International Handbook of Clinical Hypnosis - E-Lib FK UWKS

244 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
chapter. The control over the opening of the vagina is best left clearly in the hands
of the female patient, rather than being on demand of her partner.
TREATMENT OF DISORDERS OF ORGASMIC RESPONSE
TREATMENT OF PREMATURE EJACULATION
Premature ejaculation is one of the most treatable of male sexual dysfunctions; a
variety of direct and indirect suggestions have been used in its treatment. Many
approaches have focused on anxiety reduction as the primary goal, as performance
anxiety is the most common cause of a rapid ejaculatory response. Hypnotically
assisted desensitization and rehearsal of appropriate sexual responding are applicable
to this anxiety-driven disorder. Creative uses of healthy dissociation and distraction
can also assist the male in being able to psychologically distance themselves
from overarousal.
Acquired oversensitivity to sexual stimulation has been implicated in those who
observe their sexual responsiveness too closely. On that basis, partial genital
anaesthesia to reduce erotic stimulation has been used Doane, 1971) with a later
return of sensation during intercourse. Time distortion techniques have been applied
to extend the perceived length of time of sexual activity, reducing anxiety and
resulting in a reduction of overarousal.
TREATMENT OF RETARDED ORGASMIC RESPONSES IN THE
MALE
Careful evaluation is required to determine that the cause of retarded orgasmic
responses is not psychiatric, organic or illicit drug- or medication-related.
The adequacy intensity, involvement and duration) and expectations of sexual
stimulation need to be considered. It is possible for a delay in the orgasmic
response to re¯ect inadequate sexual stimulation, which may in turn re¯ect inadequacies
in sexual behavior, partner involvement or some other distracting
process.
All the approaches designed to heighten sexual arousal in the female arousal
disorders can be applied to the male patient: detailed mental rehearsal of successful
sexual arousal; increased absorption and ampli®cation of initially small sexual
responses; metaphors of arousal and lubrication such as an analogy with sweating
and a healthy journey of discovery through the sexual organs and ®nding the sites
of sexual pleasure.
Dramatic e.g. television or theatre techniques) and cartoon rehearsal of arousing
sexual behavior that the patient is reluctant to relate to themselves may be used as a
model and assist in the patient giving themselves approval for sexual involvement
and pleasure.