‘Persistent inability to achieve orgasm despite responding to sexual stimulation.’

As a sex engineer and relationship therapist, I often use a combination of counselling and massage as a treatment to help people with sexual performance challenges. I call this treatment Psychosensual. By combining both talk and touch, I first find out the psychological drivers causing any interference with sexual fulfilment. I then follow this with a specially designed intimate bodywork treatment to create an experience that is as near to the usual sexual arousal cycle as possible but remains within the therapeutic boundaries between myself and the client. This psychosensual treatment can give remarkable results, sometimes overcoming a sexual performance blockage in just one session; however if the client has difficulty reaching orgasm due to past trauma or who experiences high anxiety or trust issues. A three-session series is recommended.

I see men and women that experience anorgasmia though I see more women, with only about 1 in 20 being men. It may be because women are more open to dealing with personal sexual issues or their frustration is more significant than men. However, it is more likely that women experience orgasm issues more because the sexual response cycle in the female is more complicated than the males. For a woman to become fully aroused and orgasm, several elements must come together, all simultaneously. Some women can have clitoral orgasms quickly, with the vaginal orgasm remaining elusive.
For men, the most common form of anorgasmia is loss of erection, whereas to be fully aroused and then not reach orgasm and ejaculation (delayed orgasm) is less frequent. Still, never the less is just as frustrating. Premature ejaculation is also just as disappointing for men ( and can be disappointing for the partner ) and, whilst not anorgasmia, is still precipitated by anxiety.

Using an analogy about mountaineering, when it comes to sexual arousal, men are like mountaineers tackling Mount Everest, a steady climb upwards to one peak; they go equipped with all the right gear to get there. On the other hand, when having sex with another person, women are like mountaineers exploring the whole Alpine mountain range. To be thoroughly enjoyed, she likes to be aware of the climate, terrain, and timing, with the valleys and rivers being just as important as the climb to the peak.  

If a female has to work to the male sexual plan, she may not reach complete sexual fulfilment. Not all men and women who have challenges with orgasm find reaching orgasm impossible as most will have experienced orgasm at some time, primarily through masturbation. But not reaching orgasm when with another person is also quite common. This inability to orgasm when with a partner is called secondary or situational Anorgasmia.

Secondary/Situational Anorgasmia

Both men and women can experience secondary or situational Anorgasmia. In men, It is often caused by the loss of erection that results in not reaching orgasm. Some men can still become erect but, when having penetrative sex, can’t orgasm, so they have to masturbate themselves to finish. So men with erectile problems can also be regarded as having a form of Anorgasmia.

Primary Anorgasmia

Primary Anorgasmia is when a person has never reached orgasm, even through masturbation and is less common with men but occurs more frequently in women.

Physiological Causes

It can be that there is a physiological reason for orgasm to be unattainable. Therefore conditions such as diabetes, multiple sclerosis, genital mutilation, total hysterectomy, spinal cord injury need to be ruled out before seeking emotional or practical help. Drug abuse, excessive alcohol and antidepressants can also inhibit orgasm.

Psychological Causes

In this article, I focus on the most common cause of Anorgasmia which is psychological, when learned survival behaviours from childhood interfere with a person’s natural sexual arousal cycle. Below are six examples of situational Anorgasmia that I have helped clients overcome. Each case gives a bit of background of the problem, the psychological aspects that influence the behaviour and then the treatment I offer to help.

My body wants to, but my head won’t let go.

The sexual encounter initially starts with optimism, when they are hopeful that maybe this time, I can reach orgasm. As the stimulation heightens and the moment’s intensity builds, the conflict between head and body can manifest. Despite a woman becoming aroused and thoroughly lubricated and a man achieving a full erection, the thought that “maybe today it will happen” can often be replaced with disappointment and frustration as the realisation that, yet again, the orgasm is to remain elusive. ‘I can’t cum, ‘ ‘I am different’, ‘I am a failure as a woman, ‘I am a failure as a man’, ‘people think I am weird’ are all feelings often expressed when the orgasm fails to come through.

So what is stopping the orgasm?

Example 1

He just can’t seem to hit the right spot.

