Gestalt psychotherapy approach to premature ejaculation

Abstract

Men who report difficulties related to premature ejaculation often experience an internal division, in which the desire to prolong the sexual act and satisfy the partner comes into conflict with the sensation of loss of control over their penis, which seems to act autonomously, accelerating the ejaculatory process. This fracture leads to a disconnection between the individual and their sexual organ, accompanied by a sense of dissatisfaction and self-condemnation. Most therapeutic strategies based on cognitive models focus on the idea of reducing penile sensitivity, encouraging the patient to divert attention from excessive sexual sensations. Furthermore, the patient is often unaware of an underlying intentionality that wants to reach orgasm quickly. However, the approach proposed in this research - starting from a Gestalt epistemology - differs from a corrective vision of sexual experience. Instead, it promotes active support of the patient's identification with his penis, allowing him to express and recognize underlying intentionality that may differ from conscious expectations. Our study explores a therapeutic method that promotes a dialogue between these two intentions: the one oriented towards satisfying the partner and the one seeking a quick orgasm. This process takes place in an interactive context involving the therapist and the patient. The therapist alternately assumes the identity of the patient and her penis, facilitating the dialogue between these two perspectives, allowing the emergence of often hidden experiences. The objective of the therapeutic approach is to bring these experiences into the therapeutic relationship or into broader social contexts, encouraging the rediscovery of the creative function of the symptom. An attempt is made to understand why the symptom persists and to allow the patient to take responsibility, reducing the anxiety and frustration associated with premature ejaculation. This study aims to verify how, through the process of identification and alienation, the symptom of premature ejaculation can become less necessary and, when it occurs, the patient can question himself more consciously about the reasons behind his choice to ejaculate quickly. The ultimate goal is to allow the patient to experience a significantly reduced level of anxiety and frustration in the area of her sexuality.