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1/3. A refinement of the concept "reticence".

    This report has 1. Made a distinction between speech disorders involving defects and those that are primarily reticence, but in any case identified speech disorders as negotiated states as opposed to fixed disease states. 2. Argued that there is a clear analytical separation between speech disorders and speech behaviors which are indicative of neurotic disorders. 3. Attempted to remove anxiety as a component of the communication process by according it its rightful place, which is central in human personality. Furthermore, we have attempted to dispel the notion that anxiety is evil and the perennial (and sole) cause of speech disorders. 4. Identified a specialist known as the rhetoritherapist (a specially trained speech teacher) as the particular king of professional qualified to deal with speech disorders (in conjuction with speech pathologists and/or psychotherapists where necessary). We have accorded to the rhetoritherapist the province of instruction and training in all aspects of invention, delivery, and reception of rhetorical speech without reference to its moral intent. 5. Identified "reticence" as the most useful of the various imprecise terms used to refer to people with speech problems, because it is devoid of connotations that go beyond the speech process. Further refinement of specific categories of speech disorders is necessary to order to expand the repertoire of available treatment strategies. Such refinement will probably include reference to the various subprocesses of human speech identified earlier in this paper as they are related to the rhetorical situation. The rhetoritherapist thus emerges as the trouble-shooter, but not the "psychotherapist," of speech pedagogy.
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keywords = communication
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2/3. Psychosexual dysfunction in patients with immobilized jaws.

    The purposes of this study were to determine and evaluate the psychosexual behavior of selected patients whose jaws were immobilized. Data for this pilot study were collected by using a standardized interview protocol with ten patients whose jaws were immobilized. The interview questions were designed to ascertain whether sexual problems existed, the nature and management of these problems, and the suggested role the operating surgeon might assume in assisting the patient. The data revealed that sexual difficulties were experienced by nine of these patients, and many of their problems were similar. The chief complaints included: (1) shortness of breath during sexual intercourse, (2) difficulty in oral foreplay, (3) poor verbal communication, (4) altered self-image, (5) sexual dysfunctions induced by pain medication, (6) depression, and (7) a lack of ability to exercise oral-genital sexual contact. Nine of the ten patients agreed that the operating surgeon should inform his or her patients with immobilized jaws of potential sexual disability. We believe that additional studies of these problems could enhance the management of patients with oral and maxillofacial injuries.
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keywords = communication
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3/3. Couple sex therapy for dysfunctions associated with congenital penile curvature.

    Three couples presented to our clinic with congenital ventral curvature of the penis resulting in unconsummated marriage in 2 cases and dyspareunia in 1. Intensive sex therapy was initiated, including use of vaginal dilators for vaginismus and dyspareunia, sex education, sensate focus exercises, and sexual techniques and methods to increase communication. Two highly motivated couples succeeded in having painless, normal, pleasurable sexual relations after short-term sex therapy. The problems of couple 3 were compounded by the wife's admitted lesbianism. However, this patient insisted on corrective surgery for her husband but she divorced him shortly thereafter. This nonsurgical approach for the treatment of sexual dysfunction secondary to penile curvature appears to be effective in selected cases. When corrective surgery is undertaken sex therapy is recommended to reinforce the operative results.
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keywords = communication
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