I read through my clinical notes.
Patient: Bethany Marcus
Symptoms: Anorgasmia/inability to orgasm
Clinical Notes: Bethany has been unsuccessful in climaxing for a period of three years. It began when she went through a traumatic experience, i. e., her husband had a twelve–month affair. The marriage has survived; however, Bethany has been troubled since the ordeal. Bethany also suffers violent sexual dreams which are distressing to her. Bethany blames herself for her husband’s infidelity.
Aim: Bethany would like to stay happily married to her husband Anthony. She would like to fulfil her role as a wife and mother to her family. Bethany would like to be able to forgive her husband and resume a satisfying sexual relationship with him.
I blow out a breath. I really like my next patient. Bethany is beautiful and smart, with absolutely no confidence. Her cockroach of a husband has done a total number on her and then lets her blame herself for his inability to keep it in his pants. If I had my way I would just tell her to leave him, but I can’t do that. I have to help her work towards her goal, which unfortunately is a happy life with Anthony. I would like to see Anthony but Bethany won’t allow it.
I open my office door.
“Hi Bethany.” She smiles shyly and walks into my office. I gesture for her to take a seat. “How have you been since I last saw you?” I ask.
“Not very well,” she quietly answers.
“Oh, why is that?” I ask. She stays silent as I sit and wait for her answer. Sometimes waiting for answers is the hardest part of this role. She shrugs her shoulders.
“I see.”
“How have you been?” she asks me and I smile. This is typical Bethany, she always puts others before herself and she sees me as a person and not just her therapist.
“Me. I’m good,” I answer. “A little demotivated this week,” I shrug and smile. “You know how it is.” She nods, grateful that my life isn’t perfect. “Tell me what’s happening,” I urge.
“Anthony told me I am terrible in bed.” Her devastated eyes meet mine. What the fuck.
“How did this come about?” I ask, trying to control my anger. This guy is a total worm.
“We were in bed and you know my problem,” I nod and stay silent. “I just can’t come, I don’t know why. It doesn’t matter what I do, what I think about, it just doesn’t happen.”
“I see,” I nod. “And what happened then?” I keep my voice monotone so as to not throw her train of thought.
“As usual, he got frustrated and asked what the fuck was the matter with me.”
“Ok,” I nod. “What did you say?”
“I told him to just finish off as it wasn’t going to happen. And then, well he just finished off, and rolled over.”
“I see,” I stay silent to let her finish but she remains silent. “What happened then?”
“I told him I was coming to you.”
“Had you not told him before?”
“No, I hadn’t.”
“And what did he say?”
“He told me that no expensive doctor could make me receptive in bed, that I’m a cold fish and that he’s never been with a woman who is so unresponsive.”
“What do you think of that?” I ask.
“He’s right,” she sighs.
“I don’t believe that,” I assert. “You may be unresponsive to him at the moment, but it’s not physical, it’s totally emotional. Bethany, I treat both men and woman who suffer from Anorgasmia and they are in loving relationships with a person they can trust.” She nods as she listens. “Have you thought about what we talked about last visit?”
“Yes,” she says. “It’s not going to be possible.”
“Why?” I ask.
“Because he doesn’t know I haven’t orgasmed in three years.”
I cross my arms. “What do you mean?” I ask, already knowing the answer.
“I’ve been faking it all along.”
I nod. This is common. “Do you think you should come clean?” I give her a small empathetic smile.
“No, he would be devastated.”
I nod, “So it’s ok if you’re devastated, just not him.”
“I know how this looks,” she whispers.
“How does this look Beth?” I urge.
“That I am a martyr.”
I smile. “Is that what you think?” I ask her softly.
“Do you?” she asks.
“No, I don’t think you’re a martyr. Would it matter to you if I did?”
She nods her head.
“It shouldn’t matter what anyone thinks Beth, only you.”
“I care what you think,” she smiles. “You’re the only person who knows about this.”
I frown. “You haven’t confided in a friend?” I ask, a little shocked.
“No. I don’t want my friends to judge Anthony, or me for staying with him.”
“I see,” I answer. “Beth, do you think that the friends you keep are really on your side?”
She looks at me as she processes what I have just asked her and then she shrugs. We both sit in silence as I wait for her to speak, but she doesn’t.
Mmm, we will come back to this. “Did you speak to Anthony about foreplay?” She shakes her head. “Mmm ok, so can I guess you didn’t do as I suggested and ask him to try Viagra?”
“I just can’t.” She looks so vulnerable my heart goes out to her. “I don’t want him to think that I think he’s not good enough for me in bed.”
“But it’s ok if he makes you feel lacking,” I sigh. She nods. “Bethany, I don’t know a woman alive that can come in seven minutes of penetrative sex with no foreplay.” She nods. “You know Beth and this is off the record but I take at least twenty minutes to get in the frame of mind and then another twenty minutes, at least, of foreplay before I even want to think about sex. He needs to know that it’s not happening. Maybe he would try harder if he knew.”