esteem. Rather, it is the feelings of inadequacy and shame about the sexual difficulty which lead the person to conceal the problem, often with a sense of embarrassment and hopelessness. The recent response to the news about Viagra is evidence that there are many individuals hoping for such help but who have been reluctant to reveal their problem.

While it is true some of these difficulties may have a biological substrate, we know that experiential factors are critical factors in sexual as well as social difficulties. Sigmund Freud was the pioneer who called such sexual problems to the attention of the medical profession.

RICHARD P. FOX MD

President-elect, American

Psychoanalytic Assn., Tustin