What You Can Change _. And What You Can't - Martin E. Seligman [87]
Arousal is the natural prelude to orgasm. In men, after enough penile stimulation a plateau of orgasmic inevitability is reached. If no interruption occurs, semen is soon released (emission) and is immediately pumped out by a set of rhythmic (at o.8-second intervals) contractions by powerful muscles at the base of the penis (ejaculation). This is accompanied by extremely intense, spasmodic pleasure. Orgasm in women is triggered by the clitoris and is then expressed by a series of rhythmic (you guessed it: o.8-second intervals) contractions of the muscles around the vagina. It is accompanied by ecstatic and rhapsodic feelings.
As we ponder the “unbridgeable” chasm between the sexes, I find it powerfully consoling to know that the underlying biology of sexual arousal and orgasm is completely parallel for men and women. He is probably feeling what you are feeling.
Men and women can break down at either phase, and where you break down defines your particular sexual dysfunction. Whatever the specific problem, it is always complicated by spectatoring. When things go wrong, or when you worry that things will go wrong, you start to watch your own lovemaking—from the outside. This gets in the way of losing yourself in the act, and so worsens the specific problem. Spectatoring creates additional anxiety, thereby starting a vicious circle. This is a clue as to what goes on in every sexual dysfunction. Arousal and orgasm are the result of biological systems that can get shut off by negative emotion. Anxiety, anger, and depression all interfere with arousal and orgasm, and spectatoring worsens all the sexual dysfunctions because it heightens anxiety.
If a woman is frightened or angry during sex, her arousal or her orgasm may be blocked. There are many commonplace sources. She may fear she will not reach orgasm, she may feel helpless and exploited, she may be ashamed of her excitement, she may expect physical pain during intercourse, she may fear pregnancy, she may find her partner unattractive, or she may think he is the wrong man. The sources of sexual blocking are parallel for men.
In the late 1960s, William Masters and Virginia Johnson invented direct sexual therapy for these then intractable problems. Their therapy was revolutionary, and it differs in three ways from the sex therapies that had gone before:
It does not label you “neurotic” or otherwise deeply troubled because you are frigid or a premature ejaculator. Rather, it formulates the problem as local (my Layer V), not global.
It treats the problem as the problem of a couple, not just of an individual: People are seen in pairs. (In some variations, if no partner shows up, there is a surrogate.)
The couple directly practices sex with the advice and instructions of the therapist. Typically, you spend one or two weeks in daily therapy. Instruction occurs during the day, and then the couple retires to the privacy of a hotel to practice what is prescribed. They report their progress the next morning.
Direct sex therapy is not a do-it-yourself affair, and therapists can now be found in almost all major American population centers. Ask your prospective therapists if they use Masters and Johnson techniques. The treatment of all the dysfunctions is similar, so I will illustrate only one.
Cindy has never had an orgasm, and her marriage to Bob is starting to unravel. They travel to Philadelphia to work with two therapists at the Marriage Council. In the second session, Cindy is taught how to masturbate with a vibrator. Afterward, alone, she has her first orgasm. This builds her confidence and dissolves some of her fear of the unknown. Next, Bob is instructed to start participating—gradually. That night, he just watches Cindy climax. The following night, he holds