A lack of skill or knowledge of the male partner to give the right type and length of foreplay is one of the more common reasons women cannot reach orgasm during sex. Many women unconsciously know the problem but feel reluctant, even unqualified, to say something to their partner about his lack of skill or bad technique. Many of these women can experience clitoral orgasm during sex when given by their own hands or the partner’s hands and even with oral sex. Still, they then find it difficult to reach orgasm through vaginal penetration. Whether it is hands, penis or a toy, if the partner is inexperienced and unskilled or merely unimaginative, the orgasm often becomes an elusive goal.

Make me feel desired.

The underlying primal dynamic of a woman is to feel desired, and this dynamic is particularly relevant during sex. If a man is either too timid, inexperienced, focused primarily on his pleasure, or just quick to orgasm himself. In that case, the mental stimulation a woman needs to take her to orgasm is not there.

The treatment strategy

Once I understand the situation, and it becomes clear that the client has experienced limited or even one type of male sexual dynamic (usually passive or lack of sexual creativity), my strategy is to create a treatment that makes her feel desired. 

The treatment starts with an initial exploratory conversation to identify her situation and her experience with sex. Often, restricting cultural and religious influences can become apparent. Or a childhood where she felt marginalised and criticised, even unloved, probably by the male primary carer (father).

Following this conversation, and once she feels at ease, I start the massage treatment with firm, confident traditional massage strokes of her upper body. As she relaxes, the strokes become longer and more explorative to excite and stimulate both her body and mind. Her responses guide me, and as her body reacts to this new form of stimulation, the treatment can become more assertive and intentionally arousing. 

If this more assertive approach is received well, she usually expresses this with verbal and physical responses. I then know that this bold, confident approach has been missing. From this point on, I follow my intuition and continue to be guided by her reactions. I may bring in body weight to stimulate her primal sexual urges. One technique is to put firm pressure on her groin and pelvic floor by slipping my arm between her legs, lifting her body, leaning into her with my shoulder, putting pressure on her crotch and pelvic floor. If this produces a positive response and sense that she is letting go and, trust me, she will move into her natural primal sexual state. In this case, direct stimulation of the clitoris and internal vaginal stimulation with hands can follow. 

This clitoral and vaginal stimulation can be as a light touch, or it can be more firm 

Example 2

She must cum first.

I often hear from men who find it difficult to orgasm and ejaculate through penetrative sex. To reach orgasm, generally, a man must first become fully aroused. He needs to be mentally stimulated and free of anxiety. The fit between penis and vagina needs to be snug, and he needs to feel entitled to enjoy mutual pleasure.

Men who can’t orgasm are usually men who are primarily other person-focused rather than self-focused; they are men who, when young, may have spent much time around an emotionally needy or anxious mother or primary female carer. These men tend to feel self-critical or have an underlying lack of self-worth, particularly when around women, making them over-vigilant, holding themselves responsible for getting everything right. 

Suppose this type of man feels he is not achieving or senses disapproval or dissatisfaction from his partner. In that case, this can result in an inability to reach orgasm with penetrative sex, and he may revert to masturbation to finish himself off. If masturbation in front of his partner does not bring him to orgasm, he may resort to masturbating when he is away from distractions.

The treatment strategy

Before any physical treatment is given, it is essential to explore the emotional influences driving his need to please. The natural primal dynamic of the male is to seek approval. Excessive focus on achievement at work, sport, appearance and even the type of car he drives can be evidence of a heightened need for support. How he performs sexually is no different, and for some men, the need to get it right can be so strong that it becomes hard for them to relax and enjoy the moment for themselves.

A preliminary fact-finding conversation to look at any childhood behaviours, particularly those around primary female carers, will start the session. His tendency to be hyper-vigilant to the female dynamic may well have started from an extremely early age. When older, this unconscious dynamic can manifest with female partners and a fear of disapproval or not judging himself to be a good enough lover will increase his anxiety. 

Orgasm is a moment of complete abandonment and trust. Any anxious feelings will trigger his fight and flight responses, which will usually result in either an inability to orgasm or a loss of erection.

