1. © 2015 Michael A Perelman, PhD
THE SEXUAL TIPPING POINT®
illustrates the multifactorial etiology of
male and female SD, which enhances our
ability to diagnose and treat SDs
using an integrated treatment approach.
THE SEXUAL TIPPING POINT®
The characteristic threshold for sexual
expression that dynamically varies within
and between sexual experiences; depicting
intra & inter-individual variability.
SEXUAL BALANCE:
The Sexual Tipping Point® model
depicts the continuously dynamic and
variable nature of an individual’s
sexual response on a distribution curve.
All STP images available gratis on request
From: MAP Education and Research Fund,
a 501(c)(3) public charity
Contact: mapedfund@gmail.com
EXPLAINING THE SEXUAL TIPPING POINT® MODEL

2. HOT
BEING “TURNED ON” IS MENTAL & PHYSICAL,
AND SO IS BEING “TURNED OFF.”
This mind/body concept
is older than Descartes!
© 2014 Michael A Perelman, PhD

3. © 2014 Michael A Perelman, PhD
DUAL CONTROL MODELS
EASILY EXPLAIN SUCH INTERACTIONS
Kaplan first published this dual control “psychosomatic” model in 1995, but
Bancroft and colleagues’ dual control model is the most well known & researched.

4. © 2014 Michael A Perelman, PhD
DUAL CONTROL MODELS
EASILY EXPLAIN SUCH INTERACTIONS
Jim Pfaus’ Classic 2009 JSM Desire Article Described
Perelman’s STP “Seesaw Model”
after Perelman (2006) J Sex Med, 3, 1004-1012
Slide courtesy of Jim Pfaus Pfaus, JSM, 2009

5. © 2015 Michael A Perelman, PhD
Men and women with SD have
various biopsychosocial-
behavioral & cultural
predisposing, precipitating,
maintaining, and contextual
factors which trigger, reinforce,
or worsen the probability of SD
occurring in any given sexual
encounter! The STP can
symbolically illustrate that
entire matrix.
HOW DOES THIS STP MODEL
APPLY TO TREATING SEXUAL DYSFUCNTION?

6. Best Possible Practice
© 2015 Michael A Perelman, PhD
SO WHAT TO DO?
First:
Recognize that SD
is always Mental & Physical:
a function of
Bio-Psychosocial-Behavioral &
Cultural [BPSBC] Factors.
Second:
Recognize that sexual function
or dysfunction for an individual
at any given moment in time, is
determined by the result of a
net summary of the above
BPSBC factors.
Identify the proportional factors:
Recognize that different factors will
have different valences resulting
out-weighing others on the mental
& physical scales thus determining
sexual function or dysfunction.PM
PM

7. 4 Containers on the scale, hold all known and unknown
Mental & Physical factors regulating sexual response.
© 2014 Michael A Perelman, PhD
KEY TO THE SEXUAL TIPPING POINT® MODEL SYMBOLS
M MP P
LET’S VISUALIZE THIS….

8. 4 Containers, hold all known and unknown
Mental & Physical factors regulating sexual response.
© 2014 Michael A Perelman, PhD
Each individual factor is ON/OFF,
represented as: HOT or NOT
KEY TO THE SEXUAL TIPPING POINT® MODEL SYMBOLS
Sex Positive (+) or Sex Negative (-)
HOT NOT
ON OFF
M MP P

9. Or currently unknown (?)
4 Containers, hold all known and unknown
Mental & Physical factors regulating sexual response.
© 2014 Michael A Perelman, PhD
Each individual factor is ON/OFF,
represented as: HOT or NOT
KEY TO THE SEXUAL TIPPING POINT® MODEL SYMBOLS
?
Sex Positive (+) or Sex Negative (-)
HOT NOT
ON OFF
M MP P

10. Neutral
Hot Not
Or currently unknown (?)
4 Containers, hold all known and unknown
Mental & Physical factors regulating sexual response.
© 2014 Michael A Perelman, PhD
An individual’s SEXUAL TIPPING POINT is displayed on a scale labeled with a Gaussian
distribution curve; a dynamic representation of their sexual response at any moment in time.
Each individual factor is ON/OFF,
represented as: HOT or NOT
KEY TO THE SEXUAL TIPPING POINT® MODEL SYMBOLS
?
Sex Positive (+) or Sex Negative (-)
HOT NOT
ON OFF
M MP P

11. ELEGANT
SOLUTION:
STP
ILLUSTRATING
AN
INTEGRATED
TREATMENT
INTEGRATED TREATMENT, THE IDEAL
SOLUTION TO BALANCE RISK/BENEFIT
© 2011 Michael A Perelman, PhD; WAS, Glasgow
Physical
?
© 2015 Michael A Perelman, PhD
Counseling