Dear Yarning Lover, thanks for reading, your comment and interest in this! I love to share my experience which hopefully will help others get this too :-) So, to answer your first question, no - it's not an obvious sex-like orgasm for the therapist to notice unless you are a very expressive person. I usually stay face down when this happens (I rarely got it face up).

My body and all its parts relax profoundly just before I reach the orgasm - and same goes for my genitals which feel warm (probably blood flowing, I don't know). I don't have any sexual thoughts. I don't even focus on my genitals but on the spot that is being massaged. When the orgasms happens it almost starts first from my belly and then propagates to my genitals.

It's a totally different kind of orgasm but very intense because I can feel internally feel the pulsations of the orgasm inside my vagina. I would say it's like an amplified mindfulness.

Also, take this from a woman who took ages to come even from direct oral stimulation. After I discovered that I can orgasm from a massage, a whole new sensual world opened for me. It was a gift that I didn't ask for, but I am very grateful of, to this day! I hope you'll be able to get your wife this kind of pleasure, but I think it's a combination of technique (From the massage therapist - like massaging a spot long enough to relax but not excessively to feel as "too much") and abandonment through trust from the person that gets the massage.

Eva.