Some men are unable to reach the completion of the treatment procedure without prior psychotherapeutic resolution of their conflicts.

There are a number of positive emotional reactions to the stop-start technique. Often, for the first time, these exercises allow a man to feel a passive role in sexual relationships. The man realizes that it is pleasant not only to “give”, but also “to receive”. He is again convinced of the love for himself by his wife, who will not abandon him, even giving himself and sacrificing his pleasure for the time when he “no longer serves” her.

If the extravaginal phase of treatment reveals emotions associated with the role-playing behavior of the person giving / receiving caress and the passive-receptive role of the husband, then the coital phase of the “stop-start” exercise, as a rule, reveals the emotions associated with progressive improvement in the man’s condition. By the time the treatment has reached the “stop-start” stage with the woman’s posture “above”, the man has already largely mastered the control of ejaculation. In simple cases, a more perfect sexual activity of a man causes delight and relief for both spouses. However, this improvement can be threatening for both husband and wife. A woman can clearly realize the source of her experiences and fears (although often this awareness is absent), and then the woman’s condition can be assessed by her actions aimed at “boycotting” her husband’s successful treatment. This “boycott” can be expressed in non-cooperation, expression of fatigue and, even worse, an open aversion to the recommended procedures. At this point, some women make aggressive critical attacks against their spouses. They discourage their husbands, let them know that even if they regain control of ejaculation, they will still be losers in other respects.

Motives of this kind of negative feedback for improvement in the husband’s condition are rooted in the deep personal insecurity of the wife. She feels “not at ease”, she is not sure of her ability to keep her husband “at herself”. His difficulties and her tolerance made her husband addicted. Now that he is about to regain the ability to act normally, will he not look for other, more attractive women? It is obvious that in such a situation a woman should receive support, assurances of love and conviction in her indispensability for her husband.

Another source of anxiety in the event of the restoration of normal ejaculation in a man is his wife’s sexual difficulties. Many wives of men suffering from premature ejaculation themselves are to some extent susceptible to manifestations of sexual disorders. It is not surprising that they and their husbands attribute these manifestations to the violations of the husband. Finally, how can one expect a full-fledged orgasm in a woman whose husband ends the sexual act prematurely? However, in most cases, sexual disorders of women are still not associated with the sexual status of their spouses.

Ejaculatory problems for her husband for a long time served as a cover for his wife’s own problems. Now, when he can perform sexual intercourse for a long time, the question arises about his wife’s ability to have an orgasm. This situation is fraught with danger, especially if there is a legend in the family circle, according to which the husband is recognized as a source of trouble, and his wife as a victim.

In order to pre-empt such emotional reactions, it is necessary already at the first session to give a clear warning that the treatment of premature ejaculation will necessarily be successful. First, the premature ejaculation of the husband should be corrected, but successful control of ejaculation by the husband does not always guarantee the normal state of the wife. The restoration of control by the husband has no special meaning here. Sexual status of the wife can be assessed only after the husband has achieved successful control. If it turns out that his wife has problems, their resolution will be followed.

As an example of the treatment of premature ejaculation with sex therapy, one can cite excerpts from the book by the well-known Czech sexologist S. Kratochvil “Psychotherapy of family and sexual disharmonies”: “V. neurotic disorders arising from the exacerbation of long-existing marital disharmony. Married 11 years, spouse two years younger than her husband. Have two children. He married at 24 after one-year dating, for love. He very much wanted his wife to be a virgin; at the beginning of sexual life with her did not recognize that it was not. Six months after the wedding, he learned that his wife had previously had sexual intercourse with another man. I felt deceived and made scenes of jealousy. Became irritable. Four years ago, I accidentally found out that a spouse was cheating on him with his co-worker. He reacted aggressively, subsequently constantly reproaching her for infidelity. Recently, the wife has a serious relationship with another man. The husband reacted violently and demanded a divorce. When the spouse agreed to a divorce, he refused to divorce and made a suicide attempt. The spouse decided to break the love affair, which led to the improvement of family relations. After resolving the conflict, the relationship between the spouses was good.

Husband sexually was more excitable and wanted to have intercourse several times a day. He ejaculated after 2 minutes from the start of sexual intercourse, including with repeated acts. The spouse was also sexually excitable, but with a short intercourse she did not reach orgasm, therefore during intercourse with her husband she never reached sexual satisfaction. It was possible to bring her to a state of orgasm with manual or oral stimulation, which her husband used, but she achieved full satisfaction only during a coital orgasm. What she could not get during intercourse with her husband, she was looking for in extramarital affairs, which, with her husband’s jealousy, caused conflict and deterioration of sexual relations.

