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. The basic Masters and Johnson method accomplishes these goals in a substantial number of patients:

1) Sensate focus I This consists of taking turns caressing or "pleasuring" each other's bodies without genital stimulation.

2) Sensate focus II This consists of taking turns body pleasuring and also includes gentle, non-demanding genital stimulation which may proceed to erection but not to orgasm.

3) Brief intromission without orgasm in the female superior position. The woman inserts her partner's penis into her vagina, thrusts a few times, and gets off before there is any anxiety or erection loss. The man reaches orgasm by manual stimulation, which is provided by himself or by his partner, depending on which is more comfortable for him.

4) Intromission to orgasm in the female superior position.

5) Intromission to orgasm in the male superior position.

This method is highly effective in those cases where the etiology is a simple fear of failure. However, many impotent men are basically afraid of sexual success and require a more flexible treatment approach which is designed to accommodate their specific needs. The following tasks may be used to circumvent or "bypass" sexual anxiety which is not primarily related to performance fears. They are designed to reduce the pressure on the man still further, and also to provide him with the tools to deal with his anxiety should this arise.

1) The use of fantasy concomitant with genital stimulation, especially during anxious moments.

2) Having the wife learn to accept clitoral stimulation as an alternative to coitus, thus relieving the pressure on the man.

3) Teaching the couple the use of self stimulation at times of tension.

Partial Impotence

It may be speculated that males who cannot ejaculate with a full erection on a psychogenic basis have reinforced the incomplete erections by ejaculating in that state. This reinforcement sequence may be regarded as the immediate cause of the syndrome of partial impotence. Treatment is based on the rationale of extinguishing that response, and reinforcing full erection instead.

The man or his partner stimulates his penis. He is advised not to allow himself to climax unless he is fully erect. If he feels that he is near orgasm he stops until he is fully erect. Finally, when he has a full erection, he climaxes. This is a frustrating but effective treatment procedure.

About The Author
David Crawford is the CEO and owner of a company known as Vigrx Plus Reviews which is dedicated to researching and comparing male enhancement products in order to determine which male enhancement product is safer and more effective than other products on the market. Copyright 2011 David Crawford of http://www.maleenhancementgroup.com This article may be freely distributed if this resource box stays attached.