CategoriesMale Sex & Vaginismus

Sexual Trauma History

The following history exemplifies onset of vaginismus subsequent to episodes of psychosexual trauma. There have been three women referred to therapy so physically and emotionally traumatized by unwelcome sexual attack that vaginismus developed subsequent to their traumatic experiences.

Couple C
When first seen, couple C had been married for 18 months, with repeated attempts to consummate the marriage reported as unsuccessful. The husband, age 31, reported effective sexual function with several other women prior to marriage. The wife, age 28, described successful sexual connection with four men over a five-year period before the specific episode of sexual trauma.

One of these relationships included coitus two or three times a week over a 10 month time span. She had been readily orgasmic in this association. The traumatic episode in her history was a well authenticated episode of gang rape with resultant physical trauma to the victim requiring two weeks’ hospitalization.

Extensive surgical reconstruction of the vaginal canal was necessary for basic physical rehabilitation. No psycho-therapeutic support was sought by or suggested for the girl following this experience.

Mr. and Mrs. C met one year after the rape episode and were married a year after their introduction. Prior to the marriage the husband-to-be was in full possession of the factual history of the gang raping and of the resultant physical distress.

During the latter stages of their engagement period, several attempts at intercourse proved unsuccessful in that despite full erection, penetration could not be accomplished. It was mutually agreed that in all probability the security of the marital state would release her presumed hysterical inhibitions. This did not happen.

After the marriage ceremony, attempts at consummation continued unsuccessful despite an unusually high degree of finesse, kindness, and discretion in the husband’s sexual approaches to his traumatized partner. Severe vaginismus was demonstrated during physical examination of the wife after referral to the Foundation.

The remaining two rape experiences were family-oriented and almost identical in history. In both instances young girls were physically forced by male members of their immediate family to provide sexual release, on numerous occasions, for men they did not know.

In one instance:
A father, and in another, an older brother, forced sexual partners upon teenage girls, 15 and 17 years of age and repeatedly stood by to insure the girls’ physical cooperation. Sexually exploited, emotionally traumatized, and occasionally physically punished, these girls became conditioned to the concept that all men were like that.

When released from family sexual servitude each girl avoided any possibility of sexual contact during the late teens and well into the twenties, until married at 25 and 29 years of age. Even then, they could not make themselves physically available to consummate their marriages, regardless of how strongly they willed sexual cooperation. Severe vaginismus was present in both eases.

The husbands’ physical and psychosexual examinations were within expected limits of normal variability. Neither husband had been made aware of the family-oriented episodes of controlled rape that had occurred years before their association with their wives-to-be.

Once apprised of the etiology of their wives’ psychosomatic illness, both men offered limitless cooperation in the therapeutic program. There are various etiological orientations to vaginismus. As evidenced previously, trauma initiating involuntary vaginal spasm can be either physiological or psychological, or both, in origin.

Of course there are factors of psychosomatic influence that predispose to vaginismus other than those frequently noted categories of channelized religious orthodoxy, male sexual dysfunction, and episodes of sexual trauma.

CategoriesKnowing Woman Sexuality

Sexual Dysfunction

The most common dysfunctions treated by sex therapists are:

    • Anorgasmia: The women has never, or only rarely, reached orgasm.
    • Delayed Ejaculation: The man can act sexually though seldom, if ever, climaxes in his partner’s presence.
    • Erectile Insecurity: Also called impotence, the condition is marked by difficulty in either getting or staying erect.
    • Inhibited Sexual Desire: A form of sexual apathy marked by infrequent sex, and a lack of thoughts and anticipation of sex.
    • Premature Ejaculation: The man climaxes more rapidly than he or his partner wishes, sometimes before intercourse begins.
    • Vaginismus: The woman desires sex, but her vaginal muscles contract involuntarily, preventing penetration.
    • Inappropriate Arousal: Being aroused by that which a culture deems inappropriate: children, animals, objects.

