Sally, aged 22, was giving a routine sexual history at her local Sexual Health clinic because she was experiencing some pain during sexual intercourse. Shehad been referred by her GP. She was specifically asked about orgasm and replied that she was 'not sure'. Later, she realised that although she has been sexually active for over three years, and 'quite enjoyed' sex, that she had never had an orgasm. Her friends at work had talked about having a climax, and Sally had always thought that they were discussing romantic feelings, or being very relaxed. She had never tried masturbation, and was too shy to mention her predicament to her current partner,Jeremy, who seemed to be unaware.

The nurse gave Sally a textbook to read on overcoming sexual fear, and Sally realised that she needed to learn to relax, to 'let go', to explore her own body, and to masturbate before involving her boyfriend, Jeremy. She began with some graded exercises, all carried out in the privacy of her own home. The nurse was very encouraging and gave Sally permission to give herself pleasure, and to take her time, and then report her progress back in the clinic. While she was doing these exercises, Sally came to understand that she had always been frightened of 'letting go'- for example she had never learned to swim, becuase she couldn't lie back and float on the water. She also came to see how much she resembled her mother- a perfectionist- who was always available to please others, but less inclined to let go and enjoy herself.

Sally learnt how to masturbate to a climax within four weeks of treatment, although she was not able to reach a climax with Jeremy. The nurse explained that both of them could attend the clinic for some work together, but Jeremy said that he was 'not bothered'. Sally was upset about this and eventually decided to break with him. She decided that her next partner would be somebody who would allow her to climax in his presence, and then during mutual masturbation, as well as during sex.