A word must be said for the cooperative wives of sexually inadequate husbands. They may arrive in therapy frustrated, resentful, bitter, revengeful, or still devoted to this man of their choice.
Regardless of the manner in which they approach therapy, once they have assured themselves that every effort is being made to treat the marital relationship; not just the sexually inadequate male, the full cooperation of more than 90 percent of the wives seen by Foundation personnel has made the vital difference between success and failure in therapy.
The wives' depth of cooperation with therapeutic suggestions is engendered primarily by the participation of the female member of the therapy team. When wives realize they always have available as a cotherapist not only a friend but also an interpreter, their willingness to cooperate usually is excellent.
They realize they are working with their husbands for their marriage. Specific directions as to handling the psyche of her husband, her place in the scheme of therapy, and, above all, her role in a sexually functional marriage come from the female cotherapist, usually in individual sessions.
The overall results obtained from attempting symptom reversal of primarily and secondarily impotent men referred to the Foundation are far from satisfactory.
The best statistical measure of the clinical results is the rate of failures.
Although the results obtained represent significant improvement over previously published material, the failure rates are still far too high. There has been improvement as work has progressed, but there is still a long way to go before there can be professional satisfaction with clinical progress.
It should be emphasized once more that etiological influence usually was multiple in origin, and that category assignment has been merely on the basis of professional decision as to the major influence among the multiple etiological forces.
The predinical diabetes is but one of several etiological factors influencing the 11 men so listed.
Indicates a 40.6 percent failure rate in the treatment of primary impotence during two weeks of intensive educational process. There is hope for continuing improvement if we state additionally that there were 9 failures in the treatment of the first 16 cases and 4 failures in treating the last 16 cases of primary impotence over the last 11 years. The downward trend certainly should continue in this failure rate.
There was a 26.2 percent failure rate recorded in the two weeks' attempt to reverse the symptoms of secondary impotence over the 11 years in the Foundation.
Unfortunately, there has been no significant reduction in the failure rate as experience has accrued.
Of course these statistics represent only the percentage failure of symptom removal during the acute phase of treatment. Any treatment termed successful by this measure has little clinical value unless the symptom reversal proves to be permanent.
Therefore, while failure rates in the acute-treatment phase are of obvious import, consideration of any corresponding success rate must be held in abeyance until at least five years after termination of the acute phase of therapy.
Religious orthodoxy and homosexual orientation represent the two areas of ideological influence associated with the highest level of treatment failure in primary and secondary impotence.
There was a 66.6 percent immediate failure to reverse symptoms of primarily impotent men, and a 50 percent failure to reverse symptoms of secondarily impotent men influenced by religious orthodoxy.
No other category approaches this in treatment failure. The nearest approach is provided by those men with an etiological background of homosexuality, usually adolescent in onset.
Here 33.3 percent of the primarily impotent men and exactly the same figure of secondarily impotent men failed to respond positively to the two weeks' intensive-treatment program. It is in these two areas that so much more work needs to be done.
Currently there is an inexcusably high level of failure rate in therapeutic return for patients handicapped by either of these two specific etiological influences.
It must always be borne in mind that it is the individual man's susceptibility to etiological influences that determines whether he is to survive as a sexually functional male or is to fall into a pattern of inadequate sexual responsivity. Of the factors initiating or controlling this innate susceptibility we know so little.