Categories
Women's Health

Sexual Values

An interesting variation on this classification of repression should be mentioned. There were several primarily non-orgasmic women whose receptivity to the repressive conditioning was slightly different. Their own particular personality characteristics or their relationship to negatively directive authority was such that they fully accepted the concept of sexual rejection.

They developed pride in their ability to comply with sexual repression and did so with apparent social grace. Their selection of a mate in most cases represented a choice of similar background. The difficulty arose with marriage.

For example:

On the wedding night, a completely unrealistic, negative sexual value system usually was revealed during their attempt to establish an effective sexual interaction. These women reported either total pelvic anesthesia or isolation of sexual feelings from the context of psychosocial support.

Women entering therapy in a state of non-orgasmic return reflected the complete failure of any effective alignment of their biophysical and psychosocial systems of influence.

They had never been able to merge either their points of maximum biophysical demand or their occasions of maximum psychosocial need with optimum environmental circumstances of time, place, or partner response to fulfill the requirements of their sexual value systems.

Primary Orgasmic Dysfunction:

A condition whereby neither the biophysical nor the psychosocial systems of influence that are required for the effective sexual function is sufficiently dominant to respond to the psychosexually stimulative opportunities provided by self-manipulation, partner manipulation, or coital interchange.

If the concept of two interdigital systems influencing female sexual responsivity can be accepted, what can be considered the weaknesses and the strengths of each? Input required by either system for the development of peak response is, of course, subject to marked variation.

There may be some value in drawing upon the previously described psychophysiological findings returned from preclinical studies. As a human female response to subjectively identifiable sexual stimuli, reliable patterns of accommodation by one system to the other can be defined, and tend to follow basic requirements set by earlier imprinting.

Patterns of imprinting can be either reinforced or redirected by controlled experimental influence. They can also be diverted in their signaling potential by reorientation of a previously unrealistic sexual value system. The sexual value system, in turn, responds to reprogramming by a new, positive experience.

Variations in the human female’s bio-physical system are, of course, relative to basic body economy. Is the woman in good health? Is there a cyclic hormonal ebb and flow to which she is particularly susceptible? Are the reproductive viscera anatomically and physiologically within normal limits, or is there evidence of pelvic pathology? Is there evidence of broad-ligament laceration, endometriosis, or residual pelvic infection?

Certainly, most forms of pelvic pathology would weigh against the effective functioning of the biophysical system. On the other hand, are there those biophysical patterns that tend to improve the basic facility of her sexual responsivity? Is there a well-established metabolic balance, good nutrition, sufficient rest, the regularity of sexual outlet?

Each of these factors inevitably improves biophysical responsivity. There must be professional consideration of multiple variables when evaluating the influence of the biophysical system upon female sexual responsivity.

Overcome Sexual Difficulty

However, the system with the infinitely greater number of variables is that reflecting psychosocial influence. Most dysfunctional women’s fundamental difficulty is that the requirements of their sexual value systems have never been met. Consequently, the resultant limitations of the psychosocial system have never been overcome.

Many women specifically resist the experience of orgasmic response, as they reject their sexual identity and the facility for its active expression.

Often these women were exposed during their formative years to such timeworn concepts as sex is dirty, nice girls don’t involve themselves, sex is the man’s privilege or sex is for reproduction only.

There are also those whose resistance is established and sustained by a stored experience of mental or physical trauma, rape, dyspareunia which is signaled by every sexual encounter.

Again from a negative point of view, there may be extreme fear or apprehension of sexual functioning instilled in any woman by inadequate sex education. Any situation leading to sexual trauma, real or imagined.

During her adolescent or teenage years or her sexual partner’s, crude demonstration of his own sexual desires without knowledge of how to protect her sexually would be quite sufficient to create a negative psychosocial concept of a woman’s role in sexual functioning.

The woman living with residual specific sexual trauma (mental or physical) frequently is encountered in this category.

Finally, there is the woman whose background forces her into automatic sublimation of psychosexual response. This individual simply has no expectations for sexual expression that are built upon a basis of reality. She has presumed that sexual response in some form simply would happen but has a little, idea of its source of expression.

In these instances, sexual sublimation is allowed to become a way of life for many reasons. Particularly is this reaction encountered in the woman who has failed to enjoy the privilege of working at being a woman.

The positive side:

The psychosocial value system can overcome physical disability with dominant identification that may be personal and/or situational in nature. In states of advanced physical disability, the strength of loved-partner identification can provide orgasmic impetus to a woman physically consigned to be sexually unresponsive.

When there has been a pattern of little bio-physical sexual demand, as in a postpartum period, sexual tension may be rapidly restored by the psychosocial stimulation of a vacation, anniversary, or other experience of special significance.

Again the biophysical and psychosocial systems of influence are interdigital in orientation, but there is no biological demand for their mutual complementary responsivity. It is in the areas of involuntary sublimation that the psychosocial system is gravely handicapped and would tend to exert a negatively dominant influence in contradistinction to any possible biophysical stimulative function.

Categories
Women's Health

Sex Drive

For many women, a basic homophile orientation is a major etiological factor in heterosexual orgasmic dysfunction. For those women committed to homosexual expression, lack of orgasmic return from heterosexual opportunity is of no consequence.

But there are a large number of women with significant homosexual experiences during their early teenage years that, in time, have withdrawn from active homophile orientation to living socially heterosexual lives.

When they marry, many are committed to orgasmic dysfunction by the prior imprinting of homosexual influence upon their sexual responsivity.

Prior homosexual conditioning acts to create a negatively dominant psychosocial influence. Their biophysical capacity, freely evidenced in homosexual opportunity, continues operant in their electively chosen heterosexual environment, but it may not be of sufficient quality to overcome the negative input from their psychosocial system.

It is difficult to evaluate homosexual influence upon heterosexual function. There can be no question that both means of sexual expression will always be an integral part of every culture. So it has been for recorded time.

The problems of sexual adjustment do not rest with those committed unreservedly to a specific pattern of response. Rather, it is the gray area dweller that creates for him or herself a sexually dysfunctional status.

When moving from one means of sexual expression to the other for the first time, the sexual value system must be reoriented if the desired transfer of sexual identification is to be completed. Such was the problem of Mrs. G who had not been able to adapt her sexual value system to her elected heterosexual world when seen in therapy.

Mr. and Mrs. G

were referred for treatment after seven years of marriage, she was 33, her husband was 38 years old. The current marriage was his second, the first ending in divorce.

