Today, the majority of treatment programs for orgasmic disorder involve a combination of different treatment approaches, such as homework assignments, sex education, com­munication skills training, cognitive restructuring, desensitization, and other techniques (M. P. Kelly et al., 1990). The most effective treatment for female orgasmic disorder was developed by LoPiccolo & Lobitz (1972) and involves teaching a woman to masturbate to orgasm.

On a psychological level, masturbation also helps increase the pleasurable anticipa­tion of sex. Education, self-exploration, communication training, and body awareness are also included in masturbation training for orgasmic problems. Masturbation exercises begin with a woman examining her body and vulva with mirrors. Then she is instructed to find which areas of her body feel the most pleasurable when touched and to stroke them. If this does not result in orgasm, a vibrator is used. As a woman progresses through these stages, she may involve her sexual partner so that the partner is able to learn which areas are more sensitive than others.

Подпись:Подпись: sexПодпись:Treating Female Orgasmic DisorderПодпись:Although masturbation training is the most effective treatment for female orgasmic disorder, some therapists do not incorporate it into their treatment for a variety of rea­sons (including patient or therapist discomfort). Interestingly, improving orgasmic re – sponsivity does not always increase sexual satisfaction. Women often prefer and engage in sexual intercourse over masturbation because it provides more intimacy and closeness, even though masturbation may be a better means of reaching orgasm (Jayne, 1981).

Two additional treatments involve systematic desensitization and bibliotherapy. Both of these have been found to be helpful in cases in which there is a great deal of sex­ual anxiety. In systematic desensitization, events that cause anxiety are recalled into imagination, and then a relaxation technique is used to dissipate the anxiety. With enough repetition and practice, eventually the anxiety-producing events lose the ability to create anxiety. Both masturbation training and systematic desensitization have been found to be effective; however, masturbation training has higher effectiveness rates (Heiman & Meston, 1997).

Bibliotherapy has also been found to be helpful for not only orgasmic dysfunctions, but other dysfunctions as well. It can help a person regain some control and understand the problems she is experiencing. Although the results may be short-lived, bibliotherapy has been found to improve sexual functioning (van Lankveld et al., 2001).

Question: I seem to have problems achieving orgasm with my partner, yet I am able to with the help of a vibrator. Are there different levels of orgasms? Sometimes it is so deep and complete and emo­tional; other times it is very satisfying but not to the tips of my toes! Is this normal? I would love to be able to achieve the same satisfaction with my partner as I can by myself or with a vibrator.

There are different levels of sexual satisfaction that result from orgasms. Orgasms differ based on stress, emotions, thoughts, physical health, menstrual cycles, sexual position, and method of stimulation. However, Masters and Johnson did find that masturbation usually evoked more powerful orgasms than intercourse. In order to experience these or­gasms with your partner, you might try masturbating together or using a vibrator with your partner.