I agree with the article below that women should educate themselves about sexuality and what pleasures them or not.  However, I disagree with the conclusion that vaginal orgasms are a myth.  Most sexologists now accept at least clitoral, vaginal and “blended” orgasms.  I agree with Grafenberg that, “Innumerable erotogenic spots are distributed all over the body, from where sexual satisfaction can be elicited; these are so many that we can almost say that there is no part of the female body which does not give sexual response, the partner has only to find the erotogenic zones.” – Gary Schubach, Ed.D., A.C.S.

Vaginal orgasm remains a myth

It is impossible to say at what age Americans will stop believing in the myth of the vaginal orgasm, much like how children grow up to stop believing in the Easter bunny. Women need to educate themselves on sexual activity, what provides them with pleasure and what does not. If women do not play an active part in the dialogue regarding their orgasms, much of their troubles will continue…..read more

http://dailycollegian.com/2012/04/26/vaginal-orgasm-remains-a-myth/

Last week, the mass media announced their interpretations of an article, G-Spot Anatomy: A New Discovery, in the May edition of the Journal of Sexual Medicine.  That article, by Adam Ostrzenski MD, concludes, from a visual examination of the cadaver of an 83 year old woman that, “The anatomic existence of the G-spot was documented with potential impact on the practice and clinical research in the field of female sexual function.”

While I do not believe that the anatomic existence of the so called “G-spot” was documented in Dr. Ostrzenski’s article, I do agree with Dr. Ostrzenski that the anatomic existence of the G-spot has enormous potential impact on the practice and clinical research in the field of female sexual function. The term “G Spot” was a brilliant marketing term created by the publishers of the best selling 1982 book, The G Spot: And Other Discoveries about Human Sexuality. However, the term, “G Spot” is not scientifically correct and that the term itself is contributing to the controversy over what it is and whether it exist.

So once again, THERE IS NO G SPOT!!! However, most women have Prostate Glands that surround their urethras that when stimulated properly, will produce a strong vaginal orgasm and sometimes result in an expulsion of fluid through the urethra. This is sometimes known as Female Ejaculation. 

Over the last fifteen years, I have written or posted to DoctorG.com, a large number of articles regarding the “G Spot” including: Once Again, Does the G Spot Exist?, Defining the G-Spot. Scientists Seek G-Spot, The Elusive G-Spot, G-Spot is the Female Prostate,  The G Spot is Still the Female Prostrate, Finding and Stimulating the G Spot Video & Transcript, The G “Spot” Controversy?, Did Gräfenberg Really Mean ‘G Spot’?m, The Role of Urethra in Female Orgasm (the original Grafenberg article) and The Human Female Prostate and Its Relationship to the Popularized Term, G-Spot. – Gary Schubach, Ed.D., A.C.S.

In the past, the assumption has been that female urethral expulsions during sensual and/or sexual activity (aka “female ejaculation”) originated either in the bladder or from the urethral glands and ducts.  A new study in the Journal of Sexual Medicine confirms the conclusions of my doctoral research project that both may be the case.  In some women, there may be an emission from the urethral glands and ducts which merges in the urethra with fluid from the bladder.  This would explain the seemingly contradictory results from previous studies.  In the cases where prostatic fluid components were discovered, a urethral expulsion may have also taken place.  In other instances, where there was just fluid with lowered amounts of urea and creatinine, an expulsion from the bladder only may have been involved..

Gary Schubach, Ed.D.

I agree with most of the article below, although there may be a sensitive area in the vagina, there is no evidence for a specific, distinct physical structure called the g-spot, is absolutely correct. Grafenberg (http://doctorg.com/site/the-role-of-urethra-in-female-orgasm) never made such a claim and was crystal clear that he was writing about the urethra and the Female Prostate, aka Skene’s glands, paraurethral glands, etc. – Gary Schubach, Ed.D., A.C.S.

Hitting the g spot

by
Sarah Vannier – Sex Columnist

Have you ever wondered how to find the g-spot? Well, I’m about to tell you! Sort of.