The presenting complaint was that Mrs. G had never been orgasmic in the marriage. Her childhood and adolescence were spent in-a small Midwestern town as an only child of elderly parents. Her mother was 41 when she was born.

Introverted as a teenager, the girl did well in school but had few friends and was not popular with male classmates. When she was 15 years old she formed a major psychosexual attachment to a high-school teacher, who seduced the girl into a homosexual relationship.

The courtship continued for six months before physical seduction was accomplished. Once fully committed to the homosexual relationship, the girl matured rapidly in personality and took a great deal more care with her dress and person. She vested total psychosexual commitment in her “teacher” throughout her high-school years.

Full responsivity in the sexual component of the relationship developed slowly for the teenager, although she was occasionally orgasmic with manipulation within a few months ‘of her first physical experience.

Initially, hers was primarily a receptive role, but as she matured in the relationship psychologically, mutual manipulation and oral-genital stimulation in natural sequence became part of the unit’s pattern of sexual expression.

During the girl’s last year in high school, mutual sexual tensions were maintained at a high level, and physical release was sought by either or both women at a minimum frequency level of three to four times a week. Both women were multi-orgasmic. Mrs. G has no history of heterosexual dating in high school.

There was physical separation when Mrs. G went to college, but since the separation represented a distance of only fifty miles, she and the teacher spent many weekends together. However, toward the end of Mrs. G’s sophomore year in college, the high-school teacher was apprehended approaching other girls, was discharged, and left the geographical area.

This was a major blow to the girl. She had lost her love and at the same time was made aware that the teacher had sought other outlets. Her grades suffered and she became severely depressed and totally antisocial.

She dropped out of school for a semester, during which time she did very little but write long forgiving letters to her mentor, and even visited her for a ten-day period under the pretext of going to see friends.

It was not until Mrs. G graduated from college that the homosexual relationship was finally terminated. During the four college years, she had only two dates, both involving attendance at school events and of no sexual portent.

After graduation, Mrs. G took secretarial training and began working in a larger city in the Midwest. She still suffered from recurrent bouts of depression and finally sought psychiatric support. Helped by this counseling, she gradually enlarged her social circle, began heterosexual dating, and once more showed an interest in her dress and person.

While in college she had developed masturbatory patterns for tension release. The frequency throughout college and during her early years working as a secretary was several times per week. She usually was multi-orgasmic, as she had been during her continuing homosexual relationship.

At age 25 Mrs. G deliberately took advantage of an available partner to attempt intercourse. This experience was sought purely from curiosity demand.

There were several coital exposures with this eager but relatively inexperienced young man.

She found herself repulsed by the man’s untutored, harsh approaches as opposed to those of her high school teacher. She was not physically responsive and found the seminal fluid objectionable.

Added to this general rejection of heterosexual interest was the fact that shortly after establishing the sexual relationship there was a 10-day delay in the onset of a menstrual period. Her fear of pregnancy only contributed to her rejection of any psychosocial concept of heterosexual functioning.

Shortly thereafter Mrs. G met her husband. He had been divorced six months previously for the stated reason that his wife had wanted to marry another man. There were two children of the marriage, both living with their mother.

They were both lonely people and gravitated to each other. There was warmth and affection between them and several mutual interests, so they married.

Mr. G was sexually well versed, kind, considerate, and gentle with his wife. She felt warmly toward him and enjoyed providing him with sexual release. In doing so she lost her incipient phobia for the seminal fluid.

However, she was unstimulated by his sexual approaches beyond that degree necessary to produce adequate vaginal lubrication. Both partners agreed they did not want children, so contraceptive medication was taken by the wife.

The marriage, though warm and comfortable, for several years was essentially one of convenience. However, as time passed, the two partners grew closer together, learned to communicate, and to exchange vulnerabilities.

Yet there was no improvement in the wife’s sexual responsivity, and this became an increasingly important factor in their lives. Mrs. G had never told her husband of her homosexual experience and was guilt-ridden by the concept that her past sexual orientation might have precluded any possibility of effective response in her now desired heterosexual state. The husband and wife were referred for treatment at her insistence.

Categories
Women's Health

Sex, Culture Influence

Increasing complaints of the inadequacy of human sexual function, it would seem that the potpourri of cultures that influence the behavior of so many might designate some area less vital to the quality of living than the sexual expression to receive and to bear the burden of the social ills of human existence.

As recently as the turn of the century, after marriage rites and the advent of offspring were celebrated as evidence of perpetuation of family and race, the woman was considered to have done her duty, fulfilled herself, or both, depending of course upon the individual frame of reference.

In reality:

The society honored her contribution as a sexual entity only about her breeding capacity, never relative to the enhancement of the marital relationship by her sexual expression.

In contradistinction to the recognition accorded her as a breeding animal, the psychological importance of her physical presence during the act of conception was considered nonexistent. It must be acknowledged.

However, there always have been men and women in every culture who identified their need for one another as complete human entities, each denying nothing to the other including the vital component of sexual exchange.

Unfortunately, whether from sexual fear or deprivation (both usually the result of too little knowledge), those who socially could not make peace with their sexuality were the ones to dictate and record concepts of female sexual identity.

The code of the Puritan and similar ethics permitted only communication in the negative vein of rejection. There was no acceptable discussion of what was sexually supportive of marital relationships.

So far the discussion has focused on an account of past influences from which female sexual function has inherited its baseline for functional inadequacy.

Because this influence still permeates the current “cultural” assignment of the female sexual role, its existence must be recognized before the psychophysiological components of dysfunction can be dealt with comprehensively.

Socio-Cultural Influence

More often than not places a woman in a position in which she must adapt, sublimate, inhibit, or even distort her natural capacity to function sexually to fulfill her genetically assigned role. Herein lies a major source of a woman’s sexual dysfunction.

The adaptation of sexual function to meet socially desirable conditions represents a system operant in most successfully interactive behavior, which in turn is the essence of a mutually enhancing sexual relationship.

However, to adapt the sexual function to a philosophy of rejection is to risk impairment of the capacity for effective social interaction. To sublimate sexual function can enhance both selves and that state to which the repression is committed if the practice of sublimation lies within the coping capacity of the particular individual who adopts it.

To inhibit sexual function beyond that realistic degree which equally serves social and sexual value systems positively, or to distort or maladapt sexual function until the capacity.

