Now, after all the years of agony and months of waiting, the couple is ready to begin. In their first interview, they are faced by both cotherapists. It could be Masters and Johnson or a second team, Dr. Richard Spitz and Sallie Schumacher, or any combination of one male and one female. Dual sex-therapy teams, a Masters and Johnson concept, give each member of the marital unit a friend in court, a person who knows what the first nocturnal emission was like, or who knows what happened during the first menstrual cycle. The couple tell of their problems and their hopes, and then each one pairs off with the member of the same sex on the therapy team to discuss family background, religious beliefs, sexual activity with this mate and others. "Did you ever watch anyone else, accidentally or otherwise, involved in sexual activity? Do you recall your reaction? Which parent did you feel closest to? Who usually chooses the time for lovemaking? Do you tell your husband [wife] what pleases you most?"
The picture that emerges could keep soap operas in material for years. Two Ph.D.'s, she in anthropology, he in physics, have a marriage unconsummated after four years. A nonorgasmic woman was traumatized at fifteen with her first sexual encounter—a homosexual one with an overzealous teacher. A husband, out of work, turns to drink and loses his potency. A frustrated woman from a Fundamentalist Protestant background, whose premarital physical contact consisted of three chaste kisses, who fought to keep herself covered during intercourse while her husband fumbled through the nightclothes to do the job. A man from a Fundamentalist background whose first sexual encounter was with a prostitute, standing up, is impotent. A man punishing his mother by denying her a grandchild is denying his wife any sexual activity.
On the second day, the male patient talks with the female therapist and his mate with the male, and each goes deeper into background and difficulties. The couple know they are not supposed to engage in any form of sexual activity, and for most, at this point in the program, this is not too tall an order. On the third day, there is a round-table discussion, stories are matched, glossed-over fabrications are confronted, righted, and the couple are ready to begin the practical—application phase. They are given instructions to go back to their room and on two occasions simply rub or touch the other person wherever they would like, except genitally, just to give them pleasure. It was Gini Johnson's idea eleven years ago that non-demanding touching, called "sensate focus," was the first step in re-establishing a physical relationship that could lead to successful sexual functioning.
From the fourth day on, couples in therapy are encouraged to proceed, at their own pace, toward a more complete appreciation of the sexual component in their lives. Wanda Bowen and her staff see the couples go in for their daily sessions with Masters and Johnson and then emerge. "I don't have to listen to the tapes [all sessions are recorded] or look at the progress sheet," Mrs. Bowen says. "It's all there in their faces. Some are crying. Some snap at each other. Some are holding hands and smiling. The anthropologist Ph.D. was a mess in dumpy clothes on the first day. When she came in one day with lipstick, her hair done, and earrings on, I didn't have to ask anybody. She was advertising to the world that they had made it."
The men who come to Masters and Johnson for help break down into two basic categories, those who cannot perform sexually (primary impotence if they have never been able to achieve an erection and have intercourse; secondary impotence if, once having been successful, they are no longer able) and those who can perform (but who have an orgasm before they are able to satisfy their mate—premature ejaculation—or those who are never able to achieve orgasm—ejaculatory incompetence). No women are considered frigid by Masters and Johnson. "The word means nothing," says Masters. They are victims of either primary orgasmic dysfunction (they have never experienced orgasm), or situational orgasmic dysfunction (once successful, but not currently).
The therapy is carefully orchestrated, from the moment of first instructed touch to successful intercourse and orgasm, to keep both partners calm and undemanding of one another. "Fear of performance is the biggest factor in sexual dysfunction, and once there is no premium on performance, we can get a lot of work done," says Masters. That work was detailed in Human Sexual Inadequacy, where Masters and Johnson reported they had failed in only 20 percent of 790 cases of male and female dysfunction that had been treated for two weeks and then followed up for five years. They did not claim success in the other 80 percent, stating that success was too difficult to define, but that failure, either in the two-week program or during the five-year follow-up, was easy to identify. Masters and Johnson's most stunning success came in the area of premature ejaculation, where only 5 of the 186 men thus afflicted could not bring their problem under control. By use of a "squeeze technique" where the female grasps the penis when the man says he is ready to climax, thus removing his desire to do so, Masters and Johnson have virtually proven this sexual problem can be vanquished. Their highest failure rate (40 percent) occurred with primary impotent men, many of whom could not overcome religious strictures that have effectively castrated them.
Because their work is shrouded in secrecy, few firsthand examples of how Masters and Johnson operate have reached the general public. One such story appeared in the July, 1969, issue of Ladies' Home Journal, told by an anonymous woman who had been married for nine years and found little sexual fulfillment in her marriage to a man who suffered from premature ejaculation. The scenario is all too familiar: intercourse degenerates into release for her husband and frustration for herself...the wife finds herself less responsive...she avoids her husband...he accuses her of extramarital activity...she becomes even less responsive...the psychiatrist is consulted... "Don't fret my dear," he answers, "your husband has a low sexual-interest level and unfortunately his problem of premature orgasm cannot be helped. Forget your problem and get involved in hobbies, go to the theater; there is more in life than sex."
This woman knew that, but she still wanted her share. Under Masters and Johnson's care everything seemed to be going well until Dr. Masters asked her if she would stay with the marriage if the sexual aspects were improved. She answered that she didn't know. "Why did you come here?" he shot back at the woman. At that point she knew he wouldn't stand for any idle chitchat, and she replied that whether or not the marriage survived, she didn't want to deprive her husband of this chance to find his manhood. She was surprised when the stern-faced Dr. Masters promised that within a year her husband would again be confident—both sexually and in his everyday life—and it would be due to her.
The evening before the round-table discussion the nervous couple found themselves consoling one another, holding each other—something unique in their marriage. They were alone in a strange city with no one to resort to except each other. This is obviously not an accidental benefit of the program. On the third day, instructed to go back to their room and simply "pleasure" each other with no special goal in mind, they did so. The woman explained: "I had never before been able to touch my husband in an uninhibited way and he had never learned to caress me with love. But now, with our fears of sexual performance or nonperformance removed, we relaxed and enjoyed each other. I was not really able to be purely platonic about the experience; I found myself becoming aroused in ways I had not felt for years."