The g-spot is named after Dr. Ernst Gräfenberg, a German doctor credited with being the first to describe an especially sensitive area inside the vagina. The g-spot is often branded as the holy grail of female sexual pleasure. Supposedly, stimulating this magical area can cause earth-shattering orgasms, the oh-so-elusive vaginal orgasm, and, on occasion, female ejaculation.…….http://www.thebruns.ca/articles/52419

Enigmatic director Michael Ninn remains one of the most fascinating, original and unpredictable talents in contemporary adult entertainment. In the nearly 10 years since Michael Ninn’s first XXX feature, few adult directors have had a greater impact than Michael Ninn. Here are a select few of his newest offerings.

Innocence 5: Little Secrets
The girls of INNOCENCE share their secret desires. A hardcore obsession in pink….

Innocence 1: Baby Doll
HARDCORE XXX SEX ACTION! Meet the fresh faces of INNOCENCE. The youngest girls of adult in a new series from Ninn Worx….

Sacred Sin
Limited Edition Collector’s 2-Disc Set. Enter the world of SACRED SIN… a world where ungodly mortal power employed to diversely sexual experience can still but offer temporary respite, a place wher…

Catherine
How do we define reality? How do we define sanity? How do we reconcile the two? Why do we think that we must? Imagine a place where time has but the barest of relevance. Concepts such as “past” and “…

Euroglam: An American in Europe
EROTIC HEAT ON THE DANUBE! An Australian embassy envoy falls in love with an American writer, as he seduces her into the dark, sexual underground of Budapest. Jodie Moore encounters the hardcore wor…

Inside Myself
A woman’s life is invaded by a phone stalker who knows her dreams, desires, and dread. The intruder awakens fears that she will confront through hardcore encounters. Anais stars in a story of sexual …

Exposed Featuring Anais
Radiant. Provocative. Sensual. Anais exposes the art of seduction in five scenes of hardcore sexuality….

Innocence 6: Baby Blue
The girls of Innocence play hard and come in pure pink and baby blue….

Exposed Featuring Angel Cassidy
Angel Cassidy reveals the sexual passions in five of her most torrid scenes. Anais costars in a stunning and sublime encounter….

Innocence 10: Wet
Love, wet with desire, sweet with young innocence. DVD features include photo gallery and behind-the-scenes footage….

Do you know these 15 crazy facts about vaginas? They come from the book, What’s Up Down There?: Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend [WHATS UP DOWN THERE] [Paperback]. By Lissa Rankin, M.D….

1. Pubic hair is not just a biological accident that forces us to the waxing salon. It serves three critical functions. First, it protects the delicate vagina. Second, it serves as a reproductive billboard to alert potential mates that you are biologically (if not emotionally) prepared to procreate. And last, it’s a pheromone carpet and traps the scents that lead potential mates to the promised land. So you might think twice before you shave it all off. It’s there for a reason. Embrace it.

2. There are 8000 nerve endings in the clitoris, dedicated exclusively to female pleasure. The penis only has 4000. Who says God didn’t take care of us girls?

3. The average vagina is 3-4 inches long, but fear not if your guy is hung like a horse. The vagina can expand by 200% when sexually aroused, kind of like a balloon. Remember, the vagina was made to birth babies, so it’s exceedingly elastic. If you have pain when getting it on with someone large, you can use dilators to help stretch the vagina so you can accommodate the whole package.

4. The vagina doesn’t connect to the lung. While the vagina can expand, it’s not an open conduit to the abdominal cavity. While microscopic sperm can swim through a tiny hole in the cervix, a tampon simply won’t fit. So if you lose something in there, don’t worry. Reach in all the way and pull it out. Do not — I repeat, do not — go hunting for whatever you’ve lost with a pair of pliers. Think of your vagina as being like a sock. If you lose a banana in a sock…it stays in the sock.

5. Yes, it’s true — your vagina can fall out. Not to belabor the sock metaphor, but it can turn inside out just like a worn out sweat sock and hang between your legs as you get older. But don’t fret; this condition — called pelvic prolapse — can be fixed.