And to function is extinguished, which is to diminish the quality of the individual and of any marital relationship to which he or she is committed.

When it is realized that this psychosocial backdrop is prevalent in histories developed from husband and wives with complaints of female sexual inadequacy, the psychophysiological and situational aspects of female orgasmic dysfunction can be contemplated realistically.

The human female’s facility of physiological response to sexual tensions and her capacity for orgasmic release never have been fully appreciated.

Lack of comprehension may have resulted from the fact that functional evaluation was filtered through the encompassing influence of socio-cultural formulations previously described in this topic.

There also has been a failure to conceptualize the whole of sexual experience for both the human male and female as constituted in two totally separate systems of influence that coexist naturally.

Categories
Women's Health

Orgasm Dysfunction

The potential for orgasm dysfunction: highlighted in the psychosocial-sexual histories of those women in marital units referred to the Foundation can be described in a composite profile.

A baseline of dysfunctional distress was provided by specific material recalled not only from sexually developmental years but further encompassing all opportunities of potential sexual imprinting, conditioning, and experience storage.

Described in many settings, the dissimulation of sexual feeling consistently was reported as a manifest requirement or as a residual of earlier learning, operant as a requirement. Imprinting is that process that helps define the behavioral patterns of sexual expression and signal their arousal.

Dysfunction Origin of the negative conditioning varied widely. At one pole it represented the influence of deliberate parental omission of reference to or discussion of sexual function as a component of the pattern of living. This informationally underprivileged background also failed to provide an example of female sexuality, recognizably secure in expression, which could be emulated.

In both situations, the sexually and socially maturing young woman was left to draw formative conclusions by negative implication, or, in the absence of this form of direction, she was forced to react to any influence available from her socio-cultural environment.

The other extreme of rejective conditioning was reported as rigidly explicit but consistently negative admonition by parental and/or religious authority against personal admission or overt expression of sexual feeling.

Negative variants, there were many levels of uninformed guidance for the young girl or woman as she struggled with psychosocial enigmas, cultural restrictions, and her own physical sexual awareness.

Usually, such guidance, though often well-intentioned, was more a hindrance than a help as she developed her sexual value system and ultimately her natural sexual function.

In a direct parallel to the degree to which the young girl developing a sexual value system seemed to have dissimulated her sexual interests during phases of imprinting, conditioning, and information storing, older women, now sexually dysfunctional, reported consistent precoital evidence of repression of sexual identity in mature sexual encounters.

Residual repression of sexual responsivity in the adult usually went well beyond any earlier theoretical requirements for a social adaptation necessary to maintain virginity, to restrain a partner’s sexual demand, or even to conduct interpersonal relationships in a manner considered appropriate by a representative social authority.

Not infrequently the residual repression of sexual responsivity was so acute as to be emphasized clinically with the time-worn cry.

Most primarily non-orgasmic women

Repressed expression of sexual identity through ignorance, fear, or authoritative direction was the initial inhibiting influence in the failure of sexual function.

Not infrequently this source of repression was identified as a crucial factor of influence for situationally non-orgasmic women as well, although these individuals had the facility to overcome or circumnavigate its control under certain circumstances.

When requirements of the sexual value system prevailing during initial opportunities at sexual function could not be fulfilled because of the component of repression, each woman attempted without success to compensate in her desire for sexual expression by developing unrealistic partner identification, the concept of social secureness, or pleasure in environmental circumstance.

Failure of her own sexual values to serve, there was almost a blind seeking for value substitutes. When a workable substitution was not identified and the void of psychosexual insecurity remained unfilled, sexual dysfunction became an ongoing way of life.

Categories
Women's Health

Male Female Sexual Response

Both contributing positively or negatively to any state of sexual responsivity but having no biological demand to function in a complementary manner.

With the reminder that finite analysis of male sexual capacity and physiological response also has attracted little scientific interest in the past.

Compare Male And Female

It should be reemphasized that similarities rather than differences are frequently more significant in comparing male and female sexual response. By intent, the focus of this topic is directed toward the human female, but much of what is to be said can and does apply to the human male.

The bio-physically and psychosocially based systems of influence that naturally coexist in any woman have the capacity if not the biological demand to function in mutual support.

Obviously, there is an interdigitation of systems that reinforce the natural facility of each to function effectively. However, there is no factor of human survival or internal biological need defined for the female that is totally dependent upon a complementary interaction of these two systems.

Unfortunately, they frequently compete for dominance in problems of sexual dysfunction.

Woman’s Response

When the human female is exposed to negative influences under circumstances of individual susceptibility, she is vulnerable to any form of psychosocial or biophysical conditioning, i.e., the formation of man’s individually unique sexual value systems.

Based on how an individual woman internalizes the prevailing psychosocial influence, her sexual value system may or may not reinforce her natural capacity to function sexually.

One need only remembers that sexual function can be displaced from its natural context temporarily or even for a lifetime to realize the concept’s import.

Women cannot erase their psychosocial sexuality and sexual identity, being female, but they can deny their biophysical capacity for natural sexual functioning by conditioned or deliberately controlled physical or psychological withdrawal from sexual exposure.

Yet woman’s conscious denial of biophysical capacity rarely is a completely successful venture, for her physiological capacity for sexual response infinitely surpasses that of man.

Indeed, her significantly greater susceptibility to negatively based psychosocial influences may imply the existence of a natural state of psycho sexual-social balance between the sexes that has been culturally established to neutralize woman’s biophysical superiority.

The specifics of the human female’s physiological reactions to effective levels of sexual tension have been described in detail, but brief clinical consideration of these reactive principles is in order.

For woman, as for man, the 3 specific total-body responses to elevated levels of sexual tension are:

  1. Increased myotonia or muscle tension
  2. Generalized vasocongestion, pooling of blood in tissues
  3. Sex flush and breast enlargement.

When clinical attention is directed toward female orgasmic dysfunction, one particular biological area, the pelvic structures is of the moment.

Specific evidence has been accumulated from the incidence of both myotonia and vasocongestion in the female’s pelvis.

Categories
Women's Health

Inadequate Orgasm

To consider situationally non-orgasmic, a woman must have experienced at least one instance of orgasmic expression, regardless of whether it was induced by self or by partner manipulation, developed during vaginal or rectal coital connection, or stimulated by the oral-genital exchange.

Orgasmic experience during homosexual encounters would rule out any possibility of a diagnosis of primary orgasmic dysfunction. Three arbitrary categories of situational sexual dysfunction have been defined as masturbatory, coital, and random orgasmic inadequacy.

