Behavior Therapy

Behavior Therapy For Delayed Ejaculation

Therapists often start with mindfulness and breathing techniques which will increase a sense of self-awareness and induce progressive relaxation.

Naturally, one of the reasons that a man doesn’t reach the point of ejaculation is that his sexual arousal isn’t high enough to trigger his ejaculation. He hasn’t (or doesn’t) reached the point of no return, so using techniques that increase sensory receptiveness and awareness are also a helpful part of any solution.

For example, men with delayed ejaculation may find that they have a kind of “sensory defensiveness”.

What this means in practice is that particular sensory input either doesn’t register in the normal way, because it’s repressed, or it produces a high level of anxiety, sometimes, in fact, overwhelming anxiety.

Woman lying on bed looking seductive
This may or may not be arousing to a man with delayed ejaculation. Or it may be threatening.

Now I know from working with men that such anxiety can be produced by many different aspects of intimate relationships: for example, open-mouthed kissing, or the sensation or smell of the vagina may produce a great deal of uncomfortable feelings or anxiety.

And sometimes these can even produce aversion, which will actually inhibit the development of normal sexual arousal.

One way of dealing with this within a behavioral treatment approach will be to use some kind of non-demand approach: this means exploring the problematic stimulus in a way that increases the man’s tolerance of this particular type of sensory stimulation.

Just to give one example of this, if a man’s inhibited and slow sexual responses have something to do with the sensation of vaginal wetness, then using lubrication on the body, rubbing sexual organs, and exploring stimulation in the shower together may be helpful.


Idiosyncratic masturbation

As for idiosyncratic masturbation, sexual therapy would generally encourage a man with delayed ejaculation to use different positions and intensities of self stimulation, or to use different fantasies or visualizations whilst masturbating.

The aim here is to break the set established patterns that have played out over such a long time. And increased flexibility of approach to masturbation will help a man to develop further patterns of stimulation and responsivity during sex with a partner.

Should resistance come up during therapy, it needs to be explored.

Clearly resistance to therapy for ejaculatory delay, particularly in situations where a man claims that he wants to “cure” the problem, is indicative of a difficulty, either psychological or behavioral, that could get in the way of effective treatment.

As has been observed several times, men who experience resistance may well become aware that they do not, in fact, like their sexual partner.

Delayed Ejaculation and Subconscious Resistance

Delayed ejaculation can be a method of expressing that fact. It’s a way that the man’s penis can express what he’s really feeling, without him having to be consciously aware of what he’s feeling.

And yes, you are correct if you’re wondering there might be a danger here that the relationship will end when this fact becomes conscious.

But another possibility is that exploring this resistance consciously can offer men and their partners and insight into why sex between them is an arousing or unappealing.

It may be, for example, that a man who is slow to ejaculate has a belief system that he is sexually inadequate, and his performance in bed is inadequate satisfy his partner.

It may be that he is being over-attentive to his partner’s needs, and paying no attention to his own sexual needs: perhaps the man believes that sex and aggression don’t mix, or that he needs to pay great attention to his partner.

It’s also possible that a man can simply be “trying too hard”, and not feeling any pleasure, because he feels a very high level of demand on him during lovemaking. That can be why his ejaculation is delayed.

Generally, with effective therapy, a man can come to see that these messages are simply picked up from other people within the family, or from some other aspect of the individual psychological history.

Masturbation as therapy for men who can’t ejaculate during intercourse

So what if a man doesn’t currently have a sexual partner? How then can therapy proceed?

The answer seems to be that a therapist could recommend that a man uses masturbation with a vibrator, seeks out further sexual information and understanding, and explores his history in a way that might shed light on why he is having difficulty reaching orgasm.

Since a few men do have difficulty reaching orgasm during masturbation, this particular form of delayed ejaculation can be approached without a partner, by exploring flexibility in masturbation techniques.

Furthermore, focusing on increasing one’s sexual arousal without looking to the goal of reaching orgasm can allow a man to experience a different approach to climax. This puts the emphasis on pleasure rather than sexual performance. This can often help with delayed ejaculation, and it certainly avoid “spectatoring“.

Sexual Pleasure vs Sexual Performance – watch the video!

Things that need to be approached during behavioral treatment of delayed ejaculation include

    • a tendency to retreat to masturbation rather than being involved with a partner
  • information and assistance around anxiety that may come up during sexual activity
  • some coaching in relationship issues such as non-demand pleasurable touch, increased intimacy, and encouraging focus on the relationship that goes beyond a sexual aspects of the couple’s interaction.
  • if there is any aspect of flashback or other sexual triggers during intimacy, then individual therapy should be applied so as to eliminate any trauma from the past.