6. Vaginas have something in common with sharks. Both contain squalene, a substance that exists in both shark livers and natural vaginal lubricant. (Cue music: “She’s a maneater…”)

7 You can catch sexually transmitted diseases even if you use a condom. Sorry to break it to you, but the skin of the vulva can still touch infectious skin of the scrotum — and BAM! Warts. Herpes. Molluscum contagiosum. Pubic lice. So pick your partners carefully.

8. The average length of the labia minora is less than ¾ inch long (yes, someone got out a ruler and measured 2981 women). Only 1.8% of women have labia longer than 1 ½ inches. But remember, every vulva is different and special. Some lips hang down. Some are tucked up neatly inside. Some are long. Some are short. Some are even. Some aren’t. All are beautiful. You’re perfect just the way you are.

9. While hair on your head can live up to seven years, pubic hair has a life expectancy of about three weeks, which is why it only grows so long. So don’t worry if you opt not to groom your pubes — you won’t need to braid them any time soon.

10. The word “vagina” comes from the Latin root meaning “sheath for a sword,” which may explain why some women simply hate the word. So if you don’t like the word “vagina,” pick your own name for your girly parts. Just call it something and don’t be afraid to talk about it.

11. Only about 30% of women have orgasms from intercourse alone. The clitoris is where the action is. Most women who do orgasm during sex have figured out how to hit their sweet spot, either from positioning or from direct stimulation of the clitoris with fingers.

12. Increasing evidence suggests that the G spot feels good because it lies right over a deep part of the clitoris. Although experts describe the G spot as being inside the vagina on the anterior wall, just under the urethra, the crura of the clitoris actually runs right there. And a recent study demonstrated that vaginal orgasms may actually be deep clitoral orgasms. But who cares? An orgasm is an orgasm. Appreciate it, regardless of where it comes from.

13. Vaginal farts (some call them “queefs” or “varts”) happen to almost all women at one time or another, especially during sex or other forms of exercise. So don’t be embarrassed if your hooha lets out a toot. You’re perfectly normal.

14. Some women do ejaculate during orgasm, but you’re normal if you don’t. The controversial “female ejaculation” most likely represents two different phenomena. If it’s a small amount of milky fluid, it likely comes from the paraurethral glands inside the urethra. If it’s a cup, it’s probably pee. Many times, it may be a little bit of both. But don’t stress out about peeing on yourself. Put a towel under you and surrender to the experience.

15.Safe sex (or even just orgasm alone) is good for you. Benefits include lowering your risk of heart disease and stroke, reducing your risk of breast cancer, bolstering your immune system, helping you sleep, making you appear more youthful, improving your fitness, regulating menstrual cycles, relieving menstrual cramps, helping with chronic pain, reducing the risk of depression, lowering stress levels, and improving self esteem. So go at it, girlfriends!

 Abridged from: http://www.psychologytoday.com/blog/owning-pink/201104/15-crazy-things-about-vaginas

HERE COME THE THOUGHT POLICE!!! Rick Santorum, who doesn’t believe in birth control, now tells us that, “A wealth of research is now available demonstrating that pornography causes profound brain changes in both children and adults”

This has no scientific basis. Any fact-checking reveals that such claims have no meaningful evidence behind them but are made periodically by right wing ideologues. – Gary Schubach

The United States provides just about the least sex education in public schools of any industrialized country. At the same time, we also have the highest rates of unwanted pregnancies, STD’s and sexual dissatisfaction of any industrialized country.

There has been a long history in the United States of opposition to age appropriate sexuality education from K-12. People appear to make an assumption that children will be taught adult sexuality before they are emotionally ready and/or that the simple teaching of age appropriate sexuality education will encourage young people to be promiscuous or engage in activities that parents find objectionable.

