Category: Sexual Dysfunction

Categories
Sexual Dysfunction

Woman Sexuality

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

A separate discussion of woman sexuality is necessary primarily because the role assigned to the functional component of 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 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

It is obvious that 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 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 carries an implication of shame, although such a dishonorable role has been rather difficult to sustain with objectivity.

The arbitrary:
Social assignment of the role of sin to female sexuality has not contributed 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 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 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
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 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
Sexual Dysfunction

Woman Sexual Phrase

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

She responds physiologically to sex-tension elevation. The four phases of the female cycle of sexual response established in 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 increasing 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 evidences increasing smooth-muscle tension by elevating from its natural, pudendal-overhang positioning and flattening on the anterior border of the symphysis.

With orgasm, reached at an increment peak of pelvic-tissue vasocongestion and myotonia, the orgasmic platform in the outer third of the vagina and the uterus contract within a 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 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 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 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 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.

Necessity for such individual consideration can best be explained by example:

It is possible for a sexually functional woman to feel 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 the manner in which erotic arousal is generated. In any situation of biophysical dominance, 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 in spite of a general state of chronic fatigue or physical disability. In any situation of psychosocial dominance, effective sexual response requires only a reasonable level of interdigital contribution by the biophysical system.

Categories
Sexual Dysfunction

Sexual Values

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

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 complete failure of any effective alignment of their biophysical and their psychosocial systems of influence.

They had never been able to merge either their points of maximum bio physical demand or their occasions of maximum psychosocial need with optimum environmental circumstances of time, place, or partner response in order 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 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 development of peak response is, of course, subject to marked variation.

There may be some value in drawing upon the previously described psycho physiological findings returned from preclinical studies. As a human female responds 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 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 from pelvic infection?

Certainly most forms of pelvic pathology would weigh against 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 well-established metabolic balance, good nutrition, sufficient rest, 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.

There are many women who 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 woman’s role in sexual functioning.

The woman living with residual of 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 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
Sexual Dysfunction

Sex Drive

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, 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 experience during their early teenage years that, in time, have withdrawn from active homophile orientation to live 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 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 a number of 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 was referred for treatment at her insistence.

Categories
Sexual Dysfunction

Sex, Culture Influence

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

Increasing complaints of 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 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 advent of offspring were celebrated as evidence of perpetuation of family and race, woman was considered to have done her duty, fulfilled herself, or both, depending of course upon the individual frame of reference.

In reality:
Society honored her contribution as a sexual entity only in relation to her capacity for breeding, 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, that 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 psycho physiological components of dysfunction can be dealt with comprehensively.

Socio Cultural Influence

More often than not places woman in a position in which she must adapt, sublimate, inhibit or even distort her natural capacity to function sexually in order to fulfill her genetically assigned role. Herein lies a major source of 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 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 self 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 in a positive way, or to distort or maladapt sexual function until the capacity.

And to function is extinguished, 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 wifes with complaints of female sexual inadequacy, the psycho physiological 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 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
Sexual Dysfunction

Orgasmic Dysfunction

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

The potential for orgasmic dysfunction: highlighted in the psychosocial-sexual histories of those women in marital units referred to the Foundation can be described in 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 which 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 any 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 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 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 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, 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
Sexual Dysfunction

Male Orgasm Influence

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

Professionals many times look for a specific influence or conditioning that predetermines sexual failure, and in most instances it can be identified if the delving goes deep enough.

Instances of neither positive nor negative dominance by either biophysical or psychosocial influence structures. If a woman has never established a close juxtaposition between the biophysical and psychosocial systems of influence because she has lived in a protective vacuum, she will not have been stimulated to develop her own sexual value system and therefore will tend to neutralize most input material of sexual implication.

The case history
below is presented to emphasize the fact that there need be no dominant influence (either positive or negative) in the development of primary orgasmic dysfunction.

Mrs. B was an only child of parents in their thirties when she was born. Both parents, teachers in a small, church-oriented college, were more restrained by habit of life-style and their own relationship than by religious influence.

