Categories
Treat Orgasm

Intercourse Position

The husband is directed to place himself in a sitting (slightly reclining, if desired) position, with his back against a comfortable placement of pillows at the headboard of the bed. With the husband’s legs adequately separated to allow his wife to sit between them, she should recline with her back against his chest, pillowing her head on his shoulder.

Length of torsos should determine the reclining angle that permits her head to rest comfortably. Her legs are then separated and extended across those of her husband.

This position provides a degree of warm security for the woman (“back-protected” phenomenon) and allows freedom of access for the man to encourage creative exploration of his wife’s entire body in the sensate-focus concept.

The level of physical communication in the manipulative sessions is encouraged further by direction for the female partner to place her hand in a lightly riding position on that of her husband.

By using slight increase in pressure or gentle directional movement, the “where and how” of her need of the moment may be immediately communicated to her receptive husband. This and other forms of nonverbal communication allow sharing of her particular desires as they occur as manifestations of her sexual value system, and constitute a secure way by which her marital partner can identify and fulfill these desires by meaningful interaction.

This means of direct physical communication also provides the woman with freedom to request specifics of genital play without the distraction of forced verbal request or a detailed explanation.

Any spontaneous form of expression of a man’s own sexual tensions is one of the most interactive contributions that he can make to his wife. It is a viable component of sexual “give to get” in any circumstance of physical sharing.

This principle applies equally to the marital unit carrying out the simplest sensate-focus exercise in the therapy program as it does to a marital unit that has never known sexual dysfunction.

The man must not presume his wife’s desire for a particular stimulative approach, nor must he introduce his own choice of stimuli. The husband’s assumption of expertise has no place in the initial learning phase of a marital unit seeking to reverse the life’s non orgasmic condition.

The trial-and-error hazard this poses is not worth the small possibility of accidental pleasure that might be achieved. In truth, error in some facet of this controlled manipulative form of physical communication has already been established, or the marital-unit members probably would not consider themselves in need of professional support.

Only after both marital partners have established the fact of the wife’s sexual effectiveness with controlled genital play and have developed dependable physical signal systems should trial-and-error stimulative techniques be crone a naturally occurring dimension of pleasure.

It is well to mention that even those partners with an established, effective sexual relationship may find it both appropriate and advisable to check out their physical signal systems by verbal communication from time to time.

An additional value derived from the non demand position and its accompanying sensate exercises is its contribution to removal of the potential spectator’s role.

This role can become as much a pitfall for the non orgasmic woman as it is for the impotent male. Already considered in descriptions of female-oriented patterns of sexual dissimulation, the spectator role is dissipated when sexual involvement of husband and wife becomes mutually encompassing for both partners.

Educational Direction

For the husband is an integral part of the genital-play episodes. The cotherapists must be certain that the basics of effective pelvic play are clearly enunciated if the male partner is to provide effective measure of stimulative return for the woman involved.

The husband is instructed both to allow and to encourage his wife to indicate specific preferences in stimulative approach either by the light touch of her hand on his or by moving slightly toward desired approach or away from excessive pressure.

Probably the greatest error that any man makes approaching a woman sexually is that of direct attack upon the clitoral glans, unless this is the stated wish of his particular partner. The glans of the clitoris has the same embryonic developmental background as that of the penis, but usually is much more sensitive to touch.

As female sex tensions elevate, sensations of irritation, or even pain, may result from direct clitoral manipulation.

Rarely do women, when masturbating, manipulate the clitoral glans directly. Therefore, the male approach to clitoral stimulation would do well to correspond to that employed by women when providing self-release. There is a further, perhaps more subtle, reason for relative care in the intensity of stimulative concentration directed to the clitoris.

This originates from the fact that the clitoris, as a receptor and a transmitter of sexual stimuli, can rapidly react to create an overwhelming degree of sensation. When such a high level of biophysical tension is reached before the psychosocial concomitant has been subjectively appreciated, the woman experiences too much sensation too soon and finds it difficult to accept.

In the interest of a pleasurable, evolving sexual responsivity, the clitoris should not be approached directly. Specifically, manipulation should be conducted in the general mons area, particularly along either side of the clitoral shaft.

It must be remembered that the inner aspects of the thighs and the labia also are erotically identified areas for most women. Pressure and direction of manual stimulation should be controlled initially by the female partner for two educative reasons.