A woman with masturbatory orgasmic inadequacy has not achieved orgasmic release by partner or self-manipulation in either homosexual or heterosexual experience. She can and does reach orgasmic expression during coital connection.

Coital orgasmic inadequacy applies to the great number of women who have never been able to achieve orgasmic return during coition. The category includes women able to masturbate or to be manipulated to orgasmic return and those who can respond to orgasmic release from oral-genital or other stimulative techniques.

The random orgasmic-inadequacy grouping includes those women with histories of orgasmic return at least once during both manipulative and coital opportunities. These women are rarely orgasmic and usually are aware of little or no physical need for sexual expression.

For Example:

They might achieve orgasmic return with coital activity on a vacation, but never while at home. Occasionally these women might masturbate to orgasm if separated from a sexual partner for long periods of time. Usually, when they obtain orgasmic release, the experience is as much of a surprise to them as it is to their established sexual partner.

The situational non-orgasmic state may best be described by again pointing out the varying levels of dominance created by the biophysical and psychosocial structures of influence. If the woman’s sexual value system reflects sufficiently negative input from prior conditioning psychosocial influence, she may not be able to adapt sexual expression to the positive stimulus of the particular time, place, or circumstance of her choosing nor develop a responsive reaction to the partner of her choice.

If that part of any woman’s sexual value system susceptible to the influence of the biophysical structure is overwhelmed by a negative input from pain with any attempted coital connection, there rarely will be an effective sexual response.

Thus there is a multiplicity of influences thrown onto the balance wheel of female sexual responsivity. Fortunately, the two major systems of influence accommodate these variables through involuntary interdigitation. If there were not the probability of admixture of influence, there might be relatively few occasions of female orgasmic experience.

Sexual Partner

A major source of orgasmic influence for both primarily and situationally dysfunctional women is partner orientation. What value has the male partner in the woman’s eyes? Does the chosen male maintain his image of masculinity? Regardless of his acknowledged faults, does he meet the woman’s requirements of character, intelligence, ego strength, drive, physical characteristics, etc.?

Obviously, every woman’s, partner’s requirements vary with her age, personal experience and confidence, and the requisites of her sexual value system.

The two case stories below underscore the variables of a woman’s orientation to her male sexual partner. The histories of Mr. and Mrs. E and Mr. and Mrs. F are presented, to emphasize that a potential exists for radical change in attitudinal concepts during the course of any marriage.

Mr. and Mrs. E were referred for treatment of orgasmic dysfunction after 23 years of marriage. They had two children, a girl 20 and a boy 29.

The history of sexual dysfunction dated back to the twelfth year of the marriage. Both had relatively unremarkable backgrounds to family, education, and religious influences.

Both had masturbated as teenagers and had intercourse with other partners and with each other before marriage. Mrs. E usually had been orgasmic during these coital opportunities with her husband-to-be and with two other partners.

During the first twelve years of the marriage, the couple prospered financially and socially and had many common interests. Their sexual expression is resolved into an established pattern of sexual release two or three times a week.

There was the regularity of orgasmic return and frequently multi-orgasmic return during intercourse. During the twelfth year of the marriage, the unit experienced a severe financial reversal. Mr. E was discharged from his position with the company that had employed him since the start of the marriage.

In the following 18 months, he was unsuccessful in obtaining any permanent type of employment. He became chronically depressed and drank too much. The established pattern of couple sexual encounters was either quite reduced or, on occasions, demandingly increased.

Husband Extramarital Relationship

Then Mrs. E found that her husband was involved in an extramarital relationship and confronted him in the matter. A bitter argument followed, and she refused him the privilege of the marital bed. This sexual isolation lasted for approximately six months, during which time.

Mr. E began working again, regained control of his alcohol intake, and terminated his extramarital interest. For the duration of this isolation period, Mrs. E had no coital opportunity and did not masturbate. When the privilege of the bedroom was restored, to her surprise she was distracted rather than stimulated by her husband’s sexual approaches and was not orgasmic.

She had lost confidence in her husband not only as an individual but also as a masculine figure. Mrs. E found herself going through the motions sexually. From the time the bedroom door was reopened until the unit was seen in therapy, she was non-orgasmic regardless of the mode of sexual approach. The coital connection had dwindled to a ten-day to the two-week frequency of “wifely duty.”

When a major element in any woman’s sexual value system (partner identification in this instance) is negated or neutralized by a combination of circumstances, many women find no immediate replacement factor. Until they do, their facility for sexual responsivity frequently remains jeopardized.

When Mr. E combined loss of his masculine image as the provider with excessive alcohol intake and, also, acquired another sexual partner, he destroyed his wife’s concept of his sexual image, and, in doing so, removed from availability a vital stimulative component of her sexual value system. The negative input of psychosocial influence created by Mr. E’s loss of masculinity and impairment of her sense of sexual desirability was sufficient to inhibit her natural sexual responsivity.

Mr. and Mrs. F were referred for treatment six years after they married when he was 29 and she was 24 years old. They had one child, a girl, during their third year together. Mrs. F Was from a family of seven children and remembers a warm community experience in growing up with harried but happy parents.

Mr. F had exactly the opposite background. He was an only child in a family where both father and mother devoted themselves to his every interest, in short, the typical overindulged single child.

He had masturbated from early teens, had some sexual experiences, and one brief engagement with coital connection maintained regularly for six months before he terminated the commitment. Mrs. F, although she dated regularly as a girl, was fundamentally oriented to group-type social commitments. She rarely had experienced single dating.

The school years were uneventful for both individuals. They met and married almost by accident. When they first began dating, each was interested in someone else. However, their mutual interest increased rapidly and developed into a courtship that included regularity of coital connection for three months before marriage.

Every social decision was made by Mr. F during the courtship. The same pattern of total control continued into marriage. He insisted on making all decisions and was consistently concerned with his own demands, paying little or no attention to his wife% interests. Constant friction developed, as is so frequently the case with marital partners whose backgrounds are opposed.

Mrs. F had not been orgasmic before marriage. In marriage, she was orgasmic on several occasions with manipulation but not during coition. As the personal friction between the marital partners increased, she found herself less and less responsive during active coital connection.

Pregnancy intervened sex

There was an occasional orgasmic success with manipulation. Pregnancy intervened at this time, distracting her for a year, but thereafter her lack of coital return was distressing to her and most embarrassing to her husband.