Most sex therapists find that when a couple finally summon the nerve to seek help, the problem is usually in an advanced stage, and can no longer be ignored, or endured. In nearly all cases, both partners need to be treated together.

The female problems such as anorgasmia and vaginismus are rare and psychological in origin. If mild, they can be solved by the woman herself with a vibrator. If severe, visit a sex therapist without delay. Male problems of ejaculatory control respond to self therapy and professional help. An erection problem can be the first sign of pre-diabetes, and the man should be tested for this promptly.

Inhibited Sexual Desire (ISD) appears to be a modern complaint amongst modern couples. Sex therapists say that it is by far the nation’s most common sexual dysfunction. For what are usually complex reasons, often including a past sexual problem, one or both partners have lost all desire for erotic intimacy.

Yet ISD is a philosophical concept, not a biological one. When and how often people wish to make love is a subjective issue. At its best, erotic love is an exquisitely sensitive bloom. Even when nurtured with the utmost love and tenderness, it can wax and wane, like the cycles of the moon.

It seems a very modern concept to regard the genitals as a set of engine parts which should be working. And that if one of these parts slows down or stops functioning, it should be taken to the auto body shop, and fixed. This mechanical way of perceiving what can be a most delicate interaction probably suits mechanical thinkers.

CategoriesKnowing Woman Sexuality

Orgasm

Erection

The clitoris is made of spongy tissue which can up fill with blood. This engorgement of tissue is vaso-congestion. Upon sexual arousal, extra blood from the pelvic arteries is pumped into the tissue, filling up the spongy spaces so that the clitoris swells in size. The muscles on each side contract and squeeze the only vein which runs along the top of the clitoris. This traps the extra blood inside; it cannot drain out. As more blood is pumped in, the swollen clitoris stiffens, rises, and lengthens to its maximum size. This is the process by which both the clitoris and penis become erect.

At the same time, extra blood is pumped into the vulva area, which thickens and flushes a deep red or purple. The outer labia swell to two or three times their pre-arousal size. The vagina responds with the sweating phenomenon. The walls are coated with moisture. The extensive system of connecting veins and muscles throughout the pelvis all respond to vaso-congestion. There is a feeling of fullness and heaviness, known as pelvic congestion. All this assists to move the woman towards the “orgasmic platform”.

The nipples also contain erectile tissue. At an early stage in arousal, they begin to harden and erect. The areola swells and spreads. The entire breasts are affected; they plump up and feel more tender; they are erotically charged when touched.

The Big O!

The clitoris and nipples are the main organs of arousal. If one or both are erotically stimulated for long enough, excitement increases until sexual tension becomes almost overpowering. As orgasm draws near, the clitoris becomes exquisitely sensitive; it cannot tolerate any more direct stimulation. It retracts, pulling back and retiring beneath its hood. Less often, the nipples become equally sensitive, and require no further stimulation.

Sexual tension is built by rhythmic friction. The thrusting of the penis causes maximum friction, maximum sensation, on the outer third of the vagina walls. In the missionary position, man on top, thrusting puts rhythmic pressure on the labia, which allows stimulation of the clitoris, though to a milder degree. Sucking or stroking the nipples in rhythmic movement produces the same effect. Erotic friction can be gentle or tough, slow or rapid, depending upon the particular needs at the time. Whichever, it must be rhythmic and persistent to build maximum sexual tension. As excitement increases, the entire body is charged with waves of tense pleasure. Muscle contractions ripple throughout the system. Like a waiting sneeze which has been building up, the persistency of the “friction factor” finally becomes explosive. The orgasmic platform has arrived. Now is the point of no return.

The vagina and surrounding tissues, the uterus, and sometimes the anus muscles all contract to a rhythmic beat at 0.8 second intervals; the same beat as in male orgasm. This beat can occur from between 3 to a maximum of 15 times, the same beat as in men. The last contractions are little more than ripples or shudders, again as in men. The more intense the orgasm, the longer the contractions last. A few women (and men) can have orgasms with no erotic friction whatsoever. They do it by fantasy, by imagination alone. Other women can have orgasms simply when they are kissed; the neck, earlobes, palms of the hands, toes — any part can be an erogenous zone.