Most studies reveal that the reverse is actually the case. If you teach children nothing about human sexuality, they will figure intercourse out on their own. It has been shown over and over again, that with more sex education, the average age when intercourse begins increases substantially . Actually, with appropriate sex education, there are much lower rates of unwanted pregnancies and STD’s . The cost of young people’s ignorance about human sexuality is just too high.

Another reason to consider age appropriate sexuality education in K-12 is the problem of bullying that has recently received much publicity in the media. Beginning at a young age, if children are taught that individuals come in all body shapes, colors and sizes it gives them a head start toward a healthier sexual future as adults as well as teaching an acceptance of diversity.

Age appropriate comprehensive sex education initiates the ability for saying “no” during sexual encounters. Desensitizing (not understanding what is meant here) young children to the word “no” encourages the ability to use the word comfortably when addressing bullies and sexual advancements. Feeling comfortable in saying “no” to sexual advancements must begin when children are as young as three years of age. If 3-5 year old children are raised in an environment where “no” and “no means no” is practiced at home and in school along with healthy views of diverse body types, this (what this are you referring to here?) would not be such a big issue.

National Sexuality Education Standards:

The goal of the National Sexuality Education Standards: Core Content and Skills, K–12 is to provide clear, consistent and straightforward guidance on the essential minimum, core content for sexuality education that is developmentally and age-appropriate for students in grades K–12. The development of these standards is a result of an ongoing initiative, the Future of Sex Education (FoSE). Forty individuals from the fields of health education, sexuality education, public health, public policy, philanthropy and advocacy convened for a two-day meeting in December 2008 to create a strategic plan for sexuality education policy and implementation. A key strategic priority that emerged from this work was the creation of national sexuality education standards to advance the implementation of sexuality education in US public schools.

Specifically, the National Sexuality Education Standards were developed to address the inconsistent implementation of sexuality education nationwide and the limited time allocated to teaching the topic. Health education, which typically covers a broad range of topics including sexuality education, is given very little time in the school curriculum. According to the School Health Policies and Practices Study, a national survey conducted by the Centers for Disease Control and Prevention’s Division of Adolescent School Health to assess school health policies and practices, a median total of 17.2 hours is devoted to instruction in HIV, pregnancy and STD prevention: 3.1 hours in elementary, 6 hours in middle and 8.1 hours in high school.[1]

Given these realities, the National Sexuality Education Standards were designed to:
• Outline what, based on research and extensive professional expertise, are the minimum, essential content and skills for sexuality education K–12 given student needs, limited teacher preparation and typically available time and resources.
• Assist schools in designing and delivering sexuality education K–12 that is planned, sequential and part of a comprehensive school health education approach.
• Provide a clear rationale for teaching sexuality education content and skills at different grade levels that is evidence-informed, age-appropriate and theory- driven.
• Support schools in improving academic performance by addressing a content area that is both highly relevant to students and directly related to high school graduation rates.
• Present sexual development as a normal, natural, healthy part of human development that should be a part of every health education curriculum.
• Offer clear, concise recommendations for school personnel on what is age-appropriate to teach students at different grade levels.
• Translate an emerging body of research related to school-based sexuality education so that it can be put into practice in the classroom.

The National Health Education Standards2 (NHES) heavily influenced the development of the National Sexuality Education Standards. First created in 1995 and updated in 2007, the NHES were developed by the Joint Committee on National Health Education Standards of the American Cancer Society and widely adopted by states and local school districts. The NHES focus on a student’s ability to understand key concepts and learn particular skills for using that content. These standards were developed to serve as the underpinning for health education knowledge and skills students should attain by grades 2, 5, 8 and 12. The NHES do not address any specific health content areas, including content for sexuality education.

The National Sexuality Education Standards were further informed by the work of the CDC’s Health Education Curriculum Analysis Tool (HECAT)[3]; existing state and internation- al education standards that include sexual health content; the Guidelines for Comprehensive Sexuality Education: Kindergarten – 12th Grade [4]; and the Common Core State Standards for English Language Arts and Mathematics [5], recently adopted by most states.