He worried as much about his image as a sexually effective male as he did about his wife’s levels of sexual frustration. Mrs. F’s lack of effective sexual response was considered a personal affront by her uninformed husband.

They consulted several authorities on the matter of her sexual inadequacy. The husband always sent his wife to authority to have something done to or for her. The thought that the situation might have been in any measure his responsibility was utterly foreign to him.

When the unit was referred for therapy he at first refused to join her in treatment on the basis that it was her problem. When faced with the Foundation demand that both partners cooperate or the problem would not be accepted for treatment, Mr. F grudgingly consented to participate.

Little comment is needed. This intentionally brief history is typical of the woman who cannot identify with her partner because he will not allow such communication. There is no world as dosed to the vital ingredient of marital expression as that of the world of the indulged only child.

Particularly is this attitudinal background incomprehensible to a woman with a typical large family orientation. When Mr. F failed to accord his wife the representation of her own requirements, she had no opportunity to think or feel sexually. The catalytic ingredient of mutual partner involvement was missing.

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Treat Orgasm

Sexual Pleasure

When conceptually she has a penis to play with, usually the woman will do just that. If she will allow the vaginally contained penis to stimulate slowly and feelingly, in the same manner, she enjoyed sensate pleasure from manual body stroking or the manipulation of her genital organs under her controlled directions, she will find herself overwhelmed with sexual feeling.

As vaginal sensation increases for the woman and confidence in ejaculatory control develops for the man, penile-containment episodes progress in a more confident vein. The teasing technique of mounting, dismounting, and remounting is extremely valuable as a means of female sex-tension increment.

There are several clinical pitfalls to be avoided under careful co-therapist direction as the marital unit is moved from phase to phase of increasing sexual responsivity by day-by-day consideration and direction.

  1. the cooperating male partner must be manipulated to ejaculation with a regularity at least approximating that described during the interrogation periods on day one or two as his concept of ideal ejaculatory frequency. This concern for regularity of release of cooperative male partners’ sexual tensions is but turn-about application of the principles of sex-tension relief, directed toward regularity of orgasmic release for the cooperative wife of the premature ejaculator.
  2. there must be regularly recurring vacations from the physical expression of sexual functioning. At least every fourth day is declared a holiday from physical sexual expression. However, the daily conferences between marital partners and the co-therapists continue at a seven-day-a-week pace. Through the two week period during which the distressed marital unit is following the Foundation program. There is so much material that must be presented, evaluated, and restated when the unit’s marital relationship is explored in depth that daily conferences are a regular part of the treatment format. When the wife’s physical progress is obvious, the partners are infinitely more willing to look at their particular contributions or lack of them to the marital relationship. As they improve the climate of the marriage, inevitably they are contributing a vital ingredient to the woman’s psychosocial structuring. This structure, in turn, positively influences the accrual of her sexual tensions. There is yet another factor of sex-tension increment derived from daily living with the subject by the marital partners. Presuming strategically placed vacations from overt sexual function, there is tremendous tension increment in the continuity of sexual expression, if orgasmic or ejaculatory levels of tension are restricted by frequency control.Once confidence in the female superior coital position has been established, with the woman enjoying the sensate pleasure of pelvic play with the intravaginally contained penis, the marital unit is directed to convert the female-superior position to a lateral coital position.

Effective Sexual Performance

With husband and wife mounted in a female superior position, there may be some difficulty in converting to a lateral coital position without first practicing the maneuver.

Initially, practice should take place without intromission if the conversion is to be accomplished smoothly, but the functional return for both sexual partners certainly is well worth the effort expended in the learning process.

The lateral coital position is reported as the most effective coital position available to men and women, presuming there is an established marital-unit interest in mutual effectiveness of sexual performance.

As described in premature ejaculation, when a facility in lateral coital positioning has been obtained, there is no pinning of either the male or female partner. There is mutual freedom of pelvic movement in lateral coital position in any direction, and there will be no cramping of muscles or necessity for tiring support of body weight.

The lateral coital position provides both sexes flexibility for free sexual expression. This position particularly is effective for the woman, as she can move with full freedom to enjoy either slow or rapid pelvic thrusting, depending upon current levels of sexual tensions.

In this coital position, the male can best establish and maintain ejaculatory control.

In order to convert from the female superior to a lateral coital position, there are several successive steps to be taken. The husband with his left hand should elevate his wife’s right leg while moving his leg under hers so that his left leg (now outside of her right leg) is extended from his trunk at about a 45-degree angle.

The wife simultaneously should extend her right leg (the one that is being elevated) so that positionally she is now supporting her weight on her left knee with the right leg extended, instead of being on her knees as in the female-superior position.

As she makes these adjustments, she should lean forward to parallel her trunk to that of her husband. Then the male clasps his partner with his left arm under her shoulders, his hand placed in the middle of her back, and his right hand on her buttocks, holding the two pelves together.

The two partners then should roll to his left (her right) while still maintaining intravaginal containment of the penis.

Once the partners have moved into the lateral positioning, the two trunks should be separated at roughly a 30-degree angle.

The male rolls back from his left side to rest on his back. The female remains relatively on her stomach and chest with minimal elevation of her left side and her head turned toward her husband. Pillows should be placed beneath both heads for comfort and to provide support for the woman’s slightly angled position.

Occasionally there is value in a supportive pillow placed along her right side. The only weight that must be supported is that of the wife’s right thigh, which rests upon the husband’s left thigh. His left thigh is supported by the bed, so there is no problem with long-continued weight support.

The concern for arm placement is resolved if the woman’s right arm is circled under her pillow and the husband’s left arm (in the same fashion) moves under her pillow beneath her shoulders or underneath her neck.

This leaves the woman’s left arm and hand and the husband’s right arm and hand for mutual play and body caressing. The female accomplishes leverage for pelvic thrusting by pulling up her extended right leg slightly so that her knee comes to rest on the bed. Her left leg should be cast over her husband’s right hip with the knee resting comfortably on the bed.

The two knees provide her with all the traction she needs for pelvic thrusting whenever sex-tension demands for any form of thrusting develop.

In view of the physical complexity of changes in position, usually it is suggested that man and wife try converting the simulated female superior mounting position to the lateral position at least two or three times before establishing coital connection and then attempting conversion from superior to lateral positions.

