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Walter was a 59 year old married man, the financial editor of a large city newspaper, and the
father of three children (two college age and one in high school). He was referred by his doctor for
psychological treatment of male erectile disorder
The problem began about four months ago, and coincided with a time when Walter was
feeling extra pressure at work due to the downsizing of the editorial staff in Walter's department.
Although Walter was not affected directly, some of his junior colleagues had been laid off, and Walter
now had to work hours that he had not seen since he was night reporter on the city beat. Not only
was he more tired than he had felt in years, but it was impossible for him not feel the sort of job
apprehension that is naturally inspired by the witnessing of mass firings. Walter had been told that
his own job was safe, but he had been in the newspaper business long enough to know that no one
could really give him any assurances. On top of it all, he had now reached a stage in life when
finding another job seemed improbable, and his financial responsibilities had peaked, with two
children in college, and a third to be entering in two years.
It was against this backdrop that he experienced his first episode of erectile failure. It
happened on a night after Walter and his wife, Cynthia, had not had sexual relations for about a
month, mainly due to Walter's utter lack of desire stemming, it seemed, from his preoccupation with
his job situation. However, on this particular night, Cynthia was decidedly in the mood, and it
appeared she would not take "no" for an answer. As she made overtures, Walter tried to dissuade
her, telling her he was really too preoccupied with work. However, she became unusually insistent.
To help him "relax," she poured him a large glass of wine, which he accepted. He still was disinclined
to pursue the matter, but then accepted a second glass, as the first did seem to ease his worries
somewhat. After consuming the second glass of wine, Walter was prepared to put his concerns aside
and attend to the display that Cynthia was now providing. She had completely disrobed in front of
him and was now stroking him in a most provocative manner. Walter was starting to get aroused.
Usually, sex with Cynthia followed a formula. They would watch the evening news in bed on
Saturday night and Walter, if feeling amorous, would turn toward Cynthia and start kissing and
fondling her. If Cynthia were similarly inclined, she would respond by relaxing her limbs and returning
Walter's kisses. After a few minutes of foreplay, Walter would assume the superior position and
Now, however, Cynthia appeared to be in rare form.
As Walter sat on the edge of their bed, Cynthia pulled down Walter's pants and undid his shirt.