Gary Schubach, Ed.D., A.C.S. – Comprehensive Exam Question Response

Discuss the pros and cons of working
with a “surrogate” in sex therapy.

          To begin with, it is necessary to define terms.  A sex surrogate is someone, male or female, who serves as a sex partner to the client as part of a sex therapy team that includes the client and the therapist.  The surrogate’s purpose is to teach and aid a client with no partner to work with, to achieve emotional and physical intimacy by using experiential exercises designed to build those skills.  This can involve exercises in the areas of social skill training, communication, relaxation techniques and sensual and sexual touching.  It also may involve, when appropriate, genital-genital contact but that is a minor portion of the total time spent in the process and usually takes place close to the end of the process after the necessary interpersonal and body sensitivity lessons are learned.

The qualities that are important in sex surrogates would include warmth, caring, empathy, comfort with their own sexuality and body, good interpersonal communication skills, and trustworthiness.  It is also important that they have  nonjudgmental attitudes towards choice of lifestyle, sexual activity  and sexual partners.  It is essential that they be emotionally mature and able to effectively cope with intimate situations.

So under what conditions would the use of a sex surrogate be appropriate?  Until about 1970, the treatment of sexual dysfunctions usually involved the traditional model of a therapist working one on one with a client in an attempt to understand the deep-seated psychological roots of the problem and to resolve them through verbal therapy.  Then came new viewpoints by such people as Masters and Johnson, Helen Singer Kaplan and Hartman and Fithian suggesting that in addition to a psychological causation, it was also possible that there was an educational deficit that might be addressed in a focused sort of way.  Many people simply did not possess the interpersonal communication and tactile skills necessary to create an environment where they would feel relaxed and comfortable enough to enjoy sex without the anxiety that can cause dysfunction.  New approaches were developed that saw sexual dysfunction not as a “problem” of one partner or the other in a relationship but as a joint relationship issue to be addressed by both partners.  Intensive strategies were developed to re-educate both partners as to normal sexual function, communications and relaxation techniques.  Sensate focus exercises were developed.  In these exercises, according to Masters and Johnson, “The purpose of the touching is not to be sexual but to establish an awareness of touch sensations by noticing textures, contours, temperatures, and contrasts (while doing the touching) or to simply be aware of the sensations of being touched by their partner.  The person doing the touching is told to do so on the basis of what interests them, not on any guesses about what their partner likes or doesn’t like.”

The problem is that these promising therapies were designed for couples, and really need to be done with a partner.  What about cases where there is no partner or if there is a partner, he or she are unwilling to participate?  It was in response to this question that the role of sex surrogate was conceived.

Outcome statistics for this type of therapy, utilizing a surrogate, have not really been kept and its popularity has faded some since its inception in the 1970’s.  A more sexually repressive period has brought out concerns by therapists about the confusion of surrogacy with prostitution, as well as the fears of therapist liability in a litigious environment.  Concerns about AIDS and other STD’s are an additional factor.  Also, while a trained surrogate knows how to deal with transference issues, there is always the possibility that the client will become emotionally attached to the sex surrogate which can create problems for the client, the therapist, and the sex surrogate.

However, I have had experience with this type of therapy and I clearly believe in its effectiveness if used with the appropriate client.  My experience has been that the client must not have too many deep-seated anxieties around sex so that it is impossible to surrender to the exercises and the process.     However, before I would even make a referral to a sex surrogate, it is important that I would have already established rapport and a sense of trust with the client.  Also, I would have already introduced the client to relaxation techniques that might include self-hypnosis, breathing exercise and guided imagery.  If the client is resistant to these exercises, then they are probably not a good candidate for the type of sex therapy that would involve using a surrogate.

The client that I would find appropriate for this type of therapy would be one who is open, willing and even eager to learn new skills and to have a joyful and loving sex life.  For that person, sex therapy utilizing a surrogate can be a rewarding and enriching experience.