The trial runs usually begin in a humorous vein; yet with functional seriousness husband and wife easily can work out the problems of comfortable arms and legs placement and rapidly accomplish facility with the position-conversion technique. Again, the lateral coital position is the most effective coital position from mutuality of shared male and female freedom of sexual experimentation.

The potential return is well worth the effort of the marital unit involved in learning to convert from the female-superior positioning. One of the more realistic goals this form of therapy may suggest to the non orgasmic woman relates to self-reorientation which tends to improve or helps to insure maximum interdigitation of the dual-system basis of effective sexual function theorized in the topic of therapy and orgasmic dysfunction.

The goal seeks to create or encourage the best possible climate in which each system (biophysical and psychosocial) can function.

Attainment of this climax first is dependent upon self-knowledge. A sexually dysfunctional woman can be therapeutically assisted to identify and develop understanding of her own psycho-social needs (the psychosocial system of sexual function).

She also can be educated to take advantage of her naturally occurring, maximum levels of sexual drive (the biophysical system of sexual function). Much can be derived from the exchange of information among the non orgasmic woman, her husband, and the cotherapists, to help her define her actual physical awareness of sexual desire.

This specific awareness of sexual need is relied upon by most sexually effective women, although not necessarily at an actively conscious level. The dysfunctional woman’s husband has a definitive contributing role in helping to develop her sense of freedom and grace in the spontaneous expression of her sexual feelings.

The husband’s role is vital to success in the treatment of orgasmic dysfunction. His attitudinal approach is the most important contributing factor (positively or negatively) to therapeutic procedure.

If he is totally cooperative, interested, supportive, and identifies quietly and warmly with his wife as she lives through the strain of the interpretive look in the mirror provided by the cotherapists, her chances of orgasmic attainment are significantly increased.

If the husband’s attitude is one of hostility, indifference, impatience, or even regimented cooperation, the chances of failure in treatment are correspondingly increased. It is not sufficient to be simply a cooperative partner.

There must be the opportunity for the beleagured wife to identify with her husband. She must be able to feel the warmth of his interest in her as an individual and as a woman, to count on him for emotional support and, above all, to feel him as much a’ partner in concern and as vitally interested in reversing her dysfunction as she is in accomplishing full expression as a woman.

Under authoritative control many women can and do break through the shell created by a husband’s indifference and ultimately develop a pattern of orgasmic release. Many more fail.

For discussion purposes, the immediate failure rates for both primary and situational orgasmic dysfunction are included as followed. A detailed presentation of failure rates and five-year follow-up of treated patients is presented in Program Statistics.

The failure rate in reversal of the presenting complaint of orgasmic dysfunction in the two week rapid-treatment program is 19.3 percent. There is little difference between the failure rates returned in treating the primarily or situationally non orgasmic woman. The one category that obviously needs significant improvement of the therapeutic approach is that of random orgasmic inadequacy (37. 5 percent).

Orgasm Experience

Infrequent or rare orgasmic return with both masturbatory and coital experience has defied the Foundation’s current therapeutic approaches. In some cases there were detrimental interpersonal relationships that could not be altered successfully.

In others there was no evidence of inherent levels of sexual tension either presently or historically described. In the majority of situations, however, the cotherapists did not find an answer to resolve the problem of random orgasmic inadequacy.

Were the failure rate in this category improved to parallel that of other categories of orgasmic inadequacy, there would be no statistical significance in reported return between the failure rates in treatment of primary or situational orgasmic dysfunction.

The close approximation of failure rates in the two arbitrary clinical divisions of woman’s non orgasmic status supports the concept of uniformity of treatment approach, regardless of whether the woman has ever had previous orgasmic experience.

An overview of female sexual dysfunction commonly reveals a stalemate in the sociosexual adaptive process at the point at which a woman’s desire for sexual expression crashes into a personal fear or conviction that her role as a sexual entity is without the unique contribution of herself as an individual.

For some reason, her permission to function as a sexual being or her confidence in herself as a functional sexual entity has been impaired. The stalemate may be derived from negation of her own sexual identity or from the attitudes and circumstances of marital interaction.

The influence may emanate from her partner’s unwitting or deliberate contribution to her loss of personal and sexual self-esteem; or it may emerge on signal from her earlier imprinted, conditioned, and experientially created sexual value system.

The blocking of receptivity to sexual stimuli is an unfortunate result of factors which deprive her of the capacity to value the sexual component of her personality or prevent her from placing its value within the context of her life.

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Treat Orgasm

Sexual Intercourse Technique

Sexual Intercourse

Probably the most effective technique is that of the teasing approach of light-touch moving at random from the breasts to the abdomen to the thighs to the labia to the thighs and back to the abdomen and breasts without concentrating specifically on pelvic manipulation early in the stimulative episode.

Particularly should direct approach to the clitoral area be avoided initially in this process. This “exercise” becomes even more effective as a means of female sex-tension increment, when interlaced with sensate-focus, stroking techniques introduced after roundtable discussion.

The male partner must be careful not to inject any personal demand for sexual performance into his female partner’s pattern of response.

The husband must not set goals for his wife.

He must not try to force responsivity.

His role is that of accommodation, warmth, understanding, and holding, but he should not be so pacific that his own sexual pleasure is negated for either himself or his partner.

Through total cooperation he allows his wife to drift with sensate pleasure and provides her with sensual stimulation without forcing her to contend with an accompanying sense of goal oriented demand to respond to a forcing form of manipulation.

The cotherapists must make it quite clear to the husband that orgasmic release is not the focus of this sexual interaction.

Manipulation of breast, pelvis, and other body areas varying from the lightest touch to an increase in pressure only at partner direction, should provide the wife with the opportunity to express her sexual responsivity freely, but without any concept of demand for an endpoint (orgasmic) goal. It must be emphasized that the effectiveness of a stimulative session is not lost to the woman simply because the session is terminated without orgasmic experience.

There is a tremendous accrual of sexual facility and interest for any woman when she knows that there will be a repeat opportunity for further sexual expression in the immediate future.

Sexual Stimulative Effects

Thus, the husband’s light, teasing, non demanding approach to touch and manipulation allows the female partner full freedom to express her interests, her demands, her sexual tensions. This sequence of opportunities permits accumulation of stimulative effects which will provide the source of her ultimate release of maximum sex-tension increment at some future point.

