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.
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.