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Directed masturbation (DM) is a standard sexual therapeutic approach with established efficacy to treat female orgasmic disorder. DM, initially named graduated masturbation exercises, was developed in the early 1970s and has evolved as a step-by-step therapeutic program that focuses on different correlates of female orgasmic difficulties.

Theoretical Frame

DM is a directive behavioral technique based on the assumptions that anorgasmic women have never adequately learned how to associate positive feelings with sexuality and sexual sensations and consequently have not learned to become orgasmic; and that anxiety related to sexual activity creates negative expectations and interferes with the ability to enjoy sexual stimuli and consequently to “let go,” experience arousal, and orgasm. DM is aimed at overcoming these learning and cognitive obstacles and allows women to experience ...

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