All specific exercises aimed toward the wife’s fulfillment of her orgasmic capacity always are introduced by direction of the cotherapists on the basis of marital-unit report. When husband and wife describe the fact that previous directions have produced a positive return of stimulative pleasure, their next level of sexual involvement is approached.

This treatment concept means, of course, that a steady progression of exercises does not necessarily take place on daily schedule. For instance, marital partners who never have verbally shared sexual reactions or expressed sexual preferences to each other usually take longer to appreciate a positive level of sexual-tension return than less restrained, more communicative husbands and wives.

Another example of delayed reactive potential centers upon marital units that have coped with functional distress for extended periods of time. These husbands and wives usually require longer to adapt to and become comfortable with their revised patterns of sexual behavior than those whose sexual dysfunction has been relatively brief.

It has been further observed that successful marital-unit adaptation to a state of sexual dysfunction, in itself a possible indication of individual and marital-unit strengths, may present a higher level of inherent resistance to reversal of the stated inadequacy than more dissident, fragmented marital relationships.

Cotherapists must constantly bear in mind during the rapid-treatment program that the authoritative introduction of specific exercises represents a deliberate breakdown of woman’s sexual responsivity into its natural components. Each exercise is introduced singly and continued until appreciated. All exercises are accrued one after another in a natural building process until they have been reassembled into the whole of an established sexual response pattern.

The directive pattern, in which each item is repeated as a new one is added in each successive verse until all items are assembled. Therefore, the marital unit must be reminded quietly each time a new direction for specific sexual activity is introduced that this introduction of new material is not an indication that previous exercises and their concomitant pleasures must be relinquished in order to enjoy the new experience.

Rather, as each new psycho physiological concept is provided for marital partner assimilation, older exercises are constantly restated until the whole reactive process is assembled.

At this point, marital partners frequently may have acquired a gavotte-like approach to sexual expression when employing the directive suggestions rather than spontaneously incorporating each new physical approach or stimulative concept into their own style or pattern of behavior.

The marital couple will need reminding that on a long-range basis there is little return from clocking each component of the therapeutic pattern for a specific length of time or introducing each new exercise into their sexual interaction in a purely mechanical manner, solely because it has been suggested by impersonal authority rather than mutually evolved.

Emphasis should be placed upon the fact that there is marked individual variation in the time span in which each area of sensory perception is appreciated. Mood, level of need, quality of partner involvement, etc., all vary widely, frequently on a day-to-day basis.

There will be occasions when spontaneous non specific or even a sexual social interaction will replace all the “touch and feeling” (foreplay) that have been so enjoyable and so necessary at other times.

Whenever exercises in sensate focus, especially those using specifically positioned opportunities have initiated newfound levels of stimulative appreciation for the non orgasmic woman, the appropriately sequential step is suggested for unit exploration during their next phase of sexual interaction.

It is essential to successful therapy to emphasize again and again the concept that sexual response can neither be programmed nor made to happen. The marital unit also must be encouraged continually to create an environment that fulfills the stimulative (bio-physical and psychosocial) requirements of each partner and in which sex-tension increment can occur without any concept of performance demand.

Each successive phase of physical approach is introduced subsequent to establishing some evidence of encompassing psychosensual pleasure as perceived by the non orgasmic woman during a prior episode.

These phases develop in sequence from the first day’s sensory exploration which takes place following the roundtable discussion. If there is obvious female pleasure in the first sensate experience, the next phase includes specific manipulative approach to genital excitation, using, if possible, the positioning.

If the first day’s exercise in sensate pleasure has not developed a positive experience for the non orgasmic woman, the second day will again be devoted to these primary touch-and-feeling episodes, instead of moving into the genital manipulative episodes usually scheduled for Day two.

Genital manipulative episodes are continued until there is obvious evidence of elevated female sex tension, before moving on to the next phase in the psychosensory progression.

Subsequent to reported success in manual genital excitation, the marital, partners are asked to try the female-superior coital position, by which means the wife may translate previously established levels of sensate pleasure into an experience which includes the sensation of penile containment.

The specific intercourse techniques of this position have been discussed and illustrated as Female superior mounting is but another step in the gradual development of sexual awareness leading from simple, sensate focus to effective response in coital connection.

The husband is asked to assume a supine position in anticipation of his wife’s superior mounting. Intromission is to take place when both partners have reached the level of sexual interchange, full erection for the man and well-established lubrication for the woman that suggests the desire for further physical expression.

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Treat Orgasm

Sexual Function Contribution

During the rapid treatment program, the daily report and ensuing discussions between the cotherapists and marital partners describing the non orgasmic wife’s reactions and as well as those of her interacting husband, provide an incisive measure of the degree to which the requirements of her functioning sexual value system are being met or negated, or the extent to which she progressively is able to adapt her requirements.

These discussions provide simultaneous opportunity for a more finite evaluation of the levels of interactive contribution to sexual function by her bio physical and psychosocial systems.

The treatment of both primary and situational orgasmic dysfunction requires a basic understanding by patients and cotherapists that the peak of sex-tension increment resulting in orgasmic release cannot be willed or forced.

Orgasmic experience evolves as a direct result of individually valued erotic stimuli accrued by the woman to the level necessary for psycho physiological release. Just as the trigger mechanism which stimulates the regularity of expulsive uterine contractions sending a woman into labor is still unknown, so is the mechanism that triggers orgasmic release from sex-tension increment.

Probably they are inseparably entwined to identify one may be to know the other.

It seems more accurate to consider female orgasmic response as an acceptance of naturally occurring stimuli that have been given erotic significance by an individual sexual value system than to depict it as a learned response.

There are many case histories recorded in this and related studies reporting orgasmic incidence in the developing human female at ages that correspond with ages reported in histories of onset of male masturbation and nocturnal emission.

These clearly described, objective accounts are considered accurate by reason of their correlation with subjective recall provided by several hundred women interrogated during previously reported laboratory studies. The initial authoritative direction in therapy includes suggestions to the marital unit for developing a non demanding, erotically stimulating climate in the privacy of their own quarters.

At no time during the two-week therapy program is either of the marital partners under any form of observation, laboratory or otherwise. Only the phenomenon of vaginismus is directly demonstrated to the husband of the distressed wife, under conditions routinely employed by appropriate practitioners of clinical medicine.

The cotherapists’ initial directions suggest ways of putting aside tension-provoking behavioral interaction for the duration of the rapid-treatment program and allow the woman to discover and share knowledge of those things which she personally finds to be sexually stimulating.

