Social Anxiety Often Co-morbid With Premature Ejaculation

Premature ejaculation is a difficult subject for many men, and there are many approaches to helping sufferers. Medical solutions include prescribing antidepressant drugs with a known side effect of retarding ejaculation. Physical solutions include building core stability to enhance ejaculatory control. Psychological solutions involve retraining the mind to pay attention to the dick resulting in a more mindful understanding of the sexual arousal cycle.

What I find interesting about most of the self help books on premature ejaculation, and indeed, therapy manuals for psychotherapists, is that they invariably presume the participation of a partner to help with the therapeutic process. Given that premature ejaculation often starts in the teenage years, what I find is that many of the men I see haven’t got partners. They avoid sex, and therefore relationships, because it is too painful to face the ‘humiliation’ of coming too soon.

What I find with single men with premature ejaculation, is there is not just a problem of ejaculatory control that needs to be addressed in therapy, but also the patterns of social behaviour, thoughts and feeling that the person has built up around their lack of ejaculatory control. For some men they even meet the diagnostic criteria for social phobia for sexual situations.

For these men, helping with ejaculatory control is just the start. We also need to unlearn a lifetime of anxiety and fear around sex. At the heart of social anxiety is a fear of social humiliation. In the case of premature ejaculators, it is the humiliation of coming too soon, and the feared negative appraisal of that event by the sexual partner. The trouble is, the self help books don’t tell you how to do that. The result is that a guy can have ‘the facts’ about solving his premature ejaculation, but is too scared to put them into practice.

If you are a premature ejaculator and this all makes sense to you, why not try reading up on social phobia and apply it to your history of sexual behaviour. I can recommend Overcoming Social Anxiety and Shyness: A Self-help Guide Using Cognitive Behavioural Techniques by Gillian Butler.