The big “O’ varies. It is not always so big. There can be physical and emotional pleasure of such exquisite intensity that the feelings seem unendurable. There can be pleasing but low-key sensations which feel on a par with the satisfaction of a long-awaited sneeze. The degree of sensation at orgasm does not necessarily reflect on the woman, her partner, or the situation. They reflect on life. Orgasm is as variable as life itself.

CategoriesKnowing Woman Sexuality

Phantom Orgasm

Sadly in life, horrendous things do happen. Women can become paralyzed in their pelvic region from road accidents, disease and so on. They can lose all sensation in their pelvic area. Yet many paralyzed women continue to be orgasmic. However, our culture tends to perceive people with such disabilities as non-sexual. Indeed, medical textbooks refer to these orgasms as “phantom orgasms.” This is a phantom of medical folklore.

Be that as it may, it is critical to understand:

A woman can have an orgasm without penetration.
A woman can have an orgasm without a penis.
A man can have an orgasm without an erection.
A man can have an orgasm without a penis.

In fact, some women (and men) have orgasms merely by willing them. They do not require foreplay, nor thrusting, to raise sexual tension first. This is rare, but it can and does happen. Keep in mind that people are individuals, and have very different levels of sexual drive.

The human spirit is a wonderful phenomenon. It can withstand the most appalling vicissitudes and still respond with courage and resourcefulness. Women are said to be more stoical than men. They are able to endure more pain, both mental and physical.

Loss of sensation is a savage assault on female primacy. A woman’s first response can be equally savage and destructive. If she responds with a seemingly quiet and depressive state, this is as damaging emotionally as a raging and bitter response. Keep in mind that the healing process can be speeded up by orgasm, if so desired. Use a vibrator, erotica, anything which works.

In a loving relationship, the partner can take control. Seduce her out of her angry or passive state. Shock her out of grief and pain by relighting her sexual fires. Turn her emotional energies away from her broken body and back to where happiness awaits.

Avoid over-concern with her feelings. She is a woman still, a real woman, and will find your particular brand of “medication” irresistible. Tell her that she is desirable. Continue to enchant her until she has an orgasm. Then tell her she is so desirable that she must be prepared for another love making session soon.

CategoriesImpotence Cure

Sexual Dysfunction in Husband & Wife

Of course, most wives would not consider public discussion of the sexual inadequacy in their marriages. For a variety of reasons they choose to keep their own counsel.

They may feel that their husband’s dysfunction has origin in, or at least is magnified by, their own lack of physical appeal, or that they forced this inadequacy by their lack of competence of sexual functioning.

Most women identify completely with, and suffer for, their husbands in the sexual inadequacy. They feel warmth and sympathy and understand the psychosocial trauma created by his obvious failure in the marriage bed.

For a variety of reasons then, most women would not consider discussing their husband’s sexual dysfunction even with their closest friend.

But most women, whether they accuse publicly or support privately, do not comprehend the degree to which they have directly influenced their husband’s sexual inadequacy.

There is no such entity as an uninvolved partner in a marriage contending with any form of sexual inadequacy.

Sexual Dysfunction is A Couple’s Problem

not a husband’s or wife’s problem.

Therefore, husband and wife should be treated simultaneously when symptoms of impotence distress the husband and wife. The Foundation will not treat a husband for impotence or a wife for non orgasmic return as single entities.

If not accompanied by his wife, the impotent husband is not accepted in therapy. Both marital partners have not only contributed to, but are totally immersed in, the clinical distress by the time any unit is seen in therapy.

How best to treat clinical impotence? The first tenet in therapy is to avoid the expected, direct clinical approach to the symptoms of erective inadequacy.

