Purpose – Problems related to sexual functioning have been reported in patients with anxiety disorders in
general and panic disorder in particular. The past literature has shown the association of sexual conflicts of
panic disorder patients with sadomasochism, and revealed the themes of: guilt, self-punishment, role of
unconscious conflicts about sexuality, anger and separation. The purpose of this paper is to explore sexual
conflicts in patients with panic disorder and their beliefs regarding guilt around sexual fantasies and dreams.
Design/methodology/approach – Interpretative paradigm and case study method was employed.
For collecting data, semi-structured interviews were recorded, transcribed and subjected to within and
cross-case analyses. Clarifying researcher’s bias and rich thick description were used for verification of data.
Findings – Cross-case analyses revealed themes of negative emotions, positive emotions and ambivalence.
Negative emotions (i.e. guilt and anger) were experienced as threatening and harmful and caused distress to
participants. Positive emotions, such as, satisfaction, pleasure and happiness were revealed in response to
questions related to sexual fantasies, thoughts dreams, emotional attachment and sexual relations.
Ambivalence was shown in response to questions related with reactions toward sexual fantasies,
masturbatory practices, sexual relations and/or emotional attachment.
Research limitations/implications – The participants of this study consisted of two self-selected
individuals who had diagnosis of panic disorder with agoraphobia. The main limitation of the study is a small
sample size comprising of men only. This research can provide grounds for more Asian studies in future
especially by including females.
Practical implications – The findings point toward addressing sexual conflict in therapeutic intervention of
panic disorder.
Social implications – The findings have implications in society in expanding the awareness and knowledge
about sexual conflicts in clinical population and general population suffering from anxiety symptoms.
Originality/value – This research study adds understanding of psychological issues in Pakistan’s
socio-cultural contex