  1. full freedom of manipulative control provides her with opportunity to feel and think sexually without having to adjust to a partner’s assumption of what pleases her.
  2. female control of manipulative activity also educates the male partner into the particular woman’s basic preferences in stimulative approach to the clitoral area.

It must also be borne in mind by the male partner that there is no lubricating material available to the clitoris. As female sex tension increases there will be a sufficient amount of lubrication at the vaginal outlet.

This should be maneuvered manually from the vagina to include the general area of the clitoris. Vaginal lubrication used in this manner will prevent the irritation of the clitoral area that always accompanies any significant degree of manipulation of a dry surface.

A further dimension of sexual excitation is derived from manipulation of the vaginal outlet when lubricating material is acquired for clitoral spread by superficial finger insertion. There is usually little value returned from deep vaginal insertion of the fingers, particularly early in the stimulative process.

While some women have reported a mental translation of the ensuing intravaginal sensation to that of penile containment, few had any preference for the opportunity.

Categories
Treat Orgasm

Female on Top Position

When the marital partners extend their psychosensory 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 in relation to 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 cotherapists 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 obvious opportunity for 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 perform, produce, and achieve is, “What if I feel like ejaculating?” It requires continuing effort by the cotherapists to convey the concept not only that acquiring ejaculatory control is possible but also that such 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 cotherapists to emphasize the fact that ejaculation or spontaneously occurring orgasm is not cause 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 coital connection.

The timing and duration of sexually stimulative activity should follow the directive formula as outlined in 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 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 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 in order to derive pleasure, each from the other.

Categories
Premature Ejaculation

Male Superior Position

Yet another reason for emphasizing the female-superior and the more effective lateral coital positioning is that the most popular position in our culture, the male-superior positioning, presents the greatest difficulties with ejaculatory control.

If the coital connection is to be brief with both partners obviously wishing rapid pelvic thrusting to release of their high levels of sexual tension, coital positioning does not matter. But if there is desire to prolong the connection either for mutual pleasure or because the female partner needs more opportunity to feel and think sexually, the male superior position, which places the greatest strain on ejaculatory control, should be avoided when possible.

On every occasion, before female-superior coital position is established and then possibly converted to a lateral mounting arrangement, a comfortable period of precoital sex play is encouraged. The wife should employ the squeeze technique at least two or three times before penetration is attempted.

It takes a significant period of time to alter an early imprinting of the pattern of rapid ejaculation.

However, in the two-week treatment program, sufficient competence in ejaculatory control can be developed to alleviate mutual fears of performance, obviate the spectator role, and provide all the opportunity necessary for continued improvement in control subsequent to release from the acute stage of therapy.

Before the couple leaves the clinic, the cotherapists emphasize the fact that problems of ejaculatory control continue to a minor degree for at least the subsequent year. Several techniques to encourage continuing success in ejaculatory control are described for marital-partner benefit. The unit is reminded that after returning to the demands of their everyday world, regularity of sexual exposure is of primary concern.

For the first six months the squeeze technique should be employed on at least a once-a-week basis prior to coital opportunity; the remainder of the unit’s sexual opportunities during the week are encouraged to develop in a natural, unconstrained fashion. This approach provides the man with the necessary means for transition from a controlled sexual experience to a completely extemporaneous opportunity.

It is also suggested that the couple take advantage of the wife’s menstrual period each month to provide at least one session of 15 to 20 minutes devoted specifically to male sexual stimulation with manual manipulation and repetitive application of the squeeze technique for control of the ejaculatory process.

Ejaculatory Control Techniques

Usually are indicated for a minimum of six to twelve months after termination of the acute phase of therapy. During the routine follow up discussions after termination of the unit’s acute phase of treatment decision to terminate use of the squeeze technique is made by professional evaluation of the degree of control during the unit’s spontaneous matings.

It also is important to emphasize that if circumstances lead to separation of marital members for a matter of several weeks, coital exposure after the couple is physically reunited may find the male returning to his role as a premature ejaculator. Obviously, the procedure in this situation is to reemploy the squeeze technique for several consecutive coital exposures.

If constituted with warmth and understanding ejaculatory control will return rapidly.

With adequate warning of the possibility of these complications, a more relaxed concept of freedom of sexual approach is possible for couples contending with severe premature ejaculation.

