‘Persistent inability to achieve orgasm despite responding to sexual stimulation.’
In my work as 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 that are causing any interference with the sexual fulfilment, then follow this with a specially designed intimate bodywork treatment to create an experience that is as near to normal sexual arousal cycle as possible but always remains within the therapeutic boundaries between myself and the client. The psychosensual treatment often has remarkable results, sometimes overcoming a sexual performance blockage in just one session. However, a three-session series is recommended if the client is having difficulty with reaching orgasm due to a past trauma or who lives with high anxiety or trust issues.
I see men and women that experience anorgasmia though I see more women, with only about 1 in 20 being men. It maybe is because women are more open to deal with personal sexual issues or perhaps that their frustration is even higher than men. However, it is more likely that women experience orgasm issues more because the sexual response cycle in the female is far more complicated than the males and it requires quite a few elements to come together all at the same time for the woman to reach the satisfaction of vaginal orgasm.
Some women can have clitoral orgasms quite quickly with the vaginal orgasm remaining elusive. For men it is usually loss of erection or reaching orgasm too promptly as their primary concern whereas to be fully aroused and then not reach orgasm and ejaculation (delayed orgasm) is less frequent but never the less is just as frustrating.
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. Women on the other hand when having sex with another person, are like the mountaineer exploring the whole Alpine mountain range, where to be thoroughly enjoyed one must be aware of the climate, the terrain, the timing, with the valleys and rivers being just as important as climbing the peaks. This means that if a female is having to work to the male sexual agenda, particularly with a male partner who is confident to climb just one mountain, then she will likely 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, mostly through masturbation. But many say they have difficulty reaching orgasm when with another person. This inability to orgasm when with a partner is termed Secondary or Situational Anorgasmia.
Both men and women experience secondary or Situational Anorgasmia, but with men, it is mostly caused by the loss erection that results in not reaching orgasm. Some men who can still become erect but when having penetrative sex can’t orgasm so then have to masturbate themselves to finish. So men with erectile problems can also be regarded as having a form of anorgasmia.
Primary Anorgasmia is when a person has never been able to orgasm, even through masturbation. This very unusual with men but occurs more frequently in women.
It can be that there is a physiological reason for orgasm to be unattainable so 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 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 worked with. Each case gives a bit of background of the problem, the psychological aspects that are influencing the behaviour and then the treatment I offer to help.
Below are six case studies of situational anorgasmia that I have worked with. Each case gives a bit of background of the problem, the psychological aspects that are influencing the behaviour and then the treatment I would give to help.
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 a woman being turned on and thoroughly lubricated and a man getting a full erection, the thought maybe today it will happen can soon be replaced with disappointment and frustration. The sexual encounter initially starts with optimism, when he or she are hopeful that maybe this time orgasm will be reached. As the stimulation heightens and the intensity of the moment builds, gradually the thought of yet another failure emerges in the mind until eventually, they accept it’s not going to happen, and familiar feelings of frustration quickly replace the sexual euphoria, exasperation, exhaustion and resignation the that yet again says to themselves ‘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’ and although one can understand these feelings none are justified.
So what is it stopping the orgasm?
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 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 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 but 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, then the orgasm often becomes an elusive goal.
Make me feel desired.
The underlying primal dynamic of a woman is to feel desired. This dynamic is particularly relevant during sex, and if a man is either too timid, inexperienced or is focussed primarily on his own pleasure or is just quick to orgasm himself then the mental stimulation a woman requires to take her to orgasm is not there.
The treatment strategy
Once I understand the situation, and it becomes apparent that the women have only 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 from the outset is designed to make her feel desired. The procedure starts with an initial exploratory conversation to identify her domestic situation and her experience so far 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 is feeling 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 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 can become more assertive and intentionally arousing. If this stronger approach is received well, usually indicated by her expressing verbal and physical responses, then I know that this assertive, confident approach is what has been missing from the mental stimulation. From this point on I follow my intuition and continue to be guided by her reactions. I sometimes will bring in body weight to stimulate her primal sexual urges. One technique is to put firm pressure to her groin and pelvic floor by slipping my arm between her legs and lifting her body and leaning into her with my shoulder thus putting pressure on her crotch and pelvic floor. If this produces a positive response and I sense that she is letting go and moving into her natural primal sexual state, then direct stimulation of the clitoris and internal vaginal stimulation with hands can follow. The clitoral and vaginal stimulation can be as light touch or be more aggressive and if she is fully relaxed and aroused and most importantly in a trusting state of mind I will continue to give deep firm penetration of the vagina to simulate penetrative sex (with fingers) This is given not as a backwards forward motion but more given as an internal massage style to massage the interior walls of the whole vagina wall reaching the G-spot at the upper front and A-spot at the far end of the vagina. Often at this point orgasm is achieved, sometimes the first of a few as this method can bring on multiple orgasms and is some cases ejaculation.
She must cum first.
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 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 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 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. If this type of man feels he is not achieving or he senses disapproval or dissatisfaction from his partner, this can result in an inability to reach orgasm indeed 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, then he may resort to masturbating when he is on his own away from distractions.
The treatment strategy
Before any physical treatment is given it is important 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 car he drives can be evidence of a heightened need for approval. 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 himself.
A preliminary fact-finding conversation to look at any childhood behaviours particularly his behaviour 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 so any anxious feelings will trigger his fight and flight responses, and this will usually result in either an inability to orgasm or loss of erection.
By looking at his early childhood, it will help him become aware from where these unconscious fears originate and to 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, particularly 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 deeper knowledge female ( or male) arousal and new skills to confidently explore his partner’s body he will quickly become a more adventurous sexually creative lover and erection and orgasm will naturally follow.
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 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
It is clear that anxiety during sex plays a large part in withholding pleasure. 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 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 feels obligated to make sure everyone else is happy than 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 soothing hands on the body immediately helps relax and calm. The hormones that are 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 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 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.
Recently, I gave a session to 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 simply 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 and 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 through 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 a higher level of 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 to her complete surprise also experienced a full body orgasm.
Below is a testimonial that was given two days after the treatment by the client mentioned in the previous paragraph.
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!
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, 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 his genetic line ends.
So men need approval to be turned on, whether it is 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 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.
I teach men skills and knowledge that will increase thier own confidence and for the partner make lovemaking adventurous and exciting as well as caring and creative.
Good girls like me shouldn’t do this.
Men and women who have grown up in either a culturally restricted society or in 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 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 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.
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 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 immerging 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.
Talk to Colin or book an appointment.
If you are experiencing challenges reaching orgasm and you identify with any of the examples given above or if you have another situation or need you want to explore in a safe, discreet professional environment, feel free to call or email Colin to talk through in confidence your needs. 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 he may be more suitable to your situation
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