Anorgasmia

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

As a trained psychosexual therapist and masseur in my role as a sex mentor, I often use both counselling and massage as one of my treatments to help people with sexual performance challenges. I call this treatment Psychosensual. 

By combining both talk and touch, I can first find out the psychological drivers that are causing interference with sexual fulfilment. Then with massage, I can create a practical situation that is as near to the normal sexual arousal process as possible. This type of treatment often has remarkable results with clients sometimes overcoming a sexual performance blockage in one session and is particularly good for clients who experience difficulty with reaching orgasm.

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I see as clients, both men and women who come to me with challenges reaching orgasm. It is fair to say that most of these are women, with about 1 in 20 being men. Not all find orgasm impossible and most have experienced an orgasm, mostly through masturbation but have difficulty when with another person. This inability to orgasm when with a partner is called secondary anorgasmia and is experienced by men and women but often with men it can progress into the loss of erection so erectile problems can also be regarded as a form of anorgasmia. Primary anorgasmia, when a person has never been able to orgasm, even through masturbation, is more common with women.

It can be that there is a physiological reason for the orgasm to be unattainable. Hence, 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.

In this article, I focus on the most common origin of anorgasmia which is psychological, when learned survival behaviours from childhood interfere with the natural the sexual arousal cycle.

Below are some examples of the more usual challenges of anorgasmia brought to me by women and men

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

 The conflict between head and body is symptomatic for most men and women who experience secondary anorgasmia. Despite her being turned on and lubricated and the man achieving a full erection, the thought maybe today it will happen is soon replaced with disappointment and frustration. The sexual encounter initially starts with optimism, with he or she being hopeful that perhaps this time orgasm will be reached. As the stimulation heightens and the intensity of the moment builds, gradually the thought of yet another failure will emerge in the mind until eventually it is accepted it definitely won’t happen. The sexual euphoria is replaced by familiar feelings of frustration, exasperation, exhaustion and the resignation the that yet again ‘I can’t cum. ”I am different’ I am a failure’.

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

 A lack of skill or ability of the male partner to give the right type and length of foreplay is one of the more common reasons women are unable to reach orgasm during sex. Many women know unconsciously what the problem is but feel reluctant even unqualified to say something to their partner about their lack of skill or bad technique. Many of these women can experience clitoral orgasm during sex if given by their own or the partner’s hands or even with oral sex but 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 simply unimaginative, then the orgasm becomes an unattainable goal.

Testimonials given by past female clients,

The underlying primal dynamic of a woman is to feel desired. This dynamic is particularly relevant during sex and if the man is either too timid, inexperienced or focussed primarily on his pleasure or is just quick to cum himself then the mental stimulation she requires to take her to orgasm will not occur.

The Treatment Strategy

 Once I understand the situation, and it becomes apparent that she has only ever experienced one type of male sexual dynamic (usually passive or lack of sexual creativity) My strategy is to create a treatment that from the outset is designed to make her feel desired. The treatment will start with an initial exploratory conversation which should identify her domestic situation and her experience so far with sex. Often cultural and religious influences will become apparent. Following this conversation and once she is feeling at ease, I start the massage treatment with firm confident traditional massage strokes of her upper body. Then as she relaxes, the strokes become longer and more explorative with the intention to excite and stimulate both her body and mind. Her responses guide me, and as her body reacts to this new form of stimulation, so the treatment becomes more assertive and intentionally arousing. If this stronger approach is received positively usually indicated by her expressing verbal and physical responses, then I know that this more assertive, confident approach is welcomed. From this point on, I follow my intuition and bring in body pressure to stimulate her primal sexual urges. I may include firm shoulder pressure to her groin and pelvic floor, putting pressure on her vagina. If the produces a positive response, and I sense that she is transcending into her primal sexual state, then direct stimulation of the clitoris and internal vaginal stimulation with my hands can begin. Again depending on her response, this can remain light and gentle or become more assertive using deep penetration and massage of the vagina wall, a sensation that can often bring on the orgasm. This method of can often bring on multiple orgasms and is some cases ejaculation.

