The first source derived from the history, is identification by the non orgasmic woman of erotically significant expectations or experiences (positive or negative) currently evoked during sexual interchange with her marital partner. The cotherapists must identify those things which the husband does or does not do that may not meet the requirements of his wife's sexual value system previously shaped by real or imagined experience or expectation.

Past experiences of positive content involving other partners, or unrealizable expectations perceived as ideal, may be over idealistically compared by her to the current opportunity; or negative experiences or negative expectation-related attitudes may intrude upon receptivity to her partner's sexual approach. Thus, a rejection or blocking of sexual input may be the end result.

A discussion of memories of perceptual and interpretive reactions associated with specific sexual activity may add further dimension to knowledge of the wife's currently constituted sexual value system, since these memories often have been noted to function as signals for subconscious introduction of stored experience, either positive or negative in nature.

The second source
directly applicable material upon which the rapid-treatment therapy relies for direction indeed, it characterizes this particular mode of psychotherapy is developed from the daily discussions that follow each sensate-focus exercise. As repeatedly stressed, defining the etiology of the presenting sexual inadequacy does not necessarily provide the basis for treatment. A reasonably reliable history is indispensable, but it is used primarily to provide interpretive direction and to amplify definition of that which is of individual significance. (It even is used from time to time to demonstrate negative patterns of sexual behaviors)

During the two week rapid treatment program, the daily report and ensuing discussions between the cotherapists and marital partners describing the non orgasmic wife's reactions (as well as those of her interacting husband) provide an incisive measure of the degree to which the requirements of her functioning sexual value system are being met or negated, or the extent to which she progressively is able to adapt her requirements.

These discussions provide simultaneous opportunity for a more finite evaluation of the levels of interactive contribution to sexual function by her bio physical and psychosocial systems.

The treatment
of both primary and situational orgasmic dysfunction requires a basic understanding by patients and cotherapists that the peak of sex-tension increment resulting in orgasmic release cannot be willed or forced. Instead, orgasmic experience evolves as a direct result of individually valued erotic stimuli accrued by the woman to the level necessary for psycho physiological release.

Just as the trigger mechanism which stimulates the regularity of expulsive uterine contractions sending a woman into labor is still unknown, so is the mechanism that triggers orgasmic release from sex-tension increment. Probably they are inseparably entwined to identify one may be to know the other.

It seems more accurate to consider female orgasmic response as an acceptance of naturally occurring stimuli that have been given erotic significance by an individual sexual value system than to depict it as a learned response. There are many case histories recorded in this and related studies reporting orgasmic incidence in the developing human female at ages that correspond with ages reported in histories of onset of male masturbation and nocturnal emission.

These clearly described, objective accounts are considered accurate by reason of their correlation with subjective recall provided by several hundred women interrogated during previously reported laboratory studies. The initial authoritative direction in therapy includes suggestions to the marital couple for developing a non demanding, erotically stimulating climate in the privacy of their own quarters.

At no time during the two-week therapy program is either of the marital partners under any form of observation, laboratory or otherwise. Only the phenomenon of vaginismus is directly demonstrated to the husband of the distressed wife, under conditions routinely employed by appropriate practitioners of clinical medicine.

The cotherapists' initial directions suggest ways of putting aside tension-provoking behavioral interaction for the duration of the rapid-treatment program and allow the woman to discover and share knowledge of those things which she personally finds to be sexually stimulating.

Further professional contribution must suggest to the marital couple ways and means to create an opportunity for the woman to think and feel sexually with spontaneity. She must be made fully aware that she has permission to express her sexual feelings during this phase of the therapy program without focusing on her partner's sexual function except by enjoying a personal awareness of the direct stimulus to her sexual tensions that his obvious physical response provides.