Secret of successful therapy (for this dysfunction):
is not to treat the symptoms of impotence at all, for to do so means attempting to train or educate the male to attain a satisfactory erection, and places the therapist at exactly the same psychological disadvantage as that of the impotent male trying to will an erection.

Therapists cannot supplant or improve on a natural process and achievement and maintenance of penile erection is a natural process.

The major therapeutic contribution involves convincing the emotionally distraught male that he does not have to be taught, to establish an erection. He cannot be taught to achieve an erection any more than he can be taught to breathe.

Erections develop just as involuntarily and with just as little effort as breathing. This is the salient therapeutic fact the disturbed man must learn. No man can will an erection.

Every impotent man has to negate or neutralize a number of psychosocial influences which have helped to create his sexual dysfunction if he is to achieve erective effectiveness.

However, the prevalent roadblock is one of fear. Fear can prevent erections just as fear can increase the respiratory rate or lead to diarrhea or vomiting.

At onset of therapy, the impotent man’s fears of performance and his resultant spectator’s role are described specifically by the cotherapists and must be accepted in totality by the distressed male if reversal of the sexual dysfunction is to be accomplished.

Every impotent male is only too cognizant of his fears of performance, and, once the point is emphasized, he also is completely aware of the involuntary spectator role he plays during the coital attempt.

The Three Primary Goals in Treating Impotence Are:

  1. remove the man’s fears for sexual performance
  2. to reorient involuntary behavioral patterning so that he becomes an active participant, far removed from his accustomed spectator’s role.
  3. to relieve the wife’s fears for her husband’s sexual performance.

Whenever any individual evaluates his sexual performance or that of his partner during an active sexual encounter, he is removing sex from its natural context. And this, of course, is the all-important factor in both onset of and reversal of sexual inadequacy.

Penis flaccidity
With any form of sexual dysfunction, sex is removed from its natural context. The man watching carefully to see whether he is to achieve an erection sweats and strains to will that erection.

The more the male strains the more distracted he becomes and the less input of sensual pleasures he receives from his partner; therefore, the more entrenched the continued state of penile flaccidity.

Sexual Tension

In a natural cycle of sexual response there is input to any sexually involved individual from two sources.

As an example, presume an interested husband approaching his receptive wife. There are two principal sources of his sexual excitation. The first is developed as the husband approaches his wife sexually, stimulating her to high levels of sexual tension.

Her biophysical response to his stimulative approach (her pleasure factor), usually expressed by means of nonverbal communication, is highly exciting to the male partner. While pleasing his wife and noting the signs of her physical excitation (increased muscle tone, rapid breathing, flushed face, abundance of vaginal lubrication), he usually develops an erection and does so without any direct physical approach from his wife.

In this situation he is giving of himself to his wife and getting a high level of sexual excitation from her in return.

The second source of male stimulation develops as the wife approaches her husband with direct physical contact.

Regardless of the technique employed, his wife’s direct approach to his body generally, and the pelvic area specifically, is sexually exciting and usually productive of an erection.

When stimuli from both sources are combined by mutuality of sexual play, the natural effect is rapid elevation of sexual tension resulting in a full, demanding erection.

Often men move into a pattern of erective failure because they do not experience sensate input from both sides of the give-to-get cycle. Loss of supportive sexual excitation frequently develops not because wives are unavailable or uninterested but because one or both of the basic modes of input of sexual stimuli is blocked.

CategoriesErectile Dysfunction

Sexual Replacement

Thirteen women have accompanied unmarried men to the Foundation, agreeing to serve as replacement partners to support these men during treatment for sexual dysfunction. In all instances both individuals were accepted in therapy with full knowledge of the referring authority.

Since the women were selected by the men involved, they were accepted as if they were wives. They were interrogated in depth and attended all therapy sessions. They lived with the unmarried males as marital partners, in contrast to the partner surrogate, who spent only specific hours during each day with the sexually dysfunctional male.