©1997 by Gary Schubach, Ed.D., A.C.S.

http://www.DoctorG.com

Gary Schubach, Ed.D., A.C.S. – Comprehensive Exam Question Response

You are a sex therapist with a client who is a 45-year-old impotent male without a sexual partner.  You (and he) decide to use a surrogate.  How would you go about finding one?  What would you look for in her?  What instructions would you give her?  In other words, discuss the use of surrogates in sex therapy.

           To begin with, it is necessary to define what we are talking about here and then look at the appropriate options.  First, let’s look at what is meant by “impotent”.  Impotence is defined broadly by Masters and Johnson as “the inability to have or maintain an erection that is firm enough for coitus.”  Within that definition there can be any number of possible causes and manifestations.  To be thorough, a full sex history should be taken and a complete physical examination, including testing for STD’s, should be conducted.  Diabetes,  alcoholism, hormonal deficiencies, prescription drugs, urethral and prostate disorders are among just a few of the possible organic causes of erectile difficulties and should be explored before the question of appropriate treatment is decided.  However, it is far more likely that the difficulty is psychologically based or is at least an important major contributing factor.

So what are the treatment options?  Until about 1970, the treatment of sexual dysfunctions usually involved the traditional model of a therapist working one on one with a client in an attempt to understand the deep seated psychological roots of the problem and to resolve them through verbal therapy.  Then came new viewpoints by such people as Masters and Johnson, Helen Singer Kaplan, and Hartman and Fithian, suggesting that in addition to a psychological causation, it was also possible that there was an educational deficit that might be addressed in a focused sort of way.  Many people simply did not possess the social interpersonal communication and tactile skills necessary to create an environment where they and their partner would feel relaxed and comfortable enough to have and maintain an erection.  New approaches were developed that saw erectile difficulties not as a “problem” of the male in a relationship but as a joint relationship issue to be addressed by both partners.  Intensive strategies were developed to re-educate both partners as to normal sexual function, communications and relaxation techniques.  Sensate focus exercises were developed.  In these exercises, according to Masters and Johnson, “The purpose of the touching is not to be sexual but to establish an awareness of touch sensations by noticing textures, contours, temperatures, and contrasts (while doing the touching) or to simply be aware of the sensations of being touched by their partner.  The person doing the touching is told to do so on the basis of what interests them, not on any guesses about what their partner likes or doesn’t like.”

The problem is that these promising therapies were designed for couples and really need to be done with a partner.  What about cases like this one where there is no partner or, if there is a partner, he or she is unwilling to participate?  It was in response to this question that the role of the sex surrogate was conceived.  A sex surrogate is someone, male or female, who serves as a sex partner as part of the sex therapy team that includes the client and the therapist.  The surrogate’s purpose is to teach and aid a client with no partner to work with, to achieve emotional and physical intimacy by using experiential exercises designed to build those skills.  This can involve exercises in the areas of social skill training, communication, relaxation techniques and sensual and sexual touching.  It also may involve, when appropriate, genital-genital contact but that is a minor portion of the total time spent in the process and usually takes place close to the end of the process after the necessary interpersonal and body sensitivity lessons are learned.

Before I would even make a referral to a sex surrogate, it is important that I would have already established rapport and a sense of trust with the client.  Also, I would have already introduced the client to relaxation techniques that might include self-hypnosis, breathing exercise and guided imagery.  If the client is resistant to these exercises, then they are probably not a good candidate for the type of sex therapy that would involve using a surrogate.  However, from the question given here, I will assume that we have already determined that use of a sex surrogate is appropriate.

Therefore, in this case, the qualities that I would be looking for in a sex surrogate would include comfort with her own sexuality and body,  good interpersonal communication skills, warmth, caring, empathy and trustworthiness.  It is also important that she have non-judgmental attitudes towards choice of lifestyle, sexual activity  and sexual partners.  It is essential that she be emotionally mature and able to effectively cope with intimate situations.

So, assuming that the use of a sex surrogate is appropriate for the individual client at hand, where do we go to find one?  The professional society for sex surrogates is the International Professional Surrogates Association (IPSA).  They offer training for persons interested in becoming sex surrogates as well as on going education programs for their members.  Their members subscribe to a highly professional code of ethics.  So if I was a sex therapist looking for a trained and qualified sex surrogate, I would definitely call IPSA and request a referral or referrals.