The course of employment. The husband was hospitalized for 6 weeks, and the wife – for the last 2 weeks of his hospital stay. Prior to this, group psychotherapy sessions were held with her husband – with the aim of correcting his form of response in marital relationships. It seemed that he had already developed a critical attitude towards his rigid, “non-adaptive” behavior. However, when he entered the department, his wife restored old behavioral stereotypes. During the first group session, he gave his wife the scene of jealousy, and they mutually blamed each other. It should, above all, teach them to communicate correctly. A whole week was devoted to this, during which the spouses slept separately. On the 2nd week of their joint stay, they were offered sexual tasks. There were no problems with the choice of contraceptives, since the wife had previously introduced a contraceptive coil. The spouses spent tactile stimulation on the first evening; then the husband had to try to get the satisfaction of his wife by stimulating the clitoris (the wife had to guide his hand with her hand). After that, the wife was supposed to stimulate her husband’s penis using a head compression technique to prevent ejaculation. Then in a sitting position from above she spent slow frictions.

The next day, the couple engaged in tactile stimulation, determining the presence of other erogenous zones. They easily achieved the onset of orgasm from his wife during stimulation of the clitoris (with her active help). Then she, remaining in quite strong excitement, went on to stimulate the penis of her husband. Stimulation with two compression of the glans head continued for 8 minutes without ejaculation. Then the wife in a state of strong sexual arousal in a sitting position, introduced the penis into the vagina and with her own movements (the husband remained motionless, in a state of relaxation) quickly reached the second orgasm simultaneously with the onset of ejaculation in her husband.

Suddenly, quick success stimulated spouses. With further studies, they had to extend the period of intravaginal frictions by slowing them down, interrupting them and applying compression of the glans penis. On the 3rd day, the spouses reported that they first performed tactile stimulation, achieved a clitoral orgasm from their wife, and then, from a sitting position on top, periodically produced slow frictions. Passively lying husband focused his attention on sensations and recognizing the time of onset of the pre-ejaculatory phase, when it was necessary to stop stimulation. After half a minute of cessation of stimulation, they conducted a new immission and continued slow frictions. At the end of intercourse, his wife with her quick movements caused a mutual orgasm.

On the other evening, the spouses were instructed to train the spouse’s “exposure” during sexual intercourse and in other positions, while ejaculation should be achieved in the position of the wife sitting on top. On the 4th day, they reported that the wife had reached the first orgasm with extra-sectoral stimulation, later they had sexual intercourse in the position of the wife with her back to her husband, and they again reached orgasm in the usual position of her sitting on top. The wife carried out frictional movements in the recommended position without additional stimulation of the clitoris and reached orgasm 2 times, first by herself and then simultaneously with the spouse. She felt this “vaginal orgasm” as qualitatively different from the orgasm that occurs during clitoral stimulation. Under him, she achieved greater sexual satisfaction.

After a day of rest, it was recommended to have sexual intercourse in postures related to the activity of a man: in the classical pose and a tergo pose. During the 5th consultation, the spouses reported that the husband had sexual intercourse without ejaculation for 4 minutes in a pose and tergo. During the transition to the classical position, the deep penetration of the penis into the vagina greatly aroused his wife. Sexual intercourse ended in the position of the wife sitting on top. the wife reached orgasm with fast movements on the husband’s penis for 4 minutes. The husband regulated his arousal so that ejaculation occurred immediately after the onset of orgasm by the wife. After the 6th consultation during intercourse, the husband caused an orgasm in his wife during frictional movements already in the classical position before he reached ejaculation. During the transition to the initial position, sexual intercourse did not end, so the wife continued to stimulate the penis, sat on top of him and with her movements in a straightened position, they reached a mutual orgasm after 5 minutes.

The husband learned to continue sexual intercourse for short breaks for more than 20 minutes, and caused a coital orgasm for his wife 2 times during one intercourse. Normalization of sexual relations led to sexual satisfaction of partners, restoration of emotional connections and mutual normalization of behavior. A positive result from the lessons was achieved due to the active cooperation of the wife and the presence of good sexual reactivity, which was previously inhibited during the marriage. The wife noted that thanks to her studies, she activated sexuality, which she had not previously decided to exercise with her husband.

From the follow-up information received 14 months after the course of therapy, it is known that sexual and marital relations with partners are normal. ”