The child did not develop as an extension of their presumed intellectual interests but became the “doll” whom they dressed exquisitely, handled little, and disregarded emotionally (as she perceived her upbringing). There was no real source of female identification, no opportunity to establish a sexual value system.

All decisions in her behalf included the theoretically objective presentation of two alternatives, but parental, primarily mother’s preference was emphasized. Mrs. B had no recollection of making a definitive decision of her own until her sophomore year at college, when she chose for a husband a relatively older man (he was in graduate school and seven years her senior). With this one decision she again relinquished all opportunity for self-determination.

They married upon his graduation at the end of her junior year in college. His assumption of total authority in marriage appeared more by default than demand and continued through 11 years of marriage, during which two children were born.

During the first years of the marriage, Mrs. B maintained a complacent attitude toward her sexual role within the marriage. However, in the last six years of the marriage she developed an intense desire to realize full sexual expression for herself and greater sexual pleasure for her husband.

Husband behavior
In this latter period her husband’s behavior, though warm and protective, was highly restrained in sexual as well as other facets of the marital relationship. He participated in the Foundation’s program with complete willingness, although with little concept of what or how anything in the marriage could be changed.

Reared by an older aunt and uncle he had learned little, by direction or observation, of the potential for human interaction on a personal level. However, he fortunately had not been given any primarily negative indoctrination.

Mrs. B’s enthusiasm for an effective sexual relationship within the marriage was and still is defined as real, but she has been unable to overcome anesthesia to any sensory perception that she can relate to erotic arousal. She has been unable to establish sensory reference within which to develop and relate her well-defined affection and regard for her husband.

The two contributing systems of influence on sexual function:
Remained in displaced positioning one from the other. To date she has demonstrated-insufficient emotional or intellectual capacity to establish a symbiotic state between her two systems of influence.

It is with mixed clinical reaction that the cotherapists regard the positive reaction of Mr. B to therapy. His response was one of delighted enthusiasm to the concept of interaction marked by both physical and verbal communication.

His feeling for his wife was intensified and he has become completely comfortable in a demonstrative marital role. While both partners feel that the alteration in the quality of the marital relationship is of significant proportion, the therapy has in fact failed to achieve the aim of reversal of the presenting distress.

This case represents a strikingly intense degree of negative conditioning, yet there was little of content in the history that could be termed specifically negative in its rejection of sexual expression.

This case also represents an example of the possible clinical warning system revealed by a negative reaction to the use of a moisturizing lotion as a medium of physical exchange. Mrs. B found its use “distracting” and of little meaning to the exchange with her partner.

While Mr. B found it to be the crucial contribution to establishing his initial ability to touch and feel with comfort and receptivity.

Categories
Sexual Dysfunction

Male Sex & Religion

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

While the multiplicity of etiological influences is acknowledged, the factor of religious orthodoxy still remains of major import in primary orgasmic dysfunction as in almost every form of human sexual inadequacy.

Investigation of 193 women who have never achieved orgasmic return before referral to the Foundation for treatment, 42 were products of rigidly channelized religious control. Eighteen were from Catholic, 26 from Jewish, and 7 from fundamentalist Protestant backgrounds.

It may also be recalled that 9 of these 42 primarily non orgasmic women reflecting orthodox religious backgrounds also were identified as having the clinical complaint of vaginismus, while 3 more women with orthodox religious backgrounds had to contend with situational orgasmic dysfunction and vaginismus simultaneously.

A history reflecting the control of orthodox religious demands upon the orgasmically dysfunctional woman and her husband is presented to underscore the Foundation’s professional concern for any orthodoxy-influenced imprinting and environmental input that can and does impose severely negative influences upon the susceptible woman’s psychosocial structure relative to her facility for sexual functioning.

Mr. A and His Wife
After 9 years of a marriage that had not been consummated, Mr. and Mrs. A were referred to the Foundation for treatment. He was 26 and she 24 years old at marriage. Mrs. A’s family background was one of unquestioned obedience to parents and to disciplinary religious tenets.