Looking at his early childhood will help him become aware of where these unconscious fears originate and see how they now unconsciously appear in his day-to-day life within work, with friends and lovers. The aim is to start a change of his behaviour, mainly where sex is concerned, to show him that given the intimate situation, these unconscious feelings are now are inappropriate and are fears that originated in his child mind but are now applied out of context.

To enhance his self-worth, I teach him to become a more skilled and confident lover and encourage him to reveal his primal assertive side. I encourage him to take the initiative to become a more adventurous sexually creative lover.

By including a female partner (or male partner if gay or if he is single a female or male volunteer) into a teaching session the sexual situation can be replicated but contained within a therapeutic, supportive environment. 

By giving him a more profound knowledge of female (or male) arousal and new skills to explore his partner’s body confidently, he will quickly become a more adventurous sexually creative lover, and erection and orgasm will naturally follow.

Example 3

If I lose control and let myself orgasm, something terrible might happen

I often hear women say that they can’t orgasm because they have control issues and that when having sex, they cannot let go and relax. Rather than seeing it as a need to control, I feel it is more a trust issue in that to let go when with another person, one must feel trusting towards that person and the situation they are both in. 

Lack of trust is a common factor in women who have experienced trauma or lack security when young. The effect of this is to create a behaviour strategy that ensures she remains in control. Talking, directing, fidgeting during sex are the classic indications of an inability to let go. This does not mean that these people are necessarily controlling people but more about remaining in control of the situation. The unconscious thought being ‘If I am in control, then I am safe, and if others around me are happy and non-threatening, then I am safe’. By not trusting the person and the event, the need to be constantly aware and alert will often cause the orgasm to be withheld.

The treatment strategy

Anxiety during sex plays a large part in withholding pleasure, and what differentiates each situation is the motive for the tension. For a person who is reluctant to trust others, the best way to help them overcome the fear is to equip them with a genuine sense of safety and security. By talking through and identifying the basis of their trust issues, one can create a treatment that comforts this. It is vital for the person who may have experienced trauma to reassure them that they are in a safe, caring place. For the women who feel obligated to make sure everyone else is happy, giving them permission to not be in charge and to be self-focused and self-caring will help them let go of their need to be responsible.

Once the treatment starts, the sensation of gentle hands on the body immediately helps relax and calm. The hormones released when we are touched a large part in this, but incorporating supportive holding even hugging movements will relax even quicker. Once the body begins to relax, and the tension dissipates, I bring in intimate touch to arouse. This treatment should always remain close and caring. The actual erotic arousal also needs to be given cautiously since any discomfort can cause an adverse reaction. Orgasm may not always happen the first time, but usually, after a series of sessions, the orgasm can be achieved.

Example 4

There is so much to think about; how can I hope to focus on orgasm

Busy life, always active, run run run, no time for me because I have lots to do!

Often these types are career persons, always on the go. Why? Because it’s a distraction. How can one enjoy sex if one is always busy? Like the ‘Giver’ type being both mentally and physically frantic is a sure way to hinder receiving pleasure. To be goal-driven may appear to be about seeking achievement, but striving for achievement is the underlying habitual behaviour. The child who has to work hard at school or the sportsman who must, on all accounts, win spends far more time attempting to reach his goal rather than winning the prize. Sex and orgasm are just other platforms for them to play out this behaviour, and the actual orgasm remains the elusive prize never to be won but always strived for.

Treatment strategy

Recently, I gave a session to a female client aged 38. She had never experienced an orgasm of any sort, not even through masturbation, a classic case of primary anorgasmia. Her frustration was palpable, and it was clear that she was at the point of resignation, believing that her body was not wired to achieve orgasm. During the initial discussion, she revealed that although she grew up in the UK, one of her parents originated from a culture that believed high academic achievement was essential. Being the eldest child of three, she felt this pressure even more strongly. From as early as she could remember, the need to work harder consistently, a mantra her mother instilled in her almost from birth. But no matter how well she did, there was always another level to reach for.

It is no surprise that achieving orgasm had become interwoven into her paycheque that achievement was not possible for this client. Her brain had become so used to always struggling to achieve and that allowing the orgasm to come through was an anathema.