They must cum before I do

 This is a comment I often hear from men who find it difficult to orgasm and ejaculate through penetrative sex.

 

For a man to reach orgasm, he first has to become fully aroused. He needs to be mentally stimulated and free of anxiety. The fit between the penis and vagina needs to be snug, and he needs to feel entitled to enjoy mutual pleasure. Men who can’t orgasm are often men who are mostly other person focussed 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. They can be men who have the tendency to feel self-critical or have an underlying lack of self-worth, particularly when around women and making him over-vigilant, holding himself responsible for getting everything right. If this type of man feels he is not achieving or he senses disapproval, this can also result in difficulty to reach orgasm with penetration. He may revert to masturbation to finish himself off. If masturbation in front of his partner does not bring him to orgasm, then he may masturbate when he is on his own away from distractions.

The Treatment Strategy

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

The preliminary fact-finding conversation will look at any childhood behaviours, particularly his behaviour around primary female carers that may have started his tendency to be hyper-vigilant to the female dynamic. When older, this unconscious dynamic can manifest with female partners and a fear of disapproval or jot being a good enough lover will increase his anxiety. Orgasm is a moment of complete abandonment and trust, so feeling anxiety will result in his fight and flight responses to take over, and this may well result in either an inability to orgasm or even loss of erection.

A period of counselling looking at his early childhood will help him become aware of where these unconscious fears originate and to see them now, where sex is concerned, they are inappropriate fears. I then 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. Once he has adopted this approach, he will soon see his partner respond positively, and this approval will arouse him further often to the point he will reach orgasm.

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 are unable to 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 a lack of security when young. The effect of this is to create a behaviour strategy to ensure she remains in control. This does not mean they are necessarily controlling people but more about being 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 need to be constantly aware and alert will often cause the orgasm to be withheld.

The Treatment Strategy 

 It is clear that anxiety during sex plays a large part in withholding pleasure. What differentiates each situation is the motive for the anxiety. 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 then create a treatment that comforts this. For the person who may have experienced trauma, it is important to reassure them that they are in a safe, caring place. For the women who feel obligated to make sure everyone else is happy then giving them permission to not be in charge and to be self-focussed and self-caring will help them let go of their need to be responsible.

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

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?

Similar to 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 the seeking achievement, but the strive for achievement is the underlaying habitual behaviour. The child who has to work hard at school or the sportsman who must, on all accounts win, spends far more of their time attempting to reach his goal rather than winning the prize. Sex and orgasm are just another platform 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 primary anorgasmic. Her frustration was palpable, and it was clear that she was at the point of resignation, believing that her body was simply not wired to achieve orgasm. During the initial discussion, she revealed that although she grew up in the UK one of her parents was from a culture that believed high academic achievement was essential and her 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 it never seemed enough and there was always another level to reach for.

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

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

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 survives. 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 a healthy offspring, it is a very sensible strategy. The primal dynamic of the male human is to be approved of. Whether it’s the size of his bank account, his biceps, his brain or his 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 approval equals rejection. Rejection by the female means no sex and no sex means the 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 will arouse him even more. Conversely, no approval means implies no selection and 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 this guy skills and knowledge that will always have her screaming in delight.

Good girls like me shouldn’t do this.

Men and women who have grown up in either a culturally restricted society or in a strongly moralistic or pious environment where sex, in general, is seen as only as procreative 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 a pang 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 enjoyed sex were selfish and demanding.

The anxiety felt of doing wrong in the name of the clan, religion or culture will always effect the ability to reach orgasm. Recent studies into multi-orgasmic women (women who orgasm multiple times within a short period) 80% of these women surveyed had shunned strong religious backgrounds. That they had then become multi-orgasmic was 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 much they have already let go of theses confining thoughts. When seeing these clients discretion and security is 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 but often, like a genie emerging from a bottle the suppressed sexual energy is released, sometimes quite explosively. Orgasm may not be the immediate result but just being allowed to express their natural sexual needs can be life-changing