In our last post, we talked about why medical treatment alone isn’t enough to tackle premature ejaculation. Now, we’re going to dive into how psychotherapy and sex therapy with a Sioux Falls therapist can help move things forward.

The guiding principle of psychological treatment for PE is to learn to control ejaculation and understand the meaning of the symptom in the context that it occurs. Psychological and behavioral interventions improve control by:

• Learning techniques to control or delay ejaculation

• Gain confidence in sexual performance

• Decrease performance anxiety

• Change rigid sexual repertoires

• Overcome barriers to intimacy

• Resolve interpersonal issues that precipitate and maintain the PE

• Come to terms with feelings or thoughts that interfere with PE

• Increase communication

From a psychodynamic viewpoint, PE can be seen as a metaphor; it is a compromised solution to one of life’s dilemmas.

Behaviorally, PE can be reviewed as a conditioned response to interpersonal or environmental occurrences. Men with PE tend to fear focusing on sexual excitement because they fear that they will ejaculate too quickly.

Psychotherapeutic treatment and sex therapy teach men to focus on their sexual arousal by teaching mindfulness meditation skills and then adding masturbation exercises to extend sexual arousal without ejaculation.

This same approach can then be applied to couples work, often utilizing sensate focus exercises.

• In psychotherapy, negative thought processes (cognitive distortions) are treated using cognitive-behavioral therapy.

• Psychoeducation is also used to give men an alternative to the sex-negative messages taught throughout our culture through religion, pornography, or a history of sexual abuse or trauma.

Does Sex Therapy Work?

Yes! Although there is a limited quality of PE treatment outcome studies, research does provide evidence that sex therapy can be effective. In addition, years of clinical experience also informs the deep understanding that psychotherapy and sex therapy are effective in treating PE.

• Masters & Johnson (1970) used the squeeze treatment technique, sensate focus, and psychotherapy and reported failure rates of 2.2% and 2.5% post-therapy and at a 5-year follow up.

• Howton (1992) found 64% of men post-therapy had a successful outcome.

• Kaplan (1983) found an 80% success rate utilizing sex therapy techniques.

Although the majority of studies did show that there are tendencies for men to have a relapse, men who...

• learned the techniques

• accepted that relapse is part of the problem

• continue to educate themselves ongoing

...report higher sexual satisfaction overall.

It is important to teach relapse prevention techniques in sex therapy and it is recommended to have maintenance sessions as needed after therapy sessions are terminated.

A Few Things You Can Do At Home

Nothing can replace working with a qualified professional, but to give you a sample of some sex therapy exercises commonly used to help men and their partners learn to psychologically focus on their bodies and sexual sensations and increase time to ejaculation, you can try these at home with your partner:

• Penetrate your partner for 30 seconds, pull out and do some other form of sexual contact for 3-4 minutes, e.g. kissing, sensual massage. Then penetrate for 30 seconds again and pull out into something else. Repeat this pattern for as long as you want to continue having sexual intercourse. During the pullout foreplay portion of the exercise, you and your partner can take turns asking for what you would like. Alternatively, you can also during penetration tell your partner, or have your partner tell you what you will do during the foreplay time.

• Penetrate your partner and have motionless intercourse for the first two minutes. Try and increase the time that you have this type of penetrative foreplay without motion. Remember, the longer you last, the longer you’ll be able to last.

Please contact our Sioux Falls therapists if you would like to learn more about our services and what is possible for you and your partner in the treatment of premature ejaculation.