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The Psychology Behind Premature Ejaculation - What's Really Causing It

01/08/2016 16:02 | Updated 01 August 2016

Ladies and gentlemen of the Huffington Post community, lend me your ears, for there's an elephant in the room right now, and that won't do.

As a practicing psychologist I see many people with sexual issues that impact heavily upon their lives. However, there's one in particular that many men find particularly stressful, and that's premature ejaculation. This is something that affects up to 4 in 10 men over the age of 18 at some point in their lives, and yet it's become taboo to talk openly about something that happens to nearly half of British men.

Well, no more. The only way to release this unfair and debilitating pressure from the shoulders of men is to open up about this, and shine a light on it. You'll see it loses its power, so come with me (if you pardon the pun) and let's explore what this phenomena actually is, and what you can do if you feel this applies to your own relationship.

First of all, what is premature ejaculation (PE)?

PE is when a man ejaculates more quickly than he would wish in sexual contact with his partner.

What causes PE? 

There can be many psychological causes of premature ejaculation, such as; sexual inexperience or novelty of a relationship, overexcitement, or too much stimulation. Other reasons can be to do with negative emotions, including; anxiety, depression, guilty feelings, relationship stress, not knowing the point of ejaculatory inevitability. However, the one issue I see more than any other is the one I will expand upon - the fear of intimacy.

Why is PE a sign of avoidance of intimacy? 

PE represents a quick way of getting away from your partner, because you don't like intimacy with him/her. Perhaps this is because you hold anger and resentment against your partner, or there may be other reasons. 

Whilst this might sound strange, it's completely true. Men who fear intimacy will subconsciously ejaculate quickly during sex because they are averse to the sense of intimacy that sex inevitably brings. 

This simple truth is reflected in the fact that one of the first questions a relationship therapist will ask a couple in order to establish how healthy their relationship is is whether or not they're still having sex, and if so how often.

Where do deeper issues with intimacy come from? 

You may come from a background of emotionally unavailable or abusive parents, which makes intimacy unappealing or scary to you. If this is the case, a very strong therapeutic relationship with a skilled therapist can help you overcome your deep routed fears of intimacy.

Your fear of intimacy might leave you feeling constantly pressured to give more than you can in your relationships both emotionally and sexually. It can lead you to detach and deactivate your emotions when issues arise.

How do I cope with a partner with intimacy fear issues?

Avoidance of intimacy doesn't mean someone doesn't care about you, and it's usually not a conscious process. However, the pain you feel from having a partner with these issues is real, and you should not underestimate this personal pain, whilst you try to understand and support your partner.

Fear of intimacy is a biological reaction that has become integrated into the central nervous system from early childhood as a result of emotionally neglectful, abusive or emotionally immature parenting, and the single best way of resolving this is through finding a therapist who can work with you both. The very worst thing you can do is to leave it and hope for the best.

When do intimacy fears start?

A fear of intimacy usually starts at a very young age, when how our parents treat us affects us for the rest of our lives, which can surprise some people.

We call it attachment theory, and here's how it works.

How a parent reacts to a child's emotions is crucial in helping them feel safe and secure. When a child is distressed, frightened or sad, they need adequate comfort from their parents in order for them to feel secure.

Unfortunately some parents can be emotionally underdeveloped, and don't deal with their own emotions very well, and therefore they are limited in how well they will understand and respond to their child's emotions. This has a major impact on the child, and how they learn to deal with their emotions and how their personality develops.

When a parent ignores or rejects a child's emotional needs, perceived weaknesses and emotions the individual often goes on to become avoidant, fearful of dismissive of intimacy. When someone has