She was one of three siblings, the middle child to an elder brother by three years and a younger sister by two years. Other than her father, religion was the overwhelming influence in her life. The specific religious orientation that of Protestant fundamentalism encompassed total dedication to the concept that sex and sin were synonymous words.

Mrs. A remembers her father, who died when she was 19, as a Godlike figure whose opinion in all matters was absolute law in the home. Control of dress, social commitment, educational direction and in fact, school selection through college were his responsibility.

There were long daily sessions, of family prayer interspersed with paternal pronouncements, never family discussions. On Sunday the entire day was devoted to the church, with activities running the gamut of Sunday school, formal service, and young people’s groups.

The young woman described a cold, formal, controlled family environment in which there was complete demand for dress as well as toilet privacy.

Not only were the elder brother and sisters socially isolated, but the sisters also were given separate rooms and encouraged to protect individual privacy.

She never remembers having seen her mother, father, brother, or sister in an undressed state. The subject of sex was never mentioned, and all literature, including newspapers, available to the family group was evaluated by her father for possibly suggestive or controversial material. There was a restricted list of radio programs to which the children could listen.

Mrs. A had no concept of her mother except as a woman living a life of rigid emotional control, essentially without a described personality, fully dedicated to the concept that woman’s role was one of service. She considered it her duty and her privilege to clean, cook, and care for children, and to wait upon her husband.

There is no recall of pleasant moments of quiet exchange between mother and daughter, or, for that matter, of any freedom to discuss matters of moment with either her brother or her sister.

As a young girl she was totally unprepared for the onset of menstruation. The first menstrual period occurred while she was in school she was terrified, ran home, and was received by a thoroughly embarrassed mother who coldly explained to the young girl that this was woman’s lot.

She was told that as a woman she must expect to suffer this “curse” every month. Her mother warned her that once a month she would be quite ill with “bad pains” in her stomach and closed the discussion with the admonition that she was never to discuss the subject with anyone, particularly not with her younger sister. The admonition was obeyed to the letter.

The mother provided the protective materials necessary and left the girl to her own devices. There was no discussion of when or how to use the menstrual protection provided.

Menstrual cramping had its onset with the second menstrual period and continued to be a serious psychosocial handicap until Mrs. A was seen in therapy. She also described the fact that her younger sister was confined to bed with monthly frequency while maturing.

During the Teenage Years

Dating in groups was permitted by her father for church-social activities and occasionally, well-chaperoned school events. College, selected by her father, was a coeducational institution which was described by her as living by the “18-inch rule,” i.e., handholding was forbidden and 18 inches were required between male and female students at all times.

Her dating was rare and well chaperoned. After graduation she worked as a secretary in a publishing house specializing in religious tracts. Here she met and married a man of almost identical religious background.

The courtship was completely circumspect from a physical point of view. The couple arrived at their wedding night with a history of having exchanged three chaste kisses, which not only was the total of their physical courtship but also represented the only times she remembered ever being kissed by a man. Her father had felt such a display of emotion unseemly.

The only time her mother ever discussed a sexual matter was the day of her wedding. Mrs. A was carefully instructed to remember that she now was committed to serve her husband. It would be her duty as a wife to allow her husband privileges.

The Husband Privileges
were never spelled out. She also was assured that she would be hurt by her husband, but that “it” would go away in time. Finally and most important, she was told that “good women” never expressed interest in the “thing.” Her reward for serving her husband would be, hopefully, in having children.

She remembers her wedding night as a long struggle devoted to divergent purposes. Her husband frantically sought to find the proper place to insert his penis, while she fought an equally determined battle with nightclothes and bedclothes to provide as completely a modest covering as possible for the awful experience.

The pain her mother had forecast developed as her husband valiantly strove for intromission.

Although initially there were almost nightly attempts to consummate the marriage, there was total lack of success. It never occurred to Mrs. A that she might cooperate in any way with the insertive attempts.

And since this was to be her husband’s pleasure, it therefore was his responsibility.

