Psychological Self-Help

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1987). Barbach has written the most. Heiman and LoPiccolo have a
good book and an instructional video (1-800-955-0888). Hutchins has
perhaps the most straight-forward technique. (Remember, these
references are for women who are having trouble orgasming, not for
those wanting multiple orgasms and/or more novelty.) Most how-to-
orgasm books/programs use similar methods: First, the pressure to
perform is removed and attitudes about self-stimulation are explored.
Certain facts are explained: 42% of women masturbated during the
last year, that masturbation more frequently (95%) produces a climax
more intense orgasm. Sexual taboos cause 40% of college-age women
to avoid masturbation, so this is a scary concept for many women and,
if so, has to be dealt with. 
Secondly, the woman slowly becomes comfortable examining and
touching herself, especially her genitals. Through something like
sensate focusing (see above) by herself, she learns what feels the best
and she overcomes any distaste with touching herself. After several
hours (spread over 10-15 days) of this "pleasuring," including the use
of a gentle vibrator, she should be able to overcome her inhibitions
about touching herself and her fear of climaxing. (Don't use anything
electrical near water.) When she feels safe and able to enjoy self-
stimulation, if an orgasm has not already occurred, she is encouraged
to masturbate until "something happens." This may take 30-45
minutes; if the orgasm takes a long time, she probably needs to use a
vibrator and erotic fantasies. Vibrators are wonderful aids for most
women (Blank, 1996 and 2000). 
Third, after she has learned to orgasm easily, the woman then
shows her lover how she masturbates and teaches him in detail.
Fourth, the male masturbates her in the same way until she can have
orgasms regularly. Lastly, if she wants to orgasm during intercourse,
they have to modify and integrate the masturbation techniques into
intercourse. This four or five step process is reported by Masters and
Johnson as being 70-80% successful. Note: two people should not try
to have climaxes at the same time; I know that is some people's idea
of how it should be, but for most couples it is much too hard to get the
timing just right. Simultaneous orgasms are for the compulsive,
perfectionistic I've-got-to-do-this-right-crowd, who foolishly miss fully
appreciating the awesomeness of both orgasms. 
It may be necessary, in more difficult cases, to understand the
causes underlying the inability to orgasm. For instance, having a bad
sexual experience or history can, of course, inhibit a sexual response
(see Heart, 1998, who was sexually abused and discusses the
physical, psychological, emotional, and spiritual aspects of this
problem). Likewise, if a woman had been consistently responding
sexually and then stopped having orgasms, obviously she should
explore what was going on at the time to cause the change. The
specific causes will determine what kind of self-help or treatment is
needed. Knox (1984) says these causes, beyond those mentioned
above, underlie a lack of sexual satisfaction: focusing too much
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