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With continued and uninterrupted stimulation, the physiologic changes which characterize sexual response may progress and build up in intensity until they approach some maximum point of departure from their normal physiologic states. While exact measurements of these progressive developments are available on only a few of the phenomena which are involved—most specifically on pulse rates and blood pressures, as we have already shown—the more general observations on tumescence, the development of muscular and nervous tensions, the loss in sensory perception, the rates of respiration, glandular secretions, and still other phenomena make it apparent that in all of its aspects sexual response may be an accumulative phenomenon which is most effectively concluded by the occurrence of orgasm.

In most human females and males, sexual responses usually develop irregularly, with sudden upsurges of arousal and the development of preliminary peaks and periods of regression in the course of an over-all rise to continually higher levels of response. The maximum peak may be reached only after a sudden rise which is more abrupt than any of the previous rises, and the level of the final peak may be much higher than the level of any of the preceding peaks of response.

Some persons, particularly younger males, may respond instantaneously to sexual stimulation and proceed quite immediately, with sharp peaks and regressions which follow rapidly upon each other, until they suddenly surge to the maximum level of response at the moment of orgasm. Some persons, particularly older persons, experience more even and more steady rises in their responses, and reach their maxima without the abrupt developments which characterize the approach to orgasm in many other individuals. There are, however, some older persons, including both females and males, who continue to react in an abrupt fashion throughout their lives.
For examples of variation in the build-up to orgasm, see the diagrams and charts in: Boas and Goldschmidt 1932:99. Dickinson 1933, 1949:figs. 126-127. Klumbies and Kleinsorge 1950a: 952-958; 1950b :64-66. Ford and Beach 1951:245-248 (Fig. 16 is theoretic and inadequate).

The speed of reaction to sexual stimuli, the speed with which physiologic changes progress toward the peak of arousal, the presence or absence of preliminary peaks and regressions, the abruptness of the approach toward orgasm, the level at which orgasm occurs, and the pattern of the muscular reactions which may follow orgasm are likely to remain more or less uniform throughout most of an individual’s life. This is established by specific records which we have on the nature of the responses of a limited number of persons who had been observed over long periods of years—over as many as sixteen years in one case, and in some cases from pre-adolescence into the late teens or twenties. These individual patterns of response may depend at least to some extent on the physiologic equipment with which an individual is born, for clinicians report striking individual variation in the responses of even very young infants to general contact, to pressure, to specific tactile stimuli, and to genital stimulation. There is, however, considerable reason for believing that some aspects of the behavioral pattern represent learned behavior which has become habitual after early experience.

Many persons may exert some deliberate control over the normal course of their sexual responses in order to modify or prolong the activity or particularly pleasurable aspects of it. By regulating the frequency of sexual contacts, by controlling the breathing rate, by holding muscles in continuous tension, by avoiding continuous stimulation, by avoiding fantasies or other controllable sources of psychosexual stimulation, and by still other means, it is possible to extend the period of preliminary activity and delay the upsurge of response which carries the physiologic developments to climax. The sexual literature for least four thousand years, from early Sanskrit to current marriage manuals, has recommended that the male in particular delay his responses in order that the female may reach orgasm simultaneously with him. There are, however, many persons who, at least on occasion, find greater satisfaction in sexual relations which proceed directly to the point of orgasm.

Coitus reservatus, the Karezza of the Sanskrit and Hindu literature, represents a maximum sophistication of such deliberate control. It has been practiced by whole communities, like the Oneida Colony in the nineteenth century in New York State. In this technique it is common for the individual to experience as many as a dozen or twenty peaks of response which, while closely approaching the sexual climax, deliberately avoid what we should interpret as actual orgasm. Persons who practice such techniques commonly insist that they experience orgasm at each and every peak even though each is held to something below full response and, in the case of the male, ejaculation is avoided. We now interpret the supposed orgasms as preliminary peaks of arousal. The possibility of prolonging this sort of experience, especially at any high level of response, apparently depends on the very fact that there is no orgasm.
Coitus reservatus, or Karezza, is the subject of some literature, including two volumes: Stockham 1901(?). Lloyd 1931. For the history of the Oneida colony, see Parker 1935.

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