She evidenced such a consistently painful response whenever penetration was attempted that frequency of coital attempt dwindled rapidly. The last three years before referral, attempts at consummation occurred approximately once every three to four months.

For 9 years this woman only knew that she was physically distressed whenever her husband approached her sexually, and that for some reason the distress did not abate, Her husband occasionally ejaculated while attempting to penetrate, so she thought that he must be satisfied.

Whenever Mr. A renewed the struggle to consummate, she was convinced that he had little physical consideration for her. Her tense, frustrated, negative attitude, initially stimulated by both the pain and the “good woman” concept described by her mother, became in due course one of complete physical rejection of sexual functioning in general and of the man involved in particular.

When seen in therapy, Mrs. A had no concept of what the word masturbation meant. Her husband’s sexual release before marriage had been confined to occasional nocturnal emissions, but he did learn to masturbate after’ marriage and accomplished ejaculatory release approximately once a week, without his wife’s knowledge. There was no history of extramarital exposure.

Of interest is the fact that Mrs. A’s brother has been twice divorced, reportedly because he cannot function sexually, and her younger sister has never married. As would be expected, at physical examination Mrs. A demonstrated a severe degree of vaginismus in addition to the intact hymen.

In the process of explaining the syndrome of involuntary vaginal spasm to both husband and wife, the procedures described were followed in detail. When vaginismus was described and then directly demonstrated to both husband and wife.

It was the first time Mr. A had ever seen his wife unclothed and also the first time she had submitted to a medical examination.

There obviously were multiple etiological influences combining to create this orgasmic dysfunction, but the repression of all sexual material inherent in the described form of religious orthodoxy certainly was the major factor.

Under Foundation direction, the process of education had to include reorientation of both the sexual and social value systems. The influence of the psychosocial system was turned from a dominant negative factor to a relatively neutral one during the acute phase of treatment.

This alteration in repressive quality allowed Mrs. A’s natural biophysical demand to function without determined opposition, and orgasmic expression was obtained. Obviously, the husband needed a definitive psychosexual evaluation as much as did his wife.

Categories
Sexual Dysfunction

Male Sexual Dysfunction

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

In order to be diagnosed as having primary orgasmic dysfunction, a woman must report lack of orgasmic attainment during her entire lifespan. There is no definition of male sexual dysfunction that parallels in this severity of exclusion.

A Male Is Judged Primarily Impotent:
The definition means simply that he has never been able to achieve intromission in either homosexual or heterosexual opportunity. However, he might, and usually does, masturbate with some regularity or enjoy occasions of partner manipulation to ejaculation.

For the primarily non orgasmic woman, however, the definition demands a standard of total inorgasmic responsivity.

The edict of lifetime non orgasmic return in the Foundation’s definition of primary orgasmic dysfunction includes a history of consistent non orgasmic response to all attempts at physical stimulation, such as masturbation, male or female manipulation, oral genital contact, and vaginal or rectal intercourse.

In Short
Every possible physical approach to sexual stimulation initiated by self or received from any partner has been totally unsuccessful in developing an orgasmic experience for the particular woman diagnosed as primarily non orgasmic.

If a woman is orgasmic in dreams or in fantasy alone, she still would be considered primarily non orgasmic.

Foundation personnel have encountered two women who provided a positive history of an occasional dream sequence with orgasmic return and a negative history of physically initiated orgasmic release.

However, no woman has been encountered to date that described the ability to fantasy to orgasm without providing a concomitant history of successful orgasmic return from a variety of physically stimulative measures.

There are salient truths about male and female sexual interaction that place the female in a relatively untenable position from the point of view of equality of sexual response.

Of primary consideration is the fact of woman’s physical necessity for an effectively functioning male sexual partner if she is to achieve coitally experienced orgasmic return.

During coition the non orgasmic human female is immediately more disadvantaged than her sexually inadequate partner in that her fears for performance are dual in character. Her primary fear is, of course, for her own inability to respond as a woman, but she frequently must contend with the secondary fear for inadequacy of male sexual performance.

