Cognitive – Behavioral Treatment and Delayed Ejaculation


One of the treatment possibilities for delayed ejaculation (DE) is cognitive behavioral therapy.

This therapy can be successful because it changes a man’s level of inhibition around sexual activity, and gives him a new perspective on sexual issues. This can allow him to fully express his sexuality.

Two experts in this field are McCarthy and Perelman. They have frequently mentioned how harsh “idiosyncratic masturbatory” patterns play a role in the etiology of delayed ejaculation.

They have also observed that how a man perceives sex in his mind may be radically different to the way in which he sees the reality of his relationship with his partner.

Cognitive behavioral therapy can be highly effective with delayed ejaculation!

So, for example, cognitive behavior therapy might show him how to introduce the fantasies he uses during solo-masturbation into sexual activity with his partner.

This has two effects: it helps him to reduce the level of guilt he experiences around sex. It also facilitates an increase in the level of arousal that he experiences. And that may help him to reach orgasm.

Additionally, Perelman suggested idiosyncratic masturbation can be dealt with very simply, for example by telling the man to masturbate using his other hand.

At first this may sound ridiculous. But switching hands in this way causes a man to understand that his orgasm and ejaculation depend almost entirely on the manner in which he is stimulated sexually. 

In general, men with delayed ejaculation who try this exercise find that they cannot reach orgasm by using their other hand. This reveals the delicate balance they have created between receiving stimulation and achieving orgasm.

It can often be a moment when a man sees very clearly the true extent of his difficulty.

But of course while simple exercises like this may provide insight, they do not cure delayed ejaculation.

To overcome delayed ejaculation effectively, a combination of several treatment techniques is usually required.

Video On Cognitive Behavioral Therapy

This might include cognitive behavioral therapy. In this approach, the man’s fears and inhibitions around sexuality are explored and eliminated. 

And when these techniques are brought into the man’s relationship with his partner, he may find his negative emotions around sex reduce so much that he can get aroused naturally once again.  

The object of the exercise is not to completely remove his fear or anger around sex, or his sexual aversion if it exists. Rather, the technique simply provides him with an ability to reach a higher level of sexual expression.

This applies before, during and after sexual activity. After this, a man may be able to attend easily to simple sexual interactions such as asking his partner for what he wants.

When a couple work together on improving communication around sexual activities, the level of intimacy that can be achieved is remarkable.

Intimate connection between the man and his partner are necessary as a precursor to sexual arousal. So you can see how effective this treatment can be for retarded ejaculation.

Generally speaking, a man’s partner has to be involved in treatment for treatment to be successful. 

One of the key factors in delayed ejaculation is that men appear to be aroused: they have a hard and prolonged erection. But in reality, the man’s true level of sexual arousal is rather low.

This seems to be some kind of autonomic response in the body to the expectation of sex. This produces an erection which allows a man to have long-lasting intercourse. But he never comes anywhere near his threshold of ejaculation.

Sidebar: Why can a man get an erection even when he is not aroused?

You could see this as a way of reframing sex. You could see it as informing the man about what’s needed for him to enjoy successful intercourse.

That’s why cognitive behavioral techniques can be so successful. For example, explaining to the man the basic sexual techniques that are necessary to arouse a woman may be all the help he needs. Another approach is to show him how to enjoy sex and how to “let go” of control during intercourse.

These things can all form part of a treatment strategy for retarded ejaculation. They reduce inhibitions around sexual arousal and allow a man to ejaculate normally – or at least more easily.

Another approach is to increase stimulation and arousal. You see, all men have some particularly sensitive areas. These can provide a higher level of sexual stimulation, perhaps even enough to bring a man to orgasm.

This might, for example, involve erotic fantasy that arouses a man into sexual activity with his partner.

It might include extra physical stimulation of different parts of the body, for example the anus, or nipples. The anus tends to be an area that few men have explored, but it can provide a lot of sexual stimulation and excitement.

Men Know What To Do!

Many men are ready to deal with the issues that underlie delayed ejaculation. They almost always have some sense of what has led to their ejaculatory problems.

And that matters, because eliminating a sexual dysfunction can sometimes reveal the underlying cause. And that may hold more emotional energy for a man than the dysfunction itself.

In one case, a client reported that he felt deprived of sexual experience as an adolescent and young man. He said he had a strong need to explore sex with many different women.

This was incompatible with his marriage. So not “being able” to ejaculate with a woman was a great way of defending against the temptation of extramarital affairs.

Clearly such issues can dealt with. Complete trust and honesty between a couple is necessary for a successful resolution. However, trust is sometimes a bit lacking in couples where the man has delayed ejaculation.

Fear of that level of communication is probably one of the reasons why couples don’t look for a solution.

Couples sometimes prefer to avoid opening up the dynamics of their relationship, even when their sex life is very unrewarding.

If a sexual dysfunction is being used to disguise some fundamental difficulties in the relationship, they will need to be addressed as well!

But when a couple is brave enough to explore their deepest and darkest sexual longings, they can achieve a level of understanding and communication which allows full expression of their sexuality.

Sadly,though, couples where the man has delayed ejaculation may be content to settle for the most conventional and reassuring form of sexual interaction – or none at all!

But there are techniques which can overcome this. A couple could each write down the sexual scenario that  they would most like to act out, but have been too frightened to talk about. 

The very act of writing these fantasies down and bringing them into awareness may help a man and woman understand each other and their relationship much more fully.