Premature ejaculation – the sexual counseling

We are speaking of premature ejaculation, Latin: ejaculatio praecox, if the man’s orgasm comes so early, that intercourse becomes impossible. In extreme cases, a man will already ejaculate when merely touching or embracing a woman. In other cases, a man will ejaculate during foreplay, during penetration, or shortly after.

Premature ejaculation has psychological reasons

Fotolia_46963768_XS kopie

© Aaron Amat/

Kevin has an appointment with a sex counsellor. He is very depressed, because he’s been having premature ejaculations for over 6 months now, and his sex-life seems ruined. „As soon as we start, it’s already over”, he shares desperately.

Kevin is 34, and a post office clerk, and married to Britney, 31, a bank employee since 7 years. Their daughter is 8. So far, their sex life has been normal. Before his marriage, the good looking Kevin had quite a number of girlfriends, and never any problems with sex.

Unlike impotency, premature ejaculations usually don’t have any organic reasons, in other words: the organs are healthy.

However, an inflammation in the urethra or the glans can increase the penis’ sensitivity towards pressure and rubbing, so that a premature ejaculation is being triggered. But this is usually realized by the patient himself, because the pain that goes along with inflammation will cause him to seek advice, not the premature ejaculation. Aside from this, a premature ejaculation always has psychological reasons and could therefore be called a ‘psychosomatic disorder’.

Premature ejaculation is a big mishap

Kevin’s counsellor soon realizes how desperate Kevin is. Kevin told him he „must get rid of ‘this’ as soon as possible”.

Psychosomatic disorders are usually triggered by a certain happening, which is bothering and burdening us and then, our brain begins to create a symptom in rather complex ways.  This process is rather interesting, because it has to do with our millions of year old evolution. I will come back to this later on.

Once a symptom has developed, it takes possession of its victim more and more, and keeps growing, quite like a cancer growth of the psyche, until it gains control over the whole personality.

Ever since it happened to him for the first time, the notion of prematurely ejaculating has been poisoning Kevin’s thoughts.  Because sex has always played a central role in his life, it now tends to ruin his joy of life altogether.  He was always been proud of having a good body and of his qualities as a lover, and so, ejaculating too soon is making his life a mess. After all, he has a gorgeous woman that he loves and desires so he is overwhelmed by the fear of losing her if his problem persists…!

His wife Bridget, however, is not overly concerned!  Her intuition is telling her that he is driving himself nuts this way and is so adding to his problem! Her advice is reasonable: don’t take it so hard! But now a paranoid Kevin keeps wondering if she may have lost interest in having sex with him!!

A vicious circle begins

Fotolia_47181737_XS - Kopie

© bluedesign /

All psychosomatic symptoms – including premature ejaculation – tend to reinforce themselves. The anxiety and insecurity that caused a symptom will fuel and reinforce it with each new „catastrophe” that happens. It’s always like this, and so each premature ejaculation will provide new energy for the vicious circuit and condition the next one. In this way, a symptom can become completely autonomic.

It’s even possible, that, for some reason the triggering circumstance will fall away – but the symptom will stay, because it has established itself. This is the real problem with all psychosomatic issues – whether they are a heart discomfort, a phobia, or a harmless insomnia.

Now if a psychotherapist starts to tackle the problem, he must keep in mind that focusing on the trigger may mean missing the target, since it may not be there anymore. Kevin’s problem is a little bit different because he has never had problems before, and so his type of premature ejaculation is not a primary but a secondary premature ejaculation.

Premature ejaculation and partnership dynamics


© Africa Studio /

In any case of premature ejaculation, taking a look at the dynamics in the partnership is of crucial importance. Special attention needs to be paid to the balance of power between the two lovers. Each relationship between 2 people is also defined by the balance or imbalance of power between them. These forces are always present.

In a „symmetrical” relationship, they will neutralize each other – or, one of the two is emotionally „overweight”, and will need and want the other one more than he is needed and wanted.  This will impact how they interact with each other, and especially touch on their sexuality, because here, millions of years old patterns of behaviour will kick in.

Marriage in a new gown

When Bridget gave birth to her daughter 8 years ago, she loved taking care of her small family and stayed at home.  But after a while, she felt seriously bored and unchallenged.


© Africa Studio /

When she received an offer by her bank, asking her to return, she jumped at the occasion and – despite the long break she had taken – she was quick to update herself. This bit of success boosted her self-confidence tremendously and gave her life a brand-new coat of paint.

