In the treatment of premature ejaculation, some specialists use group psychotherapy. There are more questions about its use than answers. And today in our country, probably, there are no psychiatrists left who are able to carry out such work. But, who knows, maybe over time there will appear those who will successfully use this method as well.
The intimate sphere is usually hidden from prying eyes, and sexological patients are usually deprived of their condition and consider themselves extremely alone in their suffering. Meanwhile, the use of group psychotherapy in violation of interpersonal relationships in a partner (including a married) couple in order to correct them should not encounter obstacles.
The main tool of influence in group psychotherapy is the psychotherapeutic group. During group psychotherapy, each patient is able to model his real life situation, reveals his characteristic values and stereotypes of behavior, tells and shows emotional experiences. The group creates opportunities, as it were, to look at themselves from the outside. As a result, communication skills are acquired and more appropriate forms of emotional response and behavior are mastered.
Of course, such actions do not directly lead to prolongation of sexual intercourse, but a man is able to compare his time with another. Make sure that not everything is as bad as it seems to him. The group psychotherapeutic process embraces not only the individual problems of the patient, but also refracts it in group relationships. The specificity of group psychotherapy consists in the purposeful and conscious use of the totality of the relationships and interactions that arise between group members (including the therapist), i.e., group dynamics are used for therapeutic purposes.
Here is how, for example, O. Mellan (1968) describes the use of group psychotherapy in men with psychosexual disorders: “At the beginning, the medical history of one of the group members is reported anonymously so that the patient can remain unrecognized if he does not voluntarily express a desire to confess that it is precisely about him. In the group, as a rule, there are men with various types of sexual disorders, which relate differently to the case presented. A group discussion and discussion begins, led by a doctor and psychologist. At the same time, the members of the group often feel that they are, in a certain sense, experts who are able to detect some pathogenic connections, for example, with the family environment. This enables patients, whose medical history is being discussed, to recognize the adverse effects of the dominant mother, incorrect views on sex life, inculcated by the family environment, etc. ”
Collective psychotherapy can be carried out in small groups (3-5 people each), where recovering patients and patients with unfavorable current sexual disorders are present. And you can create groups for broad psychotherapeutic work so as not to scare away patients and not fix their attention to sexual problems. Thus, the famous sexologist S. Liebig recommended creating groups of 10-15 people and did not advise to achieve complete uniformity of the composition of patients in diagnoses and syndromes. This, according to his observations, sometimes enhances the intragroup interaction of patients and their activity. He advised holding 10-15 group conversations lasting about one hour 1-2 times a week, and in order to bring patients closer together and arouse their interest in group conversations, he recommended the following techniques:
1. Search for the general, typical in patients of the group. Based on the discovery of similar, typical complaints, patients gradually, with the help of a doctor, come to an understanding of the generality of their condition, which eliminates the idea of the exceptional nature of their disease and leads to the idea that they are not alone in their suffering.
2. The development by patients of methods for actively combating the disease. They explain to the patients that they were united in a group with the aim of teaching methods of conscious and active resistance to painful manifestations.
3. Anonymous discussion. The doctor tells patients about the general laws of “nervous” diseases and analyzes the medical history of one of the patients prescribed with them.
4. “Psychotherapeutic mirror.” This technique is a development of the previous one: the doctor’s story about the diseases reflects the facts from the case histories of the patients present, as a result of which the patients get the opportunity to hear the opinions of the doctor and other patients and at the same time remain an “undisclosed” group.
5. Therapeutic perspective. The group is formed so that it contains patients who are at different stages of treatment and with different severity of these diseases (sick and recovering, with mild and severe manifestations of the disease).
This selection principle forms the “will to health” and creates a therapeutic perspective. For the same purpose, previously treated patients are invited to group psychotherapeutic conversations. Would it be difficult for a patient who considers premature ejaculation to be the only reason for his family difficulties? He thinks that if it were not for this disorder, then his life would be exceptionally happy and devoid of any problems. But in the process of group psychotherapy, his insecurity in the male role or the fear of being rejected by a woman, or the subordinate position developed in relation to the partner, or all together, will always be revealed.
One such patient, in the group where the classes were held, came into contact only with aggressive, dominant women and was a limp instrument in their hands. This exacerbated the man’s self-doubt, and also led to the appearance of various unpleasant feelings in relation to these women. Awareness of the mechanism of such behavior and its origins, reaching childhood, allowed us to take measures aimed at changing the situation, and thereby break the vicious neurotic circle.
In group psychotherapy, many factors play an important role: from the selection of the group to the personality of the therapists themselves. And her goal in our case is not so much the treatment of accelerated ejaculation, as the correction of interpersonal relationships that are the cause or effect of this disorder.
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