Details of treatment for the various forms of male sexual dysfunction need not be repeated; clinical situations with replacement partners are managed in the same way as with wives.

Of the 13 men, 4 were premature ejaculators who with the aid of their replacement partners had this particular symptom brought under control. Of the 2 men who were primarily impotent, 1 achieved success in coital function and the other finished the course of therapy without resolving his sexual dysfunction.

Of the 7 secondarily impotent men who brought replacement partners to therapy, 5 experienced successful reversal of their symptoms during the two-week clinical program.

Three unmarried women referred to the Foundation brought with them replacement partners of their choice. In each instance the current relationship was one of significant duration. The shortest span of mutual commitment was reported as six months. Two of the three women had previously been married.

Replacement Partners

Were treated as husbands of sexually inadequate wives. They attended all sessions and went through in-depth history taking to provide information sufficient to define their roles in providing relief for their distressed women companions.

Two women provided histories of situational orgasmic dysfunction with occasional orgasmic return with manipulative or mouth genital approaches, but they had never been orgasmic during coition. In one instance coital orgasmic return was accomplished.

In the second it was not. In both circumstances the male replacement partners were totally cooperative with therapists and patients. In the third instance, a woman reporting that she had never been orgasmic was indeed fully orgasmic both with manipulative and coital opportunities during the acute phase of the therapeutic program. Again, full cooperation from the replacement partner was both expected and received.

No unmarried woman has been referred for therapy without being accompanied by a replacement partner of her choice, nor has there been any professional concept that a male partner surrogate would be provided if an unmarried woman had been unable to establish a meaningful relationship with a cooperative man before referral to the program.

Refusing to make a male partner surrogate available to a sexually inadequate woman, yet providing a female partner surrogate for a dysfunctional man seems to imply application of a double standard for clinical treatment; such is not the case.

As repeatedly described, psychosocial factors encouraged in this method of psychotherapy are developed from the individual’s existing value system.

Sexual Heritage

A man places primary valuation on his capacity for effective sexual function. This is both valid and realistic. His sexual effectiveness fulfils the requirement of procreation and is honoured with society’s approval, thereby providing support for the cultural idiosyncrasy of equating sexual function with masculinity.

Even prior exposure to a “sex is sin” environment does not preempt this primary valuation. As a result, a man usually regards the contribution made by a partner surrogate as he would a prescription for other physical incapacities. Further, he is able to value a woman who makes such a contribution.

For him, the restoration of sexual function justifies putting aside temporarily any other value requirements which might exist.

For her, on the other hand does not have a similar sexual heritage. As far as is known, her effectiveness of sexual function is not necessary to procreation.

In addition, prevailing attitudes through much of history have not encouraged valuation of female sexuality as a means of human expression.

Therefore, partner surrogate selection for the sexually incompetent woman would require quite different psychosocial considerations than would a similar selection for a sexually inadequate man.

Socio culturally induced requirements are usually reflected by woman’s need for a relatively meaningful relationship which can provide her with “permission” to value her own sexual function. It is the extreme difficulty of meeting this requirement in a brief, two-week period which influenced Foundation policy to deny the incorporation of the male partner surrogate into treatment concepts, yet to accept male replacement partners selected by the unmarried women themselves to join them in the program.

In all cases, the length and security of the relationship had been firmly established before the patient was referred. This key area of therapeutic concern was, of course, carefully checked with referring authority before accepting the unmarried woman for treatment.

For the sexually dysfunctional woman, security of an established man-woman relationship, real identification with the male partner, and warmth and expression of mutual emotional responsivity are all of vital concern first, in securing a positively oriented sexual value system and, second, in promoting effective sexual functioning.

These social and sexual securities cannot be established in the brief period of time available during the acute phase of the therapeutic program. For these reasons, the use of a male partner surrogate in the treatment of sexually dysfunctional unmarried women was felt contraindicated.