To circumnavigate this repetitive dynamic, I assured her that orgasm was not the expected outcome of the treatment. She should just enjoy the massage and the sensation of arousal and let go of the need to try harder. By taking my time and incorporating elements that took her mind and body to an unfamiliar place of relaxation, she could focus on herself. As she became more aroused, the erotic stimulation took her quickly to a higher level of pleasure and soon, the part of her that had remained suppressed for so long broke through. She then went on to experience her first orgasm and, to her complete surprise, it was a full-body orgasm.

Below is a testimonial that she gave two days after the treatment.

I fully appreciated the time you took to find out the history and reasons why l might have had problems achieving orgasms. It was an eye-opener and I was impressed with your subject knowledge. Although l was nervous, to begin with the glass of wine helped! I knew l could totally trust you and knew that l was in your expert hands. I was blown away by the whole experience and for me the icing on the cake, achieving that elusive orgasm! It has changed my perception, and l am very happy about the experience. I can absolutely recommend you to others, and once again, a big thank you!

Example 5

She doesn’t seem to like what I am doing.

As hunter-gatherers, we shared everything, including sexual partners. Not because we were sexually indulgent but because the more sex had, the more chance the species survived. Females would instigate sex by displaying their desire to attract as many males as possible. Harvesting sperm to ensure the best biological match may seem to the modern code of morality a bit carnal, but as an assurance to achieve healthy, plentiful offspring, it is a very sensible strategy. 

The primal dynamic of the human male is to be approved of. Whether it’s the size of his bank account, biceps, brain or penis, approval is essential to ensure his genetic survival since deep in his psyche – with its origins reaching back to the beginning of time itself – lack of acceptance equals rejection. Rejection by the female means no sex, and no sex means his genetic line ends.

So men need approval to be turned on, whether it is the approval of performance or a sensitive, intimate touch or a wild scream of ecstasy as he makes love to women, any sign that she gives that indicates he is doing a good job arouses him even more. Conversely, no approval implies no selection and, therefore, potential rejection. So a man who believes that his female partner is not enjoying herself will feel anxious and concerned, and orgasm will be a challenge to reach.

Treatment strategy

I teach men skills and knowledge that will increase their own confidence and make lovemaking adventurous and exciting as well as caring and creative. Mens classes

Example 6

Good girls like me shouldn’t do this.

Some people have grown up in either a culturally restricted society or a strongly moralistic or pious environment where sex is seen only as procreative. These people often say that when having sex, they often feel guilt, shame, dishonour, remorse, embarrassment and that to enjoy sex is the quickest route to hell and damnation.

An acclaimed male porn actor once told me that even after 15 years in the business, even when masturbating by himself, he still felt pangs of guilt. No surprise that his Scottish Presbyterian mother had indoctrinated her young son to believe that sex was not to be enjoyed but endured by women and that men who wanted sex were selfish and demanding.

The anxiety felt of doing wrong in the name of the clan, religion or culture will always affect the ability to reach orgasm. In recent studies into multi-orgasmic women (women who orgasm multiple times within a short period) 80% of these women surveyed had shunned their religious backgrounds. They had then become multi-orgasmic due to their now higher natural levels of oxytocin in the body before and during sex. 

Conversely, women who felt in a conflict between their beliefs and the natural sexual desire had a far lower level of oxytocin in the system before and during sex.

Treatment strategy

Success in helping people who experience a lack of orgasm due to guilt and shame can vary greatly, and much depends on how far they have let go of these confining thoughts. When seeing these clients, discretion and security are paramount as often they remain obligated to their situation and fear being found out. The actual treatment starts gently as this allows them to relax into the situation then like a genie immerging from a bottle, the suppressed sexual energy is released, sometimes quite explosively. Orgasm may not be the immediate result, but being allowed to express their natural sexual needs can be life-changing.

Talk to Colin or book an appointment.

If you are experiencing challenges reaching orgasm and identifying with any of the examples given above or having another situation or need to explore in a safe, discreet, professional environment, feel free to call or email Colin to talk through your needs in confidence. 

Colin will then tell you if he feels he may be able to help or will point you in the direction of another specialist who may be more suitable for your situation 


call: 07966 522 696

complete an enquiry form [Click Here]

Click here to read more about psychosensual treatments for men and women

Click here to read more about sensual massage for women