A typical history of an acute episode of alcohol consumption as an etiological factor in the onset of secondary impotence is classic in its structural content. The clinical picture is one of acute psychic trauma on a circumstantial basis, rather than the chronic psychosocial strain of years of steady attrition to the male ego as described in the case history for the premature ejaculator.
The ultimate level in couple communication is sexual intercourse. When there is couple complaint of sexual dysfunction, the primary source of absolute communication is interfered with or even destroyed and most other sources or means of interpersonal communication rapidly tend to diminish in effectiveness.
To establish at least a minimum of patient screening, at the onset of the clinical treatment program, no units were accepted in therapy unless the complaining partner in the couple (e.g., the impotent male or the non-orgasmic female) had a history of at least six months of prior psychotherapeutic failure to remove the symptoms of sexual dysfunction. Very soon this proved to be a poorly contrived standard, of little screening value.
There have been three cases referred as problems of dyspareunia in which individual women were involved in gang-rape experiences. In all three instances there were multiple coital connections, episodes of simultaneous rectal and vaginal mountings, and finally traumatic tearing of soft tissues of the pelvis associated with forceful introduction of foreign objects into the vagina.