Categories
Women's Health

Female on Top Position

When the marital partners extend their psycho sensory interchange to coition in the female-superior position, the wife once mounted is instructed to hold herself quite still and simply to absorb the awareness of penile containment.

Interspersed with moments of sensate pleasure created by her proprioceptive awareness of vaginal dilatation should be the opportunity to feel and think sexually. The vaginal distention should be interpreted as the sensual desire for further increment in sexual pleasure.

This increasing demand for sexual stimulation can be further implemented by the female partner if she will institute a brief period of controlled, slowly exploring, pelvic thrusting. The husband’s specific responsibility at this moment is to provide the needed erect penis without any concept of a demanding thrusting pattern on his part.

In anticipation of her need, the co-therapists must encourage the wife to think of the encompassed penis as hers to play with, to feel, and to enjoy, until the urge for more severe pelvic thrusting involuntarily emerges into her levels of conscious demand. It may take several episodes of female-superior coital positioning, as the woman plays pelvically with the contained penis before full sensate focus develops vaginally.

Once vaginal sensation develops a pleasant or even a fully demanding vein, the next phase is to add to the sensate picture the male-initiated, non demanding, slow pelvic thrusting.

The non-demanding thrusting by the husband should be kept at a pace communicated by his wife. This constrained form of male pelvic thrusting is suggested to create an obvious opportunity for the extension of the female’s sensory potential and to provide sufficient stimulative activity to maintain an effective erection.

Ejaculatory Control

At this time the question frequently asked by the male member of marital units whose concept of sexual interaction has been based primarily on the stock formula of performing, producing, and achieving is, “What if I feel like ejaculating?” It requires continuous effort by the co-therapists to convey the concept not only that acquiring ejaculatory control is possible but also that such a facility usually is enhancing for the male as well as his female partner.

The couple must be educated to understand that ejaculatory control enlarges the range of sensual pleasure in the sexual relationship for both marital partners. However, it is appropriate for co-therapists to emphasize the fact that ejaculation or spontaneously occurring orgasm is not caused for alarm, nor is this involuntary breakthrough considered a breach of direction.

The husband and wife must be reassured that if such a breakthrough from the original direction occurs, the experience should be enjoyed for itself. Within a reasonable length of time, the unit is encouraged to provide another opportunity in which to follow the originally described interactive concepts.

When the husband has developed security of erective maintenance, the episodes of vaginal containment with exploratory pelvic thrusting should continue for as long as both partners demonstrate pleasurable reactions. At appropriate intervals during the total coital episode, the partners should separate two or three times and lie together in each other’s arms.

Once rested, they should return to whatever manner of manual sensate pleasuring they previously enjoyed and continue without any concept of time demand. They should remount, again using the female-superior position, repeating earlier opportunity for the wife’s stimulative proprioceptive awareness of vaginal containment of the penis to be emphasized by alternate periods of exploratory thrusting and lying quietly together in the coital connection.

The timing and duration of sexually stimulative activity should follow the directive formula as outlined in the Therapy topic. Generally interpreted, any period of time is acceptable that emerges from mutual interest and continues to be enjoyable for both marital partners without the incidence of either emotional or physical fatigue.

Once both partners have been successfully educated to employ experimental pelvic movement during their episodes of coital connection rather than following the usual prior pattern of demanding pelvic thrusting, a major step has been accomplished.

Women have little opportunity to feel and think sexually while pursuing or receiving a pattern of forceful pelvic thrusting before their own encompassing levels of excitation are established.

If a woman initiates the demanding thrusting, she usually is attempting to force or to will an orgasmic response. The wife repeatedly must be assured that this forceful approach will not contribute to the facility of response.

If the husband initiates the driving, thrusting coital pattern, the wife must devote conscious effort to accommodate to the rhythm of his thrusting, and her opportunity for quiet sensate pleasure in coital connection is lost.

Frequently, it is of help to assure the wife that once the marital unit is sexually joined, the penis belongs to her just as the vagina belongs to her husband. When vaginal penetration occurs, both partners have literally given of themselves as physical beings to derive pleasure, each from the other.

Categories
Women's Health

Woman Sexuality

A separate discussion of female sexuality is necessary primarily because the role assigned to the functional component of a woman’s sexual identity rarely has been accorded the socially enforced value afforded male sexuality.

While the parallel between sexes as to physiological function has gained general acceptance, the concept that the male and female also can share almost identical psychosocial requirements for effective sexual functioning brings expected to protest.

Only when a male requests treatment for symptoms of sexual dysfunction, and possible contributing factors are professionally scrutinized in the clinical interest of symptom reversal, are the psychosocial influences noted to be undeniably similar to those factors which affect female responsivity.

Then such factors as selectivity, regard, affection, identity, and pride (to name a few of the heterogeneous variables) are revealed as part of the missing positive or present negative influence or circumstances surrounding the sexual dysfunction.

Woman Sexual Dysfunction

Man has had society’s blessing to build his sexual value system in an appropriate, naturally occurring context and woman has not. Until unexpected and usually little understood situations influence the onset of male sexual dysfunction, his sexual value system remains essentially subliminal and its influence more presumed than real.

During her formative years, the female dissembles much of her developing functional sexuality in response to societal requirements for a “good girl” facade.

Instead of being taught or allowed to value her sexual feelings in anticipation of an appropriate and meaningful opportunity for expression, thereby developing a realistic sexual value system.

She must attempt to repress or remove them from their natural context of environmental stimulation under the implication that they are bad, dirty, etc.