CategoriesEjaculatory Incompetence

Sexual Failure

Several episodes of erective failure had developed during the last six months of the marriage. The man’s severe levels of distraction, created by the ambiguity of his commitments, were obvious. The non ejaculatory pattern was one of first withholding voluntarily and then being unable to ejaculate on demand.

Virgin male

One man was single at the time of therapy, although he had been previously married for approximately one year. His marriage was annulled. His basic distress was simply that of fear of performance. Strangely, the performance fears did not arise from failed experience (he was a 29-year-old virgin at marriage), nor were religious, family, or homosexual influences of particular moment. He had been particularly insecure and introverted as a teenager.

Dating was not attempted until 19 years of age and was rarely enjoyed thereafter. Social interchange was a rarity with either male or female companions. His postgraduate degree was in Library Science, and in his obvious withdrawal from social reality books were his companions.

He met and married a 33-year-old woman with an almost identical background of withdrawal from social participation. The gavotte-like courtship consumed three years and confined sexual expression to kissing and handholding.

Although widely read on the subject of sexual functioning, the man had only attempted masturbatory release a half dozen times in his life and had failed to ejaculate on two of these occasions.

His guilt feelings about masturbation in general, and his grave concern with the two failed masturbatory performances in particular, tended to reduce any interest in overt sexual functioning.

Since he had a fairly regular pattern of pleasurable experience with nocturnal emission, his comparison of these two experiences led him to believe that he was inadequate in ejaculatory function when under the stress of conscious sexual stimulation.

The wedding night and a subsequent year of repetitive attempts at coital functioning proved him right in his assumption that he could not ejaculate with penile containment and under the stress of overt sexual stimulation. His wife took the fact of his ejaculatory incompetence to reflect personal rejection of her as a woman and, after a year of marriage, sought and was granted an annulment. His last attempts at sexual performance before the annulment were reported as partial or complete erective failures.

Seven months after termination of the marriage the man was referred for treatment. He was treated successfully with the aid of a partner surrogate.

Ejaculatory incompetence in youth

He was seen in therapy with a history of ejaculatory incompetence dating from age 18; he was surprised by the police in a local “lovers’ lane” parking area while being manipulated to ejaculation by a young woman. The girl’s terror and his overwhelming embarrassment and fear of public exposure left an indelible residual.

Although actual exposure did not occur, he was unable to ejaculate intravaginally through two subsequent engagements and numerous other coital opportunities. He had no homosexual history. Since he had been on the verge of ejaculating when surprised, he thereafter was always frozen by fear of observation when a similar level of excitation developed.

When seen on referral to the Foundation, he was voluntarily accompanied by a young woman to whom he was married a few days after termination of the acute phase of therapy. Since this is a unique situation, this couple has been listed in the general statistics as married rather than considered as a man with a replacement partner. They had planned to be married as soon as therapy proved successful and the possibility for future pregnancy was established.

Four of the 17 men referred for ejaculatory incompetence could and did ejaculate intravaginally both before and during marriage until a specifically traumatic event, psychosocial in origin, terminated their facility for or interest in intravaginal ejaculation.

  1. In the first instance, after six years of marriage the husband unexpectedly encountered his wife committing adultery. Her partner had just ejaculated and was withdrawing as the husband entered the bedroom. The traumatic picture of observing seminal fluid escaping his wife’s vagina was his first fixed observation of activity in the bedroom. Forgiveness was begged and in time conceded. But when husband and wife coition was attempted, the mental imagery of seminal fluid escaping the vagina was sufficient to depress the husband’s ejaculatory interest. He could not live with the concept of his seminal fluid mingling even symbolically with her lover’s ejaculate.
  2. In the second instance, husband and wife were surprised in the primal scene by their two children, ages six and eight, bursting into the bedroom. They were in active coital connection without clothes or the protection of bedding. The husband, just in the act of ejaculating, could not stop. The children’s observation of the continuing coital connection was infinitely more disturbing to him than to his wife. He was devastated by the interruption. For the next nine years, whenever ejaculation was imminent, no matter how well-locked the door, the fears of interruption and observation were such that this man could not ejaculate intravaginally.
  3. c) In the third instance, after 12 years of marriage and two children the wife insisted upon having a third child, which the husband neither wanted, nor personally felt was indicated for psychosocial and financial reasons. For nine months he controlled his ejaculatory urge whenever his wife, following her menstrual calendar, insisted upon coital connection.

