How difficult is it to treat delayed ejaculation within a short-term psychosexual model? A case study comparison

ABSTRACT

Delayed ejaculation (DE) has historically been considered an obscure and difficult to treat condition. This article uses two composite cases to draw attention to young men experiencing DE who respond well to a short-term integrated psychosexual intervention. Via comparing and contrasting two cases the article questions whether the upheld belief that men with DE have repressed hostility towards women coupled with a fear of letting go can be generalised; alternatively it suggests that pornography usage and masturbation styles are important in considering this disorder. This article therefore supports previous research that has linked masturbation style to sexual dysfunction and pornography to masturbation style. Finally, the article uses psychodynamic theory to consider whether the prognosis of these cases could be predicted and concludes that the clients’ early experiences may be one of the factors in predicting suitability for short-term behavioural interventions. The article concludes by suggesting that the successes of psychosexual therapists in working with DE are rarely recorded in the academic literature, which has allowed the view of DE as a difficult disorder to treat remain largely unchallenged. The article calls for research into pornography usage and its effect on masturbation and genital desensitisation.

KEYWORDS:

• Delayed ejaculation (DE)
• short-term psychosexual therapy
• pornography
• masturbation
• genital desensitisation

Acknowledgments

Thanks to Jane Seymour and David Hewison (Tavistock Relationships) for their valuable feedback on this article and Kris Teelwah and David Phillips (Croydon University Hospital) for generously supporting my desire to publish.