She is allowed to retain the symbolic romanticism which usually accompanies these sexual feelings, but the concomitant sensory development with the symbolism that endows the sexual value system with meaning is arrested or labeled for the wrong reasons, objectionable.

The reality of female sexual function today aside from its vital role in reproduction, still implies shame, although such a dishonorable role has been rather difficult to sustain with objectivity.

The arbitrary:
The social assignment of the role of sin to female sexuality has not contributed to a desirably consistent level of marital harmony. Nor has society always found it easy to eliminate recognition of female sexuality while still supporting and maintaining the male’s role of tacit permission to be sexual with honor, or even praise.

Especially is this true of a society that continues to celebrate events before and after the fact of sexual expression (marriage, birth, etc.), and mourns the female menopause because it is presumed to signify the demise of sexual interest.

Since, as far as is known, elevated levels of female sexual tension are not technically necessary to conception, the natural function of a woman’s sexuality has been repressed in the service of false propriety and restricted by other unnecessary psychosocial controls for equally unsupportable reasons.

In short
The negation of female sexuality, which discourages the development of an effectively useful sexual value system, has been an exercise of the so-called double standard and its socio-cultural precursors.

Residual societal patterns of female sexual repression continue to affect many young women today. They mature acutely aware of repercussions from sexual discord between their parents and among other valued adults, so they grope for new roles of sexual functioning.

Discomfort in the communication of sexual material still prevails between parents and their children.

The young frequently are condemned, by lack of information about what is sexually meaningful, to live with decisions equally as unrewarding sexually as those made by their parents.

In other words, because of cultural restraints, the members of younger generations must continue to make their own sexual mistakes, since they, like previous generations, rarely have been given the benefit of the results of their parents’ past sexual experience; good, bad, or indifferent as that experience may have been.

The necessary freedom of sexual communication between parents and sons and daughters cannot be achieved until the basic component of sexuality itself is given a socially comfortable role by all active generations simultaneously.

Categories
Women's Health

Woman Sexual Phrase

She responds physiologically to sex-tension elevation. The four phases of the female cycle of sexual response established in the 1960s will be employed to identify clinically important vasocongestive and myotonic reactions developing in the pelvic viscera of any woman responding to sexual stimulation.

Sex-tension increment, the first physical evidence of her response to sexual stimulation is vaginal lubrication.

Lubrication is produced:

By a deep vasocongestive reaction in the tissues surrounding the vaginal barrel. There also is evidence of increased muscle tension as the vaginal barrel expands and distends involuntarily in anticipation of penetration.

When sex tensions reach plateau phase levels of responsivity, a local concentration of venous blood develops in the outer third of the vaginal barrel, creating partial constriction of the central lumen.

This vaginal evidence of a deep vasocongestive reaction has been termed the orgasmic platform. The uterus increases in size as venous blood is retained within the organ tissues.

The clitoris evidence increasing smooth-muscle tension by elevating from its natural, pudendal-overhang positioning and flattening on the anterior border of the symphysis.

With orgasm, reached an increment peak of pelvic-tissue vasocongestion and myotonia, the orgasmic platform in the outer third of the vagina and the uterus contract within regularly recurring rhythmicity as evidence of high levels of muscle tension.

Finally, with the resolution phase, both vasocongestion and myotonia disappear from the body generally, and the pelvic structures specifically.

If the orgasmic release has been obtained, there is rapid detumescence from these naturally accumulative physiological processes. The loss of muscle tension and venous blood accumulation is much slower if orgasm has not been experienced and there is an obvious residual of sexual tension.

The presence of involuntary-muscle irritability and superficial and deep venous congestion that woman cannot deny, for these reactions develop as physiological evidence of both conscious and subconscious levels of sexual tension.

With the accumulation of myotonia and pelvic vasocongestion, the biophysical system signals the total structure with stimulative input of a positive nature.

Regardless of whether women voluntarily deny their biological capacity for sexual function, they cannot deny the pelvic, irritative evidence of inherent sexual tension for any length of time.

Once a month with some degree of regularity women are reminded of their biological capacity. Interestingly, even the reminder develops in part as the result of local venous congestion and increased muscle tension in the reproductive organs.

On occasion, the menstrual condition, through the suggestive sensation created by pelvic congestion, stimulates elevated sexual tensions.

The presence or absence of patterns of sexual desire or facility for a sexual response within the continuum of the human female’s menstrual cycle also has defied reliable identification.

Possibly, confusion has resulted from the usual failure to consider the fact that two separate systems of influence may be competing for dominance in any sexual exposure.

The necessity for such individual consideration can best be explained by example:

It is possible for a sexually functional woman to feel the sexual need and to respond to high levels of sexual excitation even to orgasmic release in response to a predominantly biophysical influence in the absence of a specific psychosocial requirement.

This freedom to respond to direct biophysical-system demand requires only from its psychosocial counterpart that the female’s sexual value system not transmit signals that inhibit or defer how erotic arousal is generated. In any situation of biophysical dominance, the effective sexual response requires only a reasonable level of interdigital contribution by the psychosocial system.

Conversely, it also is possible for a human female to respond to erotic signals initiated by the predominant psychosocial factors of the sexual value system, regardless of conditions of biophysical imbalance such as hormonal deficiency or obvious pathology of the pelvic organs.

A woman may respond sexually to the psychosocial system of influence to orgasmic response in the face of surgical castration and spite of a general state of chronic fatigue or physical disability. In any situation of psychosocial dominance, the effective sexual response requires only a reasonable level of interdigital contribution by the biophysical system.

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
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)