ABSTRACT
Prescriptive psychotherapy would provide a cookbook approach that would enable clinicians to look up a particular problem in a comprehensive cookbook and find the correct recipe for a cure. The type of prescriptive psychotherapy that the author was practising was both an empirically and experientially based eclecticism. The key cases represent the common dilemma a prescriptive approach faces that standard prescriptions succeed smoothly sometimes, fail miserably other times, and are met with resistance and difficulties often times. Each case involved a chronic and severe form of vaginismus that made intercourse impossible. A behaviourally oriented formulation conceptualises vaginismus as due to conditioning experiences wherein penetration becomes associated with pain or fear. Vaginismus is maintained because it serves as an avoidance response that reduces intense fears due to anticipated pain. Maintenance is the stage in which people work to continue the gains attained during action and to prevent a relapse to their more troubled patterns of functioning.
