Treatment of Premature Ejaculation with Cognitive Behavioral Therapy

Abstract

Cognitive behavioral therapy (CBT) is a type of therapy that accentuates the interrelationships among cognitions, emotions, and behaviors, and suggests that changing any one of these three aspects leads to changes in the others. Treatment for emotional problems targets cognitions and behaviors as a pathway to moderate emotions. Men with premature ejaculation (PE) have difficulty focusing on their own sensations; experience thoughts of anticipatory failure; have difficulty relaxing their bodies while sexually aroused; experience a lack of awareness of body management techniques; overfocus on their partner’s body and reactions; and experience a restricted, uneasy, or anxious sensuality. Several CBT techniques are employed in the treatment of PE based in these psychosexual skills deficit. Traditionally, an array of individual, conjoint, and group therapy approaches employing behavioral procedures—such as stop-start (Semans) or squeeze technique (Masters and Johnson)—have been used to treat PE. The efficacy of these therapies has been attributed to heightened male awareness of sexual sensations, focus on pleasure, reduced anxiety and performance demands, and a decreased emphasis on intercourse.