The outstanding example of such a situation is, of course, that of the woman married to a premature ejaculator. From the point of view of mutual responsibility for sexual performance, the woman has only to make herself physically available in order to provide the male with ejaculatory satisfaction.

The premature ejaculator in turn makes himself available, there usually is little correlation between intromission, rapid ejaculation, and female orgasmic return during the episode.

Married Premature Ejaculator

The biophysically disadvantaged female usually is additionally disadvantaged from a psychosocial point of view. Not only is there insufficient bio-physical opportunity to accomplish orgasmic return, but in short order the wife develops the concept of being sexually used in the marriage.

She feels that her husband has no real interest in her personally nor any concept of responsibility to her as a sexual entity. Many times the wife might be at a peak of sexual excitation with intromission. Without fear for her husband’s sexual performance she could be orgasmically responsive shortly after coital connection, displaying full bio-physical capacity for sexual response.

But as she sees and feels the male thrusting frantically for ejaculatory release, she immediately fears loss of sexual opportunity, is distracted from input of biophysical stimuli by that fear, and rapidly loses sexual interest.

With the negative psychosocial-system influence from the concept of being used more than counterbalancing the high level of biophysically oriented sexual tension she brought to the coital act, orgasmic opportunity is lost.

Brief attempt should be made to highlight the direct association of male and female sexual dysfunction in marriage, for there were 223 couples referred to the Foundation for treatment with bilateral partner complaints of sexual inadequacy. By far the greatest instance of a combined diagnosis was that of a non orgasmic woman married to a premature ejaculator.

Of the total 186 premature ejaculators treated in the 11 year program, 68 were married to women reported as primarily non orgasmic and an additional 39 wives were diagnosed as situationally non orgasmie. Thus, in 107 of the 223 marriages with bilateral partner complaint of sexual dysfunction, the specific male sexual inadequacy was premature ejaculation.

Since the in-depth descriptions of the premature ejaculator presented in earlier topic include full descriptions of the problems of female sexual functioning in this situation, there is no need for a detailed history representative of the 68 women primarily non orgasmic in marriages to prematurely ejaculating men.

Another salient feature in the human female’s disadvantaged role in coital connection is the centuries old concept that it is woman’s duty to satisfy her sexual partner. When the age old demand for accommodation during coital connection dominates any woman’s responsivity, her own opportunities for orgasmic expression are lessened proportionately.

If woman is to express her biophysical drive effectively, she must have the single-standard opportunity to think and feel sexually during coital connection that previous cultures have accorded the man.

The male
must consider the marital bed as not only his privilege but also a shared responsibility if his wife is to respond fully with him in coital expression. The heedless male driving for orgasm can carry along the woman already lost in high levels of sexual demand, but his chances of elevating to orgasm the woman who is trying to accommodate to the rhythm, depth, and power of his demanding pelvic thrusting are indeed poor.

It is extremely difficult to categorize female sexual dysfunction on a relatively secure etiological basis. There is such a multiplicity of influences within the biophysical and psychosocial systems that to isolate and underscore a single, major etiological factor in any particular situation is to invite later confrontation with pitfalls in therapeutic progression.

Categories
Sexual Dysfunction

Male Libido

Male Female Sexual Response, Inadequate,Orgasm,Inadequate Orgasm, impotent, inexperience sexual male, sexual response, male libido, sexual dysfunction, orgasmic dysfunction, woman sexuality, sex drive

Random orgasmic inadequacy is illustrated in the history below. With but two episodes of orgasmic attainment in her life, Mrs. H provides a history of one manipulative and one coital effort to orgasmic release. Her two highlighted sexual experiences were as much of a surprise to her when they occurred as they were to her husband.

There seems to be a clinical entity of low sexual tension which by history does not represent specific trauma to a sexual or any other value system. If so, it is rare both in occurrence and in professional identification. Perhaps the case history reported below is representative of such a situation.

Mr. and Mrs. H
were referred to the Foundation after 11 years of marriage with the wife’s stated complaint that she was just not interested in sex. She was 47 and her husband 44 years old. Her childhood and adolescent years had been spent in comfortable surroundings. She was the eldest by three years of two sisters and reported a relatively uneventful, non traumatic background for growth and development.

