Treatment For Retarded Ejaculation |
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Treating delayed ejaculation (retarded ejaculation)To treat delayed ejaculation, one has to know how it starts! In fact there are several theories, though few of them have much evidence to support them. The body of evidence that has emerged from clinical practice, however, is sufficiently instructive to support several theories. The limited number of men who look for treatment for delayed ejaculation does make it unreliable to assume that all cases originate in the same causes. These, then, are the common features that many men with delayed ejaculation tend to show. Many men with anorgasmia seem to have a lack of self-awareness, and a tendency to externalize their feelings. Their connection with their own sexuality is weak, and the prospect of looking at feelings is often an unattractive one. There are often obvious connections between historical life events and the current sexual problems that a man faces, although he may refuse to acknowledge the connection. Men often think that there must be a physical cause for their anorgasmia. They also frequently have experienced disappointing sex or have a limited experience of sex. Often they have been brought up in an environment which cut them off from their feelings and acted to harden them against the vicissitudes of life, a process which has been described as one of toughening up and battling against physical or mental weakness. There has often been an incomplete or inadequate opportunity at puberty to develop strong male characteristics at puberty. Sexual excitement or activity makes us all see the world in a very different way from the way we see it normally. Most men and women have a sexual life which is clearly defined and separate from everyday life. We can slip between the two with a greater or lesser degree of ease - erotic thoughts can intrude on everyday tasks, or we can be distracted during sex by thoughts of everyday activities. But we move between the two without much difficulty. However, for some men and women, moving between the everyday world and the erotic world can be challenging - the erotic world may be seen or felt as dangerous. What this approach reveals is that many men appear to wish to avoid entering their erotic world. In many cases they may not even be able to enter an erotic world, having no concept of such a thing in their minds.....if they wish to be erotic, they create an environment which seems erotic, but does not come from within their internal sexual process. There is, in essence, no arousal. Men who are in this position may also have negative associations of male sexuality with violence and abuse. This also dampens down their sexual response. The power and vitality of their sexual life is weakened and their internal erotic world is unable to provide them with the arousal needed for successful sex. Because aggression is a fundamental part of human sexuality, men who are turned off by aggression or violence will split their aggressive impulses from their sexual ones, and that further weakens their sexual desire and arousal. However, an autoerotic occupation with fantasy and porn may be arousing enough to produce an orgasm during masturbation. The consequence of all this is that men with male orgasmic disorder may not be able to function sexually with ease: they may not, for example, be able to ask for what they want sexually. They may not be accustomed to becoming aroused through the touch of a loved one, or they may not know how to get aroused by erotic stimulation. Because sex becomes mechanical and lacks real connection, they may develop behaviors which are essentially designed to avoid sex, including erectile dysfunction.
Psychological Concepts and the Etiology of delayed ejaculation In her highly influential theorizing, Kaplan (1974, 1987, 1995) compared the etiology of delayed ejaculation with constipation or with blocked micturition, where vegetative reflexes, normally under voluntary control, can be inhibited by emotional arousal or psychological conflicts. This causes an automatic defense reaction, excessive control, and the inability to release the behavioral sequence. In Kaplan's experience, the causes of emotional arousal or the qualities of psychological conflict are nonspecific and it is therefore impossible to identify a specific etiologic constellation that would allow a clear differentiation of delayed ejaculation from other sexual disorders like erectile dysfunction. According to Kaplan, the man with an orgasmic inhibition unconsciously holds back and tries to avoid the emergence of anxiety by increasing his control efforts whereas the man suffering from erectile dysfunction either totally avoids the unconsciously-dangerous sexual encounter or, more often, is flooded by anxiety when his defense mechanisms fail. In both cases, a loss of erection results. Other authors have tried to derive specific causes of delayed ejaculation from their clinical experience. Some of these assumptions refer to negative experiences like unwanted pregnancy, traumatic sexual experiences, or sexually transmitted diseases. Other assumptions focus on more immediate behavioral factors like deficient sexual stimulation, inhibitions about requests involving one's own sexual wishes and needs, the fear of getting caught while indulging in sexual activities, distorted attitudes and expectations, or learning deficits. In contrast to other sexual dysfunctions, where immediate causes like fear of failure or spectatoring are considered the deciding factors by most sex therapists, most explanations of the causation of delayed ejaculation continue to draw on in-depth explanations claiming that deep-rooted conflicts or unconscious fears or fantasies play the key role for this dysfunction. The common final pathway of these factors is the irrational fear of ejaculating intravaginally. The wide array of possible conflicts and fantasies that has been described can only be briefly listed and assigned to some broader categories here. * Incest fears: Psychosexual development has not been successfully completed and the oedipal constellation could not be solved constructively. On an unconscious level, every sexual intercourse is an incestuous situation draped with taboo, forbiddance, and the fear of punishment. * Castration fears: Fear of castration is related to incest fears but can also have different sources, stemming partly from earlier developmental phases. Castration fears can be meant in the literal sense that the penis may get injured or damaged in the vagina ("vagina dentata"), but in most cases they can be understood in a broader sense as fears of self loss or fears of death (orgasm as "little death"). *Fears of hurting the woman: These fears are, in a sense, the counterpart to castration fears and are interpreted by psychoanalysis as a defense against castration fears. In this line of thinking, the penis acts as a dangerous weapon; sexual intercourse and especially orgasm and ejaculation are experienced by the man as very threatening and harmful for the woman. Here, as in other constellations, the symptom has a protective function, in this case for the woman. * Fears of loss of control: The letting go, the altered consciousness, and the loss of control associated with orgasm are the source of strong fears. A lot of different factors can be involved, such as fear of embarrassment, shame due to a restrictive sexual upbringing, or conflicts resulting from a masculine stereotype, where the man isn't allowed to show emotions and always has to be in control. *Hostility and anger: According to these
assumptions, men with delayed ejaculation exhibit marked feelings of hostility, anger, or
rage toward women. These feelings can be traced to different sources
related to unresolved conflicts from psychosexual development and can be
hidden behind overtly caring and gentle behavior toward women. It is easy to see that the majority of these concepts are highly speculative and hardly amenable to empirical verification. As a matter of fact, some of the available questionnaire studies indicated a higher degree of hostility and anxiety in patients with delayed ejaculation (Dekker, 1993). But these studies had significant methodical limitations and their results did not allow a clear interpretation regarding the cause and effect status of these characteristics. From a more behavioral perspective, Perelman (1994) thinks that high-frequency masturbation plus idiosyncratic masturbatory techniques are among the most frequent causes of delayed ejaculation. He maintains that, in many cases, the man has conditioned himself to ejaculate only in response to a particular, often very vigorous, touch by his own hand on a particular spot of his penis. The result can be a completely conditioned sexual dysfunction (see the case of Paul and Miriam).
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Treatment of delayed ejaculation; the way to cure retarded ejaculation
] Delayed ejaculation treatment (2) |
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