After I located a qualified sex surrogate, she, the client and I would meet to see if we could agree to work together.  In that session we would discuss the ground rules for the program of therapy as well as safer sex practices and come to some agreements in those areas.

After that, I would have some instructions for the surrogate, although I would like to think of our relationship as consisting of two trained professionals working together in cooperation for the best interests of the client.  It is possible that she may know as much or more than I do about aspects of an effective treatment program and I would certainly be open to her feedback and input.

I will be seeing the client in at least weekly verbal sessions to review how he is feeling about the therapy and discuss any issues that are coming up for him during the process.  Also, I will watch for the time when he is ready to progress to the next step in the process and would keep in at least weekly touch by phone with the surrogate to get her feedback and jointly plan the next session.

In dealing with a 45 year old man with erectile issues, the first thing to do is to take his attention off of whether or not he has an erection.  In an initial session in my office with the client and the surrogate, it is important for us to make the point that it is impossible to just “will” an erection.  Additionally, in order to successfully have erections it is necessary to create an environment of relaxation and comfort, free from the pressures of performance anxiety.  An agreement would be made with the client that for the initial sessions with the surrogate that there will be no coitus or attempt to reach orgasm any other way.

I would then instruct the surrogate to begin a series of “sensate focus” exercises with the client.  This would involve non-genital touching exercises in giving and receiving, with no specific area of the body to be focused on, no goals to be reached and no pressure to perform.  Also, the surrogate will work with the client in communications exercises designed to develop skills in communicating what is pleasurable and what the client or a partner might like differently in the way of touch.

After the surrogate has communicated with me that the client has become comfortable and feels competent with his new touching and communications skills, I would discuss with the surrogate whether the client is ready to move to the next step in the process, to begin to concentrate his and her touching on the sex organs and the surrogate’s breasts.  Again, they would be under instructions not to aim for coitus or orgasm.  I might instruct the surrogate to have both of them guide each other’s hand to show what is pleasurable to each during masturbation.  If an erection occurs, they will be instructed to stop what they are doing until it goes down and then start over again.  As this begins to happen more frequently, the client should start to be assured that there is nothing to worry about in losing an erection and as he builds confidence that he can get another one.

After the client and the surrogate have indicated to me that he has overcome his fears of failure and is beginning to have confidence in his responses, I would instruct them to proceed to intercourse in a deliberate and non-demanding way.  The surrogate would be instructed to take the initiative, with her on top and to masturbate him until he has an erection.  Then, with his permission, she would insert him into her vagina.  She would be instructed to remain still for a while so that he can get used to the feeling of being inside her without having to do anything.  If he loses his erection, that is fine and they simply begin again.  As the client becomes comfortable with simple insertion, the surrogate is instructed to begin movement, stimulating the penis and helping keep it erect.  As the client becomes more comfortable with intercourse, I would instruct the surrogate, while still on top, to allow the client to initiate thrusting and moving back and forth inside her, again with no goal of orgasm.  Finally, when the client becomes comfortable with this stage, I would instruct the surrogate to begin to allow the client to experiment with various positions.

All of this is flexible and adaptable to each client and his needs.  Outcomes statistics for this type of therapy, utilizing a surrogate, have not really been kept and its popularity has faded some with a more sexually repressive period and fears about STD’s.  However, I have had experience with this type of therapy and I clearly believe in its effectiveness, used with the right client.  My experience has been that the client must not have too many deep-seated anxieties around sex so that it is impossible to surrender to the exercises and the process.  The client that I would find appropriate for this type of therapy would be one who is open, willing and even eager to learn new skills and to have a joyful and loving sex life.  For that person, sex therapy utilizing a surrogate can be a rewarding and enriching experience.

©1997 by Gary Schubach, Ed.D., A.C.S.

http://www.DoctorG.com