Jeremy came to seek help with his fiancee Melanie, because he was having increasing difficulty in reaching a climax with her. In fact, he had not 'come' with her for over three months, although they had had good sex for the two years before that. Indeed, Jeremy told the therapist that he had been able to have a climax with other partners but not now with Melanie.

For her part, Melanie was very upset, and thought that Jeremy was getting 'cold feet' about the wedding which was due to take place four months away. She came in for therapy because she wanted to help Jeremy 'sort himself out'. Jeremy insisted that he loved Melanie, and was in fact keener on getting married than she was. His explanation was that he was anxious about satisfying Melanie, and that sex with her was more special than with any of his other partners.

During assessment, Jeremy described how his parents were 'perfect'. He saw marriage as very special and hoped that his relationship with Melanie would be as successful as that which his parents seemed to enjoy. He described himslef as a 'bit of a perfectionist' and admitted that letting go and having fun with Melanie was something he used to do but now did not have the time for.

It became clear in assessment that Jeremy had no physical cause of his anorgasmia. The fact that he was still able to masturbate to orgasm was an indication of this. His difficulties always began once he had entered Melanie's body.

He reported that he had been able to 'let go' as long as he did not feel committed to Melanie. As soon as they became engaged, he began to see sex as something very special. He was able to masturbate to climax, but could not allow Melanie to do the same for him.

He began to see that he had placed sex with Melanie in a different category to all his other sexual experiences. He was sure he wanted to marry, and compared this relationship to that of his parents. He began to see that he was too anxious to let go with Melanie.