Direct sexual therapy seems to be quite effective in alleviating the dysfunctions of arousal and orgasm in both men and women (Marks, 1981; Heiman and LoPiccolo, 1983). Saving couples from divorce and separation.
In addition to good success with erectile dysfunction and female unresponsiveness, failure to improve occurs only in 2 percent of cases of premature ejaculation, and in 20 percent of the remaining orgasmic disorders.
Moreover, systematic desensitization may also be effective in enhancing desire and orgasm, particularly in women with sexual anxiety (Andersen, 1983). Caution is required in two respects, however. First, the Masters and Johnson reports of success are not as well documented as many would like. Masters and Johnson do not report percentages of successes, but rather they report percentages of failures.
So, for example, they report that only 24 percent of females "failed to improve" following sensate focus training for arousal dysfunction. This is not equivalent to a 75 percent cure rate. What "failure to improve" means is not well defined. Moreover, the percentage of patients showing only mild improvement, great improvement, or complete cure is not reported. While direct sex therapy techniques are far superior to what preceded them, well-controlled replications with explicit criteria for sampling and for improvement will be needed before they can be considered definitive (Zilbergeld and Evans, 1980).
The second caution is that while the therapeutic techniques seem effective, the reasons for their good effects are not wholly clear. As has often been the case in psychology and in medicine, effective cure often precedes understanding, and this seems to be the case for sexual dysfunctions as well.
Next: We now turn from the sexual dysfunctions, in which arousal and orgasm are inadequate, to those sexual problems in which arousal and orgasm are adequate, but in which they occur to unusual and bizarre objects. These are the sexual disorders.