Finally, agreeing to his terms for continuance of effective sexual function in the marriage, his wife instituted contraceptive protection to avoid pregnancy. However, ejaculatory incompetence had been established, and the husband continued incapable of intravaginal ejaculation during the subsequent four-and-a-half-year period before seeking consultation.

Contraceptive

Finally, in a marriage of just over 21 years duration. The husband had established a strong attachment to another woman and was having regular intercourse outside of marriage. His mistress made him aware that she had suffered through a previous illegitimate pregnancy and constantly expressed serious concern for any risk of conception; so he accepted the responsibility for contraception and chose to use condoms routinely.

On one occasion the condom ruptured just as he was ejaculating.

The young woman’s initial screams of protest when she became aware of his transgression and the hysterical evidence of the severe levels of her pregnancy phobia were major blows. They never met again.

His traumatic reaction to her total rejection of him personally was of such magnitude that he was no longer able to ejaculate intravaginally with his wife. The memory of his failed commitment to contraceptive protection was so vivid and his sense of loss so painful that whenever ejaculation was imminent he would stop thrusting or withdraw.

His wife had no concept of the cause for the major reversal in his established pattern of sexual behaviour and took his state of voluntary ejaculatory incompetence as evidence

CategoriesEjaculatory Incompetence

Poor Sexual Performance

One of the men handicapped in sexual performance by strict adherence to fundamental Protestantism developed symptoms of erective inadequacy after three years of marriage. The three marriages averaged seven and one-half years’ duration before the husband and wifes were seen by authority. Two of these units were referred initially for conceptive inadequacy rather than ejaculatory incompetence.

Three men offered dislike, rejection, or open enmity for their wives as sufficient reason for failure to ejaculate intravaginally.

In the first instance

A man married a distant relative whom he found totally objectionable physically. The advantages of the marriage were of monetary and social import.

It probably mattered not whom the man married, as his sexual commitment was of homosexual orientation. He was able to function coitally with his wife from an erective point of view, but after .penetration he was repulsed rather than stimulated by her demanding pelvic thrusting and delighted in denying to her the ejaculatory experience.

After six years of marriage and continuation of his homosexual commitments, he decided that children should be a part of his marriage’s image to the community. But the established pattern of voluntary restraint was so strong that he could not ejaculate for conceptive purposes.

After three years of involuntary ejaculatory constriction and a total of nine years of marriage, the unit was seen in treatment. The presenting complaint was not a request for relief of the ejaculatory incompetence or for treatment of the homosexual commitment, but rather was for the concerns of conceptive inadequacy.

In the second instance

The marriage was of convenience, with no respect, interest, or admiration for the woman involved. Intercourse was initially considered an unpleasant duty by the husband, to be indulged in reluctantly and only when confrontation no longer could be avoided. The husband was so physically repulsed by his wife that, although erections were maintained, he rarely reached sufficient levels of sexual tension to approach ejaculation.

On those few occasions when ejaculation seemed imminent, he would arbitrarily terminate coital connection to deny his wife consummation of the marriage. His great pleasure was to pretend he had ejaculated and then to enjoy her frustration when she ultimately discovered that he had not succumbed to her driving demand to consummate her marriage.

He was consistently involved with other women outside of marriage with, of course, no ejaculatory difficulty. Despite her full knowledge of the degree of her husband’s rejection of her as a person, she still wanted her marriage to survive, and the unit was referred for therapy.