Kevin was happy for her; initially. Later on, envy and fear blended in – the fear of losing her. Office parties, birthdays, a staff outing to Paris, phone calls from colleagues he didn’t know; and Bridget joining a tennis club with a friend, all this  made Kevin feel like losing control over the whole situation. And then the problems with premature ejaculation began, and made his misery complete.

Bridget’s new life had dramatically changed the partnerships dynamics between them…and from a “stay at home mummy” she was now slowly developing into a career lady, and gaining more autonomy.
A shift of power in the relationship to her side left a startled Kevin feeling insecure.

Kevin remembers to this day how it all began: Bridget came home late one night from a bank party and he wanted to have sex with her. But she was too tired and wanted to sleep. Kevin was not able to accept her ‘no’ as a ‘no’ and after some back and forth, she finally resigned and gave in.  But she couldn’t get into it as she usually did. Instead of just dropping it and stopping there, Kevin urged her to continue, and after he penetrated her, he climaxed after a few pushes.

Once, premature ejaculation was useful

Many physical dysfunctions like premature ejaculation once played an important role in our long evolutionary development. But today, many have lost their purpose, while still being developed during our embryonic development. Nature is slow to deprogram mechanisms which once proved successful, and who knows if it ever will because we might fall back into the primordial stage at anytime and then these mechanisms will secure our survival as a species. As a result, our once successful primitive nature can break out in modern times, where it is of little help and highly counterproductive for the individuals involved.

Mating in the animal kingdom is usually a short affair


Lions have a short copulation ©Alta Oosthuizen/

Premature ejaculation is here the normalcy.  The reason is that most animals are easy game for predators while distracted. Copulating is therefore dangerous and needs to get dealt with as quickly as possible. Also our ancestors mated in this short way, there was no celebrating an erotic finesse.

But as we developed as a species, our mating time grew to an over indulgence in the senses. While „quickies” went out of fashion, they still served their purpose when it was necessary to finish fast. When a primeval couple was disturbed, he ejaculated on the spot and so both fulfilled his mission and saved both their lives, – well done!
Or, if he became aware that a capricious primordial beauty didn’t really know if she wanted to or not, and might suddenly change her mind during intercourse, he finished fast, intent on having his release. In terms of evolution, this type of man was also successful, because he procreated despite of adversities.

The activated primordial mating pattern

We can now understand what happened deep down in Kevin’s sub-consciousness.

The primeval copulation pattern of premature ejaculation which nature provides for difficult situations kicked in. Subconsciously, he now perceives his wife as a fickle ‘maybe’ candidate that he needs to release before she will change her mind. This is the start of a vicious circle – reinforced by anxiety and sustained by the fear of failure.

Sexual counselling will help Kevin gain insight into how his problem came about and satisfy his need to understand himself. But that won’t cure him from premature ejaculation. This will only happen if he can gain a positive attitude to the change in his marriage and psychotherapy could help him.

The reason for premature ejaculation is always fear

If a premature ejaculation is primary, it has nothing to do with the actual partnership, but will happen with each and every woman. What once was a merely psychosomatic symptom has become an autonomic and   chronic condition and the vicious circle of failure and fear of failure can’t be left anymore.

In this case sexual counselling aims at equipping the couple techniques which allow the man to regain control over his arousal. The partners support is of vital importance here. A man without a partner can’t work on his problem, since obviously; masturbation can’t be the tool to treat it. The first couple exercises for a primary premature ejaculation are identical with the ones for secondary premature ejaculation, so please take a look here: Impotence

How a man can learn how to control his ejaculation reflex

The couple will be using the exercise „stimulating stroking”, during which the man will learn how to control his arousal and to postpone an ejaculation. The woman will stimulate the man with her hand and he will signal her to stop when he is close to a climax. Then he will allow to the arousal die away completely. Once it’s gone, the exercise will be repeated.

It’s very important that he will come quite close to the „point of no return”, risking an ejaculation. It’s quite possible that this might occur, while he is still trying to develop more security. Once the man has lost the anxious apprehension of premature ejaculations, and feels sure that he can control his ejaculation reflex, the two can try normal intercourse. It would be a good practice for him to stop after a few pushes, or pull out, again to let the erection wear off.

If problems occur, intercourse should be postponed and the two should return to the manual exercises. Applying the squeeze technique, during which one partner stops the orgasm by squeezing the glands, is usually not needed. The above stimulation technique is much more pleasant for the couple, because it is not so technical and perfectly sufficient to gain control over premature ejaculations.

Of course the description of the exercises was simplified and abbreviated, to give you an idea what it is all about, in reality, a lot more components come into play, as well as the individual situation of the couple. But I do hope I was able to give you a road map and to show you where the journey will go.