Sex Therapy for Premature Ejaculation

What is sex therapy?

Couple Cousulting a Sex Therapist for Premature Ejaculation

While sex therapy for PE involves mainly the man, sometimes his partner can also participate.

Sex therapy for premature ejaculation is a form of psychotherapy with a therapist, who specializes in sexual dysfunctions. Sex therapists (or sexologists) are often members of a professional association, or accreditated by one. For example, where I live in Quebec, Canada, sexologists are members of the Professional Order of Quebec sexologists (POQS), an NPO assuring the protection of sex therapists’ patients. To be a member of the POQS, each therapist needs the required level of competence and education to treat sexual dysfunctions.

In the USA, a similar organization exists. It’s the American Association of Sexuality Educators, Counselors and Therapists (AASECT). The AASECT also certifies that each therapist has the required degree and up-to-date knowledge and competence.

If you are interested in trying a sex therapy for premature ejaculation, you have to choose a sexologist certified by your country’s or state’s main professional association. Unfortunately, some unqualified therapists do not have the required level of education, and they can sometimes present themselves as legit sexologists. Since sex therapy can be expensive, always verify your therapist certification first. If you’re looking for an AASECT certified sex therapist near you, our interactive map can help you find the closest professional.

How Does a Sex Therapy Session Work?

Patient following a sex therapy for premature ejaculationDuring a therapy session, your therapist will ask you some questions about your life experiences (including your relational and sexual experiences). They will try to identify some thoughts and behaviors that you have developed over the years that may cause or contribute to your problem. Your therapist may ask you to try some exercises at home that will help you address your issue. You can find on this page some examples of premature ejaculation exercises.

Usually, during your first sessions, you’ll be alone with your therapist. If you are in a relationship and your therapist think it would be useful to the therapy, it’s possible to have couple sessions if your partner is comfortable with it. There is, however, some form of therapies that will only treat couples together.

The Type of Sex Therapy for Premature Ejaculation

Different type of psychotherapy exists. You can find here the primary form of sex therapy for premature ejaculation backed by efficacy studies.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is a form of treatment based on the assumption that some negative thoughts are the origin of faulty behaviors (in our case, rapid ejaculation)1. From all the form of therapy that has data to back up their efficacity, it is the most used2. Other than Premature Ejaculation, it is also used to treat anxiety, mood, personality and eating disorders among other troubles3.

Several negative thoughts or behaviors may cause, or contribute to your premature ejaculation. Here is a short list4:

  • Anticipation of failure (“I always come quickly; therefore I won’t last this time either”);
  • Difficulty relaxing their bodies (muscles contractions, including, PC muscles);
  • Overfocus on arousing stimuli and on your partner / not focusing on your own arousal;
  • Misconceptions about sex / thinking that sex is an innate skill (“Sex should be spontaneous,” “Sex can’t be learned,” “Some are good at sex, I’m not”);
  • Unrealistic beliefs about average sex time (“I should be able to make love for hours without ejaculating”);
  • Unrealistic beliefs about partner pleasure and orgasm (“My partner should always have an orgasm”);
  • Fear of losing his partner / fear being cheated on (“If I don’t last long, my partner will leave me, or cheat on me”);

Other faulty cognitions/anxiety, based on some doctors and therapists experience, also include:

  • Issues related to faulty male body image (“My penis is too small to please my partner,” “I’m not muscular enough to be a real man”);
  • Misconceptions/lack of knowledge about the influence of chronic porn use on ejaculatory control with a partner;

On top of working on cognitive processes (thoughts), cognitive behavioral therapy often includes a standard behavioral therapy within it.

Standard Behavioral Therapy

The conditioning principle is the foundation of standard behavioral therapies. The idea behind a behavioral sex therapy for PE is that an inadequate learned arousal response could cause rapid ejaculations. Thus, premature ejaculators may have never learned how to control and modulate their arousal level. If you’re wondering how an inadequate arousal response can make you ejaculate too fast, you can consult this page.

The behavioral therapy consists of a series of exercises (sometimes called a re-education) to help the patient to understand his arousal better and adopt a more controlled response.

Functional-Sexological Approach

F. de Carufel and M. Trudel, two researchers from Montreal, developed a new form of therapy5 based on the reduction of “physical arousal” response. Since uncontrollable organic factors set the point where our ejaculation reflex is triggered, the therapy consists of learning ways to decrease the arousal response via breathing techniques, muscles relaxation, and a better choice of sex position for premature ejaculation.

Other Types of Therapies

You can also find other types of premature ejaculation therapies. There is, to my knowledge, no study that confirms their efficacity. That doesn’t mean that they do not work, only that a research team hasn’t tested them. Considering the cost of a therapy, I wouldn’t advise a non-proven form of therapy.

Psychodynamic Therapy and Psychoanalysis

Psychodynamic therapy is a form of therapy based on the belief that a psychic tension between the unconscious and conscious part of the psyche causes the rapid ejaculation reflex. While some therapist uses this therapy to treat PE, I’m not aware of any study that has shown it efficacity for this particular condition.

Hypnotherapy

There is some anecdotic success story about how hypnosis could help to treat premature ejaculation. However, to my knowledge, there is no study about the efficacity of hypnotherapy for Premature Ejaculation.

Find a Sex Therapist Near Me

We’ve developed a tool to help our readers to locate a certified sex therapist near them. Right now, the directory only includes AASECT accredited therapist, but we are planning to expand our lists to include members of sexologists associations of other countries. So, if you’re looking for a sex therapist in the USA, you can check our interactive map and directory of sex therapists.

Sources:

  1. Beck AT (1993) Cognitive therapy of depression: a personal reflection. Scottish Cultural Press, Aberdeen (Scotland), Ellis A (1962) Reason and emotion in psychotherapy. Lyle Stuart, New York
  2. Field TA, Beeson ET, Jones LK (2015), “The New ABCs: A Practitioner’s Guide to Neuroscience-Informed Cognitive-Behavior Therapy” (PDF), Journal of Mental Health Counseling37 (3): 206–220
  3.  Hollon SD, Beck AT (2013). “Chapter 11 Cognitive and Cognitive-Behavioral Therapies”. In MJ Lambert. Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (6th ed.). Hoboken, NJ: John Wiley & Sons. pp. 393–394
  4. Metz ME, Pryor JL (2000) Premature ejaculation: a psychophysiological approach for assessment and management. J Sex Marital Ther 26(4):293–320, McCarthy B (1988) Male sexual awareness: Increasing sexual satisfaction. Carrol & Graf, New York, Zilbergeld B (1992) The new male sexuality. Bantam Books, New York
  5.  De Carufel F, Trudel G (2006) Effects of a new functional-sexological treatment for premature ejaculation. J Sex Marital Ther 32(2):97–114