Mrs. H was a relatively attractive woman with a reasonable number of dating opportunities during high-school and college years. Despite thoroughly enjoying the social aspects of the dating opportunities, there was little sexual stimulation from the few petting experiences she accepted.

She never masturbated and recalled no awareness of pleasant pelvic sensation during her childhood.

Her mother was a relatively self-sufficient woman with multiple socio cultural interests. She never discussed material of sexual content with her daughter. When Mrs. H. was 15, her father was killed in an automobile accident.

After college Mrs. H sought opportunity for a professional career in the business world. She continued working throughout her twenties, doing exceptionally well professionally. There was established social opportunity, but she found herself resistant to both male and female (one occasion) approaches to shared sexual experience.

Her resistance was not described as aversion. It was just that she was essentially unstimulated by any sexual approach and saw no point in a commitment without interest.

She had a number of women and men friends and many interests. She worked hard, enjoyed her vacations, traveled extensively, but simply avoided sexual approach. At age 36 she met and married a man three years her junior who was working in the same professional field. They formed their own business venture.

From Mrs. H’s point of view the marriage was simply a form of business merger. The same could not be said for her husband. He was very much interested in sexual functioning. He had been married for less than two years in his mid twenties and listed a large number of sexual opportunities with a wide variety of experiences before this marriage.

Mrs. H was totally cooperative in sexual functioning, but was basically unmoved. She lubricated well with coital connection, found pleasure in providing release for her husband, but was totally uninvolved personally.

She had never masturbated, and her husband’s attempts to stimulate her not only were unsuccessful but at times she even found them amusing when “nothing happened.” Neither repulsed nor frustrated, she simply wasn’t involved in sexual expression.

This was not her husband’s reaction to their mutual sexual experiences. He found her lack of responsiveness utterly frustrating. Together they prospered from a financial point of view, but her obvious lack of sexual interest was depressing to him as an individual:

Eighteen months before referral to the Foundation, Mrs. H was highly stimulated on one occasion during coital connection and was orgasmic. The couple thought success had been attained, but subsequent coital episodes found her essentially unstimulated. There was one other such episode of orgasmic attainment.

On this occasion, the business had gained an important new source of financial return and the unit had celebrated their success with dinner and the theater. She was orgasmic that night by manipulation only. Thereafter, there was no significant level of response regardless of the mode of stimulation. It was a high level of male frustration that brought the unit to the Foundation for treatment.

Orgasm and Masturbation

These were a few cases of masturbatory orgasmic inadequacy. The classification represents a stage of woman’s sexual responsivity and, other than for categorizing purposes, has no assigned value and will not be illustrated in depth. There are two types of history that dominate this classification.

The first: is the story so often obtained from women guilt-ridden from masturbatory experimentation. They try to masturbate as young women, and after failing a time or two, simply withdraw from experimentation with the concept that they have fallen from grace. Later in their mature sexual experience, genital-area manipulation as a means of sexual excitation is at best moderately successful, but they are not orgasmic except during coition.

The second: is that of the female “don’t touch” syndrome. When taught that masturbation is evil they react by avoiding any approach to self-stimulation during adolescence and their maturing years. They may be orgasmic during socially acceptable coital opportunity but cannot be manually or orally elevated to orgasmic return.

The sexually dysfunctional woman as affect the male sexual function has been discussed in depth. There are so many variations on the theme of orgasmic inadequacy that many chapters could have been written, and the subject still would not have been covered adequately.

The concepts of a duality of psychosocial and biophysical structuring which influence woman’s sexual response patterns has been advanced. If any woman’s sexual value system is either undeveloped or damaged by an imbalance of either of these two theoretical systems of influence, the return may be varying degrees of orgasmic inadequacy.

When faced with the clinical responsibility of treatment demand for primary or situational orgasmic dysfunction, the cotherapist must have established theoretical concepts of sexual dysfunction if he is to treat effectively.