Contribution to the Problem of Vaginal Orgasm1

Results in the therapy of psycho-sexual difficulties in women are frequently not quite satisfactory. Psycho-analysts particularly interested in feminine psychology have noted this fact. Many have therefore concluded that they must be content if they can help the patient to adjust herself to incomplete sexual gratification and to sublimate the sexual desire by converting the penis envy (which some analysts regard as the central problem) into the wish for a child. Nevertheless we cannot accept this solution as the final aim of therapeutic endeavour—least of all, if we understand the pathogenesis of this inability to attain complete sexual gratification. To assume that one single problem is responsible for all the difficulties is to impede our progress towards a solution from the very start.

Psycho-analytical literature presents a variety of approaches to the problems of feminine psychology and sexuality. The consensus of all the investigators (whose material was gathered from many different patients) indicates that the major factors in the conflicts creating vaginal anæsthesia are: Oedipus fixation, unconscious guilt accompanying aggression towards both parents, masculinity strivings, rejection of femininity, and penis envy. Although these investigators have added to the understanding of feminine psychology and helped patients to adjust better to social and sexual life, still, in the treatment of frigidity, they have not always succeeded in bringing about pleasurable orgasm. An important reason for this failure, I believe, is the incomplete and undetailed analysis of sensation in the vagina. Patients who complain of sexual anæsthesia or inability to reach vaginal orgasm during intercourse can describe in detail vaginal sensations of greatly varying degree, quality and location. If these are to be understood they must be thoroughly analysed.

In the initial phase of analysis complaints of sexual anæsthesia are nearly uniform but as analysis progresses minute yet