Pathogenetic therapy is one of the forms of work for the provision of sexual assistance by sex therapists (as psychotherapists in the United States call sexual problems). It is based on conversations between the patient and the doctor, during which the psychogenic causes of the disorder are identified, more or less clear connections and motives are found, including those that have remained unconscious until now. In this case, the biography of the man is analyzed with special attention to the following:

– his relations with partners and people around him at different periods of his life; – causes and conflicts that could lead to premature ejaculation;
– worries about the circumstances with ejaculation;
– life situations that preceded premature ejaculation and could affect the occurrence of sexual disorders.

The analysis of a specialist is oriented in such cases both to the current situation of today and to the past.

The basis of pathogenetic psychotherapy is the understanding by the sextherapist of the personality and its relationship to its problems. The main principle of such therapy is the correction of the behavior of a man (his partner) and a change in his / her attitudes and / or behavior. At the same time, psychological work is not limited to pure information and instructions of a psychotherapist. He achieves a situation where a man (and his partner, if necessary) comes to the truth on the basis of his own efforts, that is, understands the reasons for accelerated ejaculation, finds out the mechanism of prolongation, realizes the importance of control, learns how to inhibit sensitivity, based on his own conclusions based resolved conflicts and experiences, and, accordingly, is trained to control the ejaculatory process.

The main objective of pathogenetic therapy in the treatment of PE is to find out the vital relationships that played a pathogenic role, deprived the man and his partner of the ability to adequately process the current situation and caused uncontrolled overexcitation. For the success of the work, the most important is the relationship between the doctor and the patient, where the dominance of the doctor, his social orientation, breadth of mind, knowledge of life, tact, the ability to listen to the patient, a sympathetic and benevolent attitude towards him, not excluding, if necessary, counteracting socially unacceptable trends the patient.

Clarification of the experience of sexual life, sexual scenarios, the system of sexual relations, specific facts of intromission with a different outcome in a man occurs in the course of skillfully conducted psychotherapeutic conversations. The doctor clarifies the details of everything that forms the man’s inner world, and compares these data with the real conditions of his life in the present and past. The patient’s attention is drawn not only to his PE and the consequences of such intercourse, but also to those external circumstances with which they came into conflict. He himself must grasp the relationship between the history of his sex life, formed by interpersonal relationships, resulting from them inadequate reaction of a partner (or several partners) to the current situation and the ability to solve the problem.

Their understanding is a turning point in therapy, but it is not achieved immediately. With successful advancement in this direction, the patient becomes less stressed, more frank, gradually begins to critically rethink his previous life positions, otherwise evaluate his situation. The decisive moment is the final process of psychotherapy – not just a change in his attitude towards PE, which in itself is not always possible. The cure occurs when you change his life position and set on existing sexual dysfunction. The psychotherapist carries out his work based on the consciousness of a man (his ability to report on events not only of the present, but also of the past and future), sociality (the ability to subordinate his own interests to the needs of his partner), independence (ability to control himself in coitus).

In psychotherapeutic conversations, various approaches, tools and techniques are used that facilitate the contact of the doctor with the patient. There is also a doctor’s assistance in normalizing family-marriage and partnerships, the family-household situation. As a result of long-term treatment and the lack of the desired result, treatment with medications or surgical intervention is possible. But these methods and methods will be discussed below.