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The tensions within the marriage increased, and finally the breaking point was reached. One night Harold’s wife sought sexual intercourse with him when he was emotionally drained and deeply concerned by his sexual failure. The encounter was a disaster. Harold failed to achieve an erection. His wife tried to comfort him and to convince him it was only because he was tired, but on the next occasion he failed again. His anxiety about his sexual performance increased each time he failed to get an erection. Each failure aggravated his anxiety about failing.

Tom avoids his wife’s sexual advances, finding excuses because he is afraid he will fail once again. After a period of rejection, she decides that she too will become sexually celibate. It is too traumatic to be rejected.

All communication between the couple ceases. They avoid physical contact, and avoid verbal expressions of affection. They have become isolated, unhappy, and anxious. And Tom is increasingly anxious about his impotence. It is to be hoped that at this point he will seek help.

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The ‘sensate focus’ exercises are designed to re-educate the couple in the importance of touch, to which are added smell, by using scented body lotions for the massage, and occasionally taste. In these sessions the giving partner gives, without seeking any return of the favour. The receiving partner receives, without the possible threat of having to give in return, and without the need to explain. All that the pleasured partner has to do is prevent the pleasuring partner from doing anything which distracts from or diminishes the pleasure felt.

With succeeding sessions the partners change roles and, after a while, pleasure each other by exploring, fondling, and caressing each other’s genitals, and begin to help each other overcome the specific sexual dysfunction, which requires additional techniques. Some sexual therapists, notably Dr Masters and Dr Johnson in

the U.S.A., find that they are able to get the most successful results in treating sexual dysfunctions if the couple are able to spend at least two weeks in a residential remedial course. This is expensive. Other sexual therapists have found that most sexual dysfunctions can be resolved using less expensive techniques.

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