The third couple

Depicting rejection of the wife as an individual resulted from the marriage of a 28 year old man and a 25 year old woman who had been raped as a teenager by 2 Negroes. She had not told him of the episode until their wedding night. Why she chose this particular time to confide in her virginal husband she could not say.

He was overwhelmed by the story. He considered her contaminated, and, although there were a few episodes of coition, he could not ejaculate intravaginally. Their six-year marriage, unconsummated by intravaginal ejaculation, ended in divorce. Eighteen months after the legal separation, the husband was referred by his local physician because he could not ejaculate intravaginally with subsequent sexual partners. His rejection of intravaginal ejaculation had carried over to other women. Of interest is the fact that his former wife joined him as a replacement partner. This unit is reported in the marital statistics.

There have been two examples of male fear of pregnancy among members of couples seeking relief from ejaculatory incompetence:

  1. A 19-year-old boy
    Who had impregnated a girl of whom he was very fond. A criminal abortion was performed under the most brutal of circumstances and massive infection resulted. The girl was ill for many months, almost losing her life.

    Ultimately, she would have nothing to do with the man who had caused her pregnancy and who had insisted upon the abortion that nearly cost her life. Since he had insisted upon the abortion rather than accept marriage as a face-saving mechanism, his levels of guilt knew no bounds.

    Five years later in another community and with another girl, a marriage was established. When attempting consummation, the husband found himself completely unsuccessful in ejaculating intravaginally and continued to be so for the next three years until seen in therapy.

    His was an overwhelming fear of causing pregnancy and of the possibly unfortunate complications thereof. Contraceptive practices offered him no real sense of security. His wife’s mere suggestion of raising a family was sufficient to produce a severe anxiety attack. Since his wife had no knowledge of the historical onset of her husband’s pregnancy phobia, she presumed personal rejection as the primary factor in his ejaculatory incompetence. The marriage was headed for legal separation when husband and wife were seen in therapy.

  2. One man simply did not want children
    His wife, although giving verbal support to his rejection of parenthood, would not practice contraception for religious reasons nor allow her husband to take contraceptive precautions. Consequently, he voluntarily refused himself the pleasure of intravaginal ejaculation in the early years of the marriage. In due course he found no difficulty with control and eventually could not respond with ejaculation to masturbatory practices. Although the marriage existed 11 years before professional aid was sought, and coital connection was generally one to three times a week, this man initially would not and ultimately could not ejaculate intravaginally.
  3. The final example
    Not one of fear of, but of rejection of pregnancy, has a familiar clinical orientation. Inevitably, there has to be the expected clinical picture of a totally dominant mother essentially choosing a wife for her only son.

    The mother had been in full control of the son’s every major decision until his marriage. Following his parents’ legal separation, the son’s father was never in the home. Throughout his teenage years his mother insisted upon total control of his social commitments.

    She chose his school, his college, and his clothes. She also chose his female companions by the simple expedient of being so abhorrent to those she did not approve that they soon sought other company. Time and again she embarrassed her son by her obvious demand for dominance. He grew to hate his mother but lacked the courage to let her know his level of rejection.

    Particularly was he careful not to offend her too deeply, for she controlled a considerable amount of money and he was all too aware of the advantages this could bring.

    Finally, there was a girl, grudgingly acceptable to his mother, that he could tolerate, so at age 27 he became engaged and in short order married the girl whom he knew only as a quiet companion who never objected to anything he wanted to do.

    Presumably, her contrast to his mother was her only redeeming grace in his eyes. His constant fantasy was of revenge upon his mother. Since she had been coyly describing her anticipation of becoming a grandmother, he vowed she would be frustrated in this one area, if no other. There would be no children.

    The thought never occurred to him that his wife might be frustrated, feel rejected, or fail to endorse his plan for revenge upon his mother. However, after marrying him she began to express her own requirements. After two and one-half years of increasing levels of mutual antagonism, the husband and wife was referred to the Foundation for treatment.