The following estimates of treatment outcome are not based on systematic research. They are the product of a survey of the literature, of our own preliminary outcome data, and of personal communications with colleagues. They are not to be interpreted as claims of effectiveness, but rather as estimates based on a consensus of clinical observations.

It should be emphasized that the behavioral strategies outlined for the various syndromes describe only the experiential aspect of sexual therapy. The exercises are designed primarily to modify the specific immediate antecedents of the symptom. This by itself cures many patients.

The muscle spasm which occurs immediately after ejaculation, and which is the immediate cause of this syndrome, is treated by systematic in vivo desensitization. Towards this objective, a variety of psychological anxiety reducing methods, such as reassurance and explanation, may be employed, as well as procedures which relax muscles by physical means.

The treatment of vaginismus is designed to extinguish the conditioned spasm of the muscles surrounding the vagina by means of systematic in vivo desensitization. Any technique which uses gradual dilatation of the spastic introitus is effective. Our method employs the following sequence: ...

The sexual exercises employed in the treatment of ISD are designed to confront the patient with his/her active though unconscious and involuntary avoidance of sexual feelings and activities and/or the tendency to focus on negative images and thoughts and to suppress sexual feelings which may emerge despite the patient's defenses against this.

The aim of treatment of this rather uncommon disorder is to reduce the anxiety which is evoked during the excitement phase, and which inhibits its expression. The original Masters and Johnson method is effective, although there are advantages to employing some flexibility to accommodate to the patients' individual dynamic needs.

The performance anxiety which is so frequently associated with impotence can be diminished in many cases by structuring the sexual interactions so that they are non-demanding and reassuring. The patient is encouraged to substitute the non-pressuring goal of pleasure for the stress producing goal of performance, and the sexual situation is arranged so that it is highly stimulating but has a low level of demand for performance or pressure.

1) Self stimulation to orgasm in presence of partner. This should occur with a gradual increase in intimacy. First the partner turns his back while the patient stimulates herself. Then he can hold her while she stimulates herself. One partner can stimulate herself to orgasm after the other has climaxed, but the patient should not attempt to reach orgasm during intercourse at this stage of treatment.

The objective of the treatment of orgasm inhibition is to modify the patient's tendency to obsessively observe his/her pre orgastic sensations and to foster abandonment to erotic feelings, which is a necessary condition of orgastic release. These aims can be implemented by structuring the situation so that the patient receives effective penile or clitoral stimulation under the most tranquil conditions that can be arranged.

The aim of the treatment of premature ejaculation is to facilitate learning voluntary control over ejaculation by fostering the patient's awareness of, and increasing his tolerance for, the pleasurable genital sensations that accompany the intense sexual excitement which precedes orgasm.