Numerable approaches to the treatment of premature ejaculation have been described, discarded, or conducted with varying levels of professional acceptance. Hypnotic suggestion, both in natural and drug-induced states of receptivity, has been a popular approach to the problem.

Penis Cream

There has been widespread acceptance of anesthetic creams and jellies prescribed for application to the erect penis theoretically to reduce neurogenic end-organ sensitivity to the stimuli of manipulation or vaginal containment. Specific drug preparations, tranquilizers, barbituates, etc., have been prescribed in an effort to dull male sensitivity to stimuli in general and to stimuli of sexual content in particular.

Many men have tried with varying degrees of success to lower their natural sexual tension levels by ingestion of sizable quantities of alcohol before anticipated sexual encounter.

Frantic men consume a never ending list of potions, nostrums, and poisons, all designed to reduce rapidity of ejaculatory response, all curiously directed to a male’s sexual functioning alone without regard for his partner’s involvement. Any form of sexual inadequacy is a problem of mutual involvement for partners in a marriage.

With a wife’s full cooperation, her willingness to learn and to apply the basic principles of ejaculatory control, and the warmth of her personal involvement expressed openly to her mate, reversal of this crippling marital distress is essentially assured. As further support of this argument for the necessity of involvement of the wife in the resolution of a well established premature ejaculatory pattern, it should be pointed out that the squeeze technique is not effective if done by the male attempting to teach himself control.

If a man manipulates his penis to erection and then applies the squeeze technique to control an imminent ejaculatory response, he usually can halt the natural progression of sex tension increment and successfully depress his ejaculatory urge.

However, once this man returns to the stimulation of a heterosexual relationship, it is as if he had made no prior solitary attempts at control. What is obviated by solitary attempts to learn ejaculatory control is the fact that with a female partner the individual male cannot entirely set the pace of sexual functioning, nor can he entirely, deny the sexual stimuli absorbed from the obvious psycho sexual involvement of his marital partner.

In The 11 Years:

186 men have been treated for premature ejaculation. There have been 4 failures to learn adequate control during the acute phase of therapy. Adequate control is defined as sufficient to provide orgasmic opportunity for the sexual partner during approximately 50 percent of the coital opportunities. The failure rate is 2.2 percent.

Three of the failures were with couples; and one was with a man previously divorced because of his premature ejaculatory pattern, who brought a replacement partner to the treatment program.

In two of the four instances there was no real motivation on the part of the male partner to learn ejaculation control. These men had accompanied their non orgasmic wives as a cooperative venture, but when they learned that they were in fact contributing to their wives’ sexual dysfunction they refused further cooperation. They simply could not accept a reversal of their deeply ingrained double standard of sexual function.

There is no specific explanation for the two remaining failures to control the premature ejaculatory tendencies of the men involved. Both units were fully cooperative but the techniques simply did not work. One of these men, 64 years old, was the only failure among 19 men 50 years or older treated for premature ejaculation.

A brief note of clinical warning is in order. After learning to control a premature ejaculatory tendency, 23 of the couples treated by clinic personnel were confronted by a brief period of secondary impotence just before or shortly after termination of the acute phase of therapy.

Sexual Function Improvement

Most couples, delighted with the significant improvement in sexual functioning, enter a period of marked frequency of coital connection as compared with their sexual exposure rate just before visiting the clinic.

Sometimes the male partner simply cannot meet the suddenly elevated frequency demand and encounters an episode of erective failure. He only has to have one such experience before all his fears of performance flood his consciousness. What new form of dysfunction is this? Has the treatment caused it? His initial anxiety reaction is of serious proportion.

The thought that he was sexually satiated for the moment never occurs either to the concerned husband or his sexually enthusiastic wife. Care must be taken by authority to warn couples of the possibility of a transitory experience with impotence, as they are adjusting their overwhelming pleasure with their newfound sexual function to the practicality of the male’s level of sexual responsivity.

With prior warning the couples take an episode of impotence in stride, even laughing at the concrete evidence of their sexual greediness. Without adequate warning, a persistence of symptoms of secondary impotence is possible, for the fears of performance and spectator roles return to their dominant position before adequate explanation of the distressful event is available,

In brief, the problem of premature ejaculation is uniquely one that can be resolved effectively and permanently. For successful resolution of the problem, a man needs some understanding of the origin of distress, a knowledge of techniques to establish control, and, above all else, a cooperative, involved sexual partner.