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CASE STORY
ANN: A Woman’s Difficulty with Orgasm, Part 2
As presented in the Sample Case, the client, Ann, successfully achieved her initial sex therapy goal: having simultaneous orgasms with her fiancé during intercourse. However, she achieved this with the help of clitoral stimulation.
Six months after her wedding, Ann was ready to resume sex counseling. She and Ben had comfortably settled into their new apartment and they were enjoying each other and their new roles as husband and wife. They had decided to wait a couple of years before having a family so they could develop a strong bond between them before children distracted them. Ann was now ready to address her desire to reach what she called “her fullest sexual potential.”
Raised in a sexually restrictive home, Ann wanted to shed any semblance of that upbringing. For her, reaching her “fullest sexual potential” meant being able to enjoy all aspects of what she considered normal sex, including cunnilingus and achieving orgasm through intercourse alone.
Ann wanted to continue individual sex counseling for the time being. She said she wanted to feel completely free during the sessions to explore all aspects of her sexuality without concern for Ben’s feelings or reactions. She claimed that Ben expressed happiness and satisfaction with their relationship and was comfortable with her pursuing therapy on her own. He volunteered to come with her whenever she felt it would be helpful to her.
Throughout their relationship, Ben had provided Ann with the emotional security she longed for. Feeling accepted and loved enabled Ann to start exploring ways to become more comfortable receiving oral sex. Up to now, her insecurities about her desirability and her self-consciousness about her genitals evoked great anxiety in her when she received oral sex. Ann’s mind would focus on her insecurities, she would be distracted from feeling any pleasure, her body would tense, Ben’s touch would become unpleasant and she would end guiding his face away from her genitals.
Now that Ann had become more secure in her relationship with Ben and her insecurities about her desirability had diminished, we looked for other reasons for her continued avoidance of cunnilingus. During our discussions, it became apparent that Ann believed that it was “selfish” to accept pleasure without reciprocating. She couldn’t passively accept and enjoy cunnilingus because she felt guilty. She felt she had to “return the favor.”
Challenging Ann’s assumptions and expectations of herself regarding sex was our next step. Ann had absorbed many of our cultural myths about sex. She believed that performance in bed is a measure of our adequacy as human beings and that there are prescribed acts that are required to be “adequate,” such as having orgasm through intercourse. She also thought that we risk our relationships if we don’t perform in prescribed ways and that it is selfish to accept being pleasured without reciprocating. As we battled with these assumptions, we started to work on her thinking about receiving oral sex in a different way: as a pleasurable act without a specific goal in mind.
To help her enjoy receiving oral sex, we started with having Ann and Ben engage in mutual oral sex. Since she found going down on Ben exciting, the excitement contributed to her experiencing cunnilingus with less anxiety. With practice and with the help of her relaxation training, Ann was able to relax and enjoy cunnilingus while engaging in mutual oral sex as part of their foreplay.
Our next step was for her to relax and to allow Ben to go down on her without any reciprocity on her part: no striving for an orgasm, no goal setting. She was to relax and allow Ben to pleasure her. Again, with relaxation and practice, Ann learned to enjoy cunnilingus without any guilt feelings about not reciprocating. As of our last session, she hadn’t climaxed through oral sex, but that wasn’t a concern for her. She enjoyed it as a prelude to intercourse.
Ann’s final goal was to achieve orgasm solely through intercourse. It was time to ask Ben to join the next session. He happily obliged. I explained that they were going to build on what they could already do. Ann knew how to stimulate herself to orgasm while Ben penetrated her. Now, the instructions for the next stage:
- Play with each other in their usual way.
- Use the woman on top position (or any position they like which facilitates Ann stimulating herself while Ben penetrates her).
- Ann stimulates her clitoris while Ben thrusts his penis slowly and rhythmically in her vagina.
- When she is about to climax, Ann STOPS the stimulation and thrust fast and hard against Ben to trigger her orgasm.
- The interruption may stop rather than trigger her orgasm. This often happens on the first couple of tries.
- If Ann doesn’t climax, repeat the procedure.
I informed them that it might take many tries before Ann could successfully climax by intercourse alone. It may also be difficult for Ben not to climax when Ann thrusts hard and fast against his penis. If she doesn’t climax, he may not be able to have another erection for a while. They said they understood and felt they could work it out.
Ann and Ben came back in two weeks. Ann was radiant! Ben was sheepishly glowing as he followed her into my office.
“We did it! I was able to climax with intercourse alone. It took several tries, but I did it. I can’t reach a climax that way every time, but now I know I can do it. I will continue to practice to make it more consistent.”
Ann had accomplished her counseling goals. No further appointments were made.
SEXPERT’S COMMENTS
Ann’s assumptions about sex placed a great deal of emphasis on personal adequacy being measured by sexual performance. In this context, sex becomes a job and can create a lot of anxiety. After challenging her assumptions, we discussed how sex can be more than oral sex, more than penetration, more than simultaneous orgasms. True intimacy with a partner means being comfortable enough with yourself to risk being vulnerable; to be able to disclose yourself without fear that you will be rejected or abandoned.
Ann was fortunate to have a partner who was secure. From his secure foundation, Ben was able to value, approve, and accept Ann. Feeling safe to be herself, Ann felt free to express her sexual desires. By doing so, Ann and Ben were able to experience “hot intimacy.”
SUMMARY
Performance in bed is not a measure of your adequacy as a person.
Equating sex with performance creates a great deal of anxiety.
Passionate sex is more than competent sexual performance.
Intimate sex is about communication, trust, acceptance, validation.
If you feel that you need more counseling for your difficulties than was offered
in the case story, you may contact me
about your specific problem via email
counseling or telephone counseling.
THANK YOU FOR YOUR INTEREST IN SEXPERT COUNSELOR.
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