sexual fulfillment, Masters and Johnson established a clinic for the treatment of sexual problems in St. Louis. Many of the students who trained at their center went on to establish practices in sex therapy around the country. Additionally, many of the therapeutic practices begun at the clinic, such as assisting couples to more fully experience and focus on basic physical sensations, are central to contemporary sex therapy nationwide. One of the key issues of concern to Masters and Johnson was the issue of impotence. In Human Sexual Inadequacy, Masters and Johnson maintained that 90 percent of impotence--the persistent inability to achieve or maintain an erection -- is psychological in origin. Even in older men, according to Masters and Johnson, emotional issues rather than organic problems are the main causes of impotence. Further research and improved medical testing since their claim has shown impotence caused purely by psychological issues to be closer to 40 percent to 50 percent. Masters and Johnson noted that having several experiences of impotence could cause men to withdraw from sexual activity entirely in an attempt to avoid the frustration and embarrassment of being unable to achieve or maintain an erection. Inadequate communication and fear related to only talking about sexual issues complicates the problem of male impotence, as well as female orgasmic inadequacy. However, Masters and Johnson reported great success in treating impotence, especially when it had its roots in fear of failure and performance anxiety. Masters and Johnson also studied and therapeutically addressed the problem of premature ejaculation. They found that the subjects in their studies had internalized a middle class culturally constituted fear of being unable to control the ejaculatory process sufficiently to satisfy their female partners. Working class men, they discovered, were not as concerned with partner satisfaction. As had Kinsey before them, Mas...