Further professional contribution must suggest to the marital unit ways and means to create an opportunity for the woman to think and feel sexually with spontaneity. She must be made fully aware that she has permission to express her sexual feelings during this phase of the therapy program without focusing on her partner’s sexual function except by enjoying a personal awareness of the direct stimulus to her sexual tensions that his obvious physical response provides.

Every non orgasmic woman, whether distressed by primary or situational dysfunction, must develop adaptations within areas of perceptual, behavioral, and philosophic experience.

She must learn or relearn to feel sexually (respond to sexual stimuli) within the context of and related directly to shared sexual activities with her partner as they correlate with the expression of her own sexual identity, mood, preferences, and expectations.

The bridge between her sexual feeling (perception) and sexual thinking (philosophy) essentially is established through comfortable use of verbal and nonverbal (specifically physical) communication of shared experience with her marital partner.

Her philosophic adaptation to the acceptance and appreciation of sexual stimuli is further dependent upon the establishment of “permission” to express herself sexually. Any alteration in the sexual value system must, of course, be consistent with her own personality and social value system if the adaptation is to be internalized.

Keeping in mind the similarities between male and female sexual response, the crucial factors most often missing in the sexual value system of the non orgasmic woman are the pleasure in, the honoring of, and the privilege to express need for the sexual experience.

Restoration of sexual feeling to its appropriate psychosocial context (the primary focus of the therapy for the non orgasmic woman) is the reversal of sexual dissembling. This, in turn, encourages a more supportive role for her sexuality. In the larger context of a sexual relationship, the freedom to express need is part of the “give-to-get” concept inherent in capacity and facility for effective sexual responsivity.

Professional direction must allow for woman’s justifiable, socially enhancing need for personal commitment, because her capacity to respond sexually is influenced by psychosocial demand.

The commitment functions as her “permission” to involve herself sexually, when prior opportunities available to formation of a sexual value system have not included an honorable concept of her sexuality as a basis upon which to accept and express her sexual identity.

Commitment apparently means many things to as many different women; most frequently encountered are the commitments of marriage or the promise of marriage, the commitment of love (real or anticipated) according to the interpretation of “love” for the particular individual.

Regardless of the form the commitment takes, after it is established the goal to be attained is enjoyment of sexual expression for its own positive return and for its enhancement of those involved.

During daily therapy sessions, interrogation of the sexually dysfunctional woman is designed to elicit material that expresses the emotions and thoughts that accompany the feelings (sexual or otherwise) developed by the sensate-focus exercise.

Also continually explored are the feelings, thoughts, and emotions that are related to the behavior of her marital partner. Her reactions when discussing material of sexual connotation are evaluated carefully to determine those things which may be contributing to ongoing inhibition or distortion being revealed by the regular episodes of psychophysiological interaction with her husband.

When a non-orgasmic female involves herself with her partner in situations providing opportunities for effective sexual function, her ever-present need is to establish and maintain communication.

Communication, both physical and verbal in nature, makes vital contributions, but it loses effectiveness in the rapid-treatment method is allowed to be colored by anger, frustration, or misunderstanding. While verbal communication is encouraged throughout the two-week period, physical communication is introduced in progressive steps following the initial authoritative suggestion to provide a non-demanding, warmly encompassing, shared experience for the woman, with optimal opportunity for feeling.

After the early return from sensate-focus opportunity as directed at the roundtable discussion has been judged fully effective by marital partners and co-therapists the marital unit is encouraged to move to the next phase in sensate pleasure genital manipulation.

The cotherapists should issue specific instructions to the marital partners as “permission” is granted to the female to enjoy genital play.

Sexual instructions should include details of positioning, approach, time span, and above all, a listing of ways and means to avoid the usual pitfalls of male failure to stimulate his partner in the manner she prefers rather than as she permits him the privilege to function.

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Treat Orgasm

Treatment of Orgasmic Dysfunction

Treat Orgasm

Neither the biophysical nor the psychosocial systems which influence the expression of the human sexual component have a biologically controlled demand to make specifically positive or negative contributions to sexual function.

This fact does not alter the potential of the systems interdigitation contribution to the formation of effective patterns of sexual response. When this potential is not realized by the natural development of psychophysiological sexual complements, the result is sexual dysfunction.

The initial psychosocial contributions toward the realization of this potential may come through a positive experience of early imprinting. Imprinting is a process whereby a perceptual signal is matched to an innate releasing mechanism which elicits a behavioral pattern. Established at critical periods in development, imprints thereafter are considered more or less permanent.

Infantile imprinting of sexually undifferentiated sensory receptivity to the warmth and sensation of close body contact is considered a source of formative contribution to an individual’s baseline of erotic inclinations and choices.

This material essentially is unobtainable in specific form during history-taking. It becomes important to the rapid-treatment program only as it is reflected by statements of preference in physical communication or other recall pertinent to ongoing patterns of sexual responsivity.

Treatment Of Orgasmic Dysfunction

Foundation personnel makes use of two primary sources of material. These sources reliably reflect the female’s prevailing sexual attitudes, receptivity, and levels of responsivity. The first source, derived from the history, is identified by the non-orgasmic woman of erotically significant expectations or experiences (positive or negative) currently evoked during a sexual interchange with her marital partner.

The co-therapists must identify those things which the husband does or does not do that may not meet the requirements of his wife’s sexual value system previously shaped by real or imagined experience or expectation.

Past experiences of positive content involving other partners, or unrealizable expectations perceived as ideal, maybe over idealistically compared by her to the current opportunity; or negative experiences or negative expectation-related attitudes may intrude upon receptivity to her partner’s sexual approach.

Thus, a rejection or blocking of sexual input may be the end result.

A discussion of memories of perceptual and interpretive reactions associated with the specific sexual activity may add a further dimension to the knowledge of the wife’s currently constituted sexual value system since these memories often have been noted to function as signals for the subconscious introduction of stored experience, either positive or negative in nature.

The second source of reliable, directly applicable material upon which the rapid-treatment therapy relies for direction indeed, it characterizes this particular mode of psychotherapy is developed from the daily discussions that follow each sensate-focus exercise.

As repeatedly stressed, defining the etiology of the presenting sexual inadequacy does not necessarily provide the basis for treatment. A reasonably reliable history is indispensable, but it is used primarily to provide interpretive direction and to amplify the definition of that which is of individual significance. (It even is used from time to time to demonstrate negative patterns of sexual behaviors)