Probably the most effective technique is that of the teasing approach of light touch moving at random from the breasts to the abdomen to the thighs to the labia to the thighs and back to the abdomen and breasts without concentrating specifically on pelvic manipulation early in the stimulative episode.
Particularly should direct approach to the clitoral area be avoided initially in this process. This "exercise" becomes even more effective as a means of female sex-tension increment, when interlaced with sensate-focus, stroking techniques introduced after roundtable discussion.
The male partner must be careful not to inject any personal demand for sexual performance into his female partner's pattern of response.
The husband must not set goals for his wife.
He must not try to force responsivity.
His role is that of accommodation, warmth, understanding, and holding, but he should not be so pacific that his own sexual pleasure is negated for either himself or his partner.
Through total cooperation he allows his wife to drift with sensate pleasure and provides her with sensual stimulation without forcing her to contend with an accompanying sense of goal oriented demand to respond to a forcing form of manipulation.
The cotherapists must make it quite clear to the husband that orgasmic release is not the focus of this sexual interaction.
Manipulation of breast, pelvis, and other body areas varying from the lightest touch to an increase in pressure only at partner direction, should provide the wife with the opportunity to express her sexual responsivity freely, but without any concept of demand for an endpoint (orgasmic) goal. It must be emphasized that the effectiveness of a stimulative session is not lost to the woman simply because the session is terminated without orgasmic experience.
There is a tremendous accrual of sexual facility and interest for any woman when she knows that there will be a repeat opportunity for further sexual expression in the immediate future.
Thus, the husband's light, teasing, non demanding approach to touch and manipulation allows the female partner full freedom to express her interests, her demands, her sexual tensions. This sequence of opportunities permits accumulation of stimulative effects which will provide the source of her ultimate release of maximum sex-tension increment at some future point.
All specific exercises aimed toward the wife's fulfillment of her orgasmic capacity always are introduced by direction of the cotherapists on the basis of marital-unit report. When husband and wife describe the fact that previous directions have produced a positive return of stimulative pleasure, their next level of sexual involvement is approached.
This treatment concept means, of course, that a steady progression of exercises does not necessarily take place on daily schedule. For instance, marital partners who never have verbally shared sexual reactions or expressed sexual preferences to each other usually take longer to appreciate a positive level of sexual-tension return than less restrained, more communicative husbands and wives.
Another example of delayed reactive potential centers upon marital units that have coped with functional distress for extended periods of time. These husbands and wives usually require longer to adapt to and become comfortable with their revised patterns of sexual behavior than those whose sexual dysfunction has been relatively brief.
It has been further observed that successful marital-unit adaptation to a state of sexual dysfunction, in itself a possible indication of individual and marital-unit strengths, may present a higher level of inherent resistance to reversal of the stated inadequacy than more dissident, fragmented marital relationships.
Cotherapists must constantly bear in mind during the rapid-treatment program that the authoritative introduction of specific exercises represents a deliberate breakdown of woman's sexual responsivity into its natural components. Each exercise is introduced singly and continued until appreciated. All exercises are accrued one after another in a natural building process until they have been reassembled into the whole of an established sexual response pattern.
The directive pattern, in which each item is repeated as a new one is added in each successive verse until all items are assembled. Therefore, the marital unit must be reminded quietly each time a new direction for specific sexual activity is introduced that this introduction of new material is not an indication that previous exercises and their concomitant pleasures must be relinquished in order to enjoy the new experience.
Rather, as each new psycho physiological concept is provided for marital partner assimilation, older exercises are constantly restated until the whole reactive process is assembled.
At this point, marital partners frequently may have acquired a gavotte-like approach to sexual expression when employing the directive suggestions rather than spontaneously incorporating each new physical approach or stimulative concept into their own style or pattern of behavior.
The marital couple will need reminding that on a long-range basis there is little return from clocking each component of the therapeutic pattern for a specific length of time or introducing each new exercise into their sexual interaction in a purely mechanical manner, solely because it has been suggested by impersonal authority rather than mutually evolved.
Emphasis should be placed upon the fact that there is marked individual variation in the time span in which each area of sensory perception is appreciated. Mood, level of need, quality of partner involvement, etc., all vary widely, frequently on a day-to-day basis.
There will be occasions when spontaneous non specific or even a sexual social interaction will replace all the "touch and feeling" (foreplay) that have been so enjoyable and so necessary at other times.
Whenever exercises in sensate focus, especially those using specifically positioned opportunities have initiated newfound levels of stimulative appreciation for the non orgasmic woman, the appropriately sequential step is suggested for unit exploration during their next phase of sexual interaction.
It is essential to successful therapy to emphasize again and again the concept that sexual response can neither be programmed nor made to happen. The marital unit also must be encouraged continually to create an environment that fulfills the stimulative (bio-physical and psychosocial) requirements of each partner and in which sex-tension increment can occur without any concept of performance demand.
Each successive phase of physical approach is introduced subsequent to establishing some evidence of encompassing psychosensual pleasure as perceived by the non orgasmic woman during a prior episode.
These phases develop in sequence from the first day's sensory exploration which takes place following the roundtable discussion. If there is obvious female pleasure in the first sensate experience, the next phase includes specific manipulative approach to genital excitation, using, if possible, the positioning.
If the first day's exercise in sensate pleasure has not developed a positive experience for the non orgasmic woman, the second day will again be devoted to these primary touch-and-feeling episodes, instead of moving into the genital manipulative episodes usually scheduled for Day two.
Genital manipulative episodes are continued until there is obvious evidence of elevated female sex tension, before moving on to the next phase in the psychosensory progression.
Subsequent to reported success in manual genital excitation, the marital, partners are asked to try the female-superior coital position, by which means the wife may translate previously established levels of sensate pleasure into an experience which includes the sensation of penile containment.
The specific intercourse techniques of this position have been discussed and illustrated as Female superior mounting is but another step in the gradual development of sexual awareness leading from simple, sensate focus to effective response in coital connection.
The husband is asked to assume a supine position in anticipation of his wife's superior mounting. Intromission is to take place when both partners have reached the level of sexual interchange, full erection for the man and well-established lubrication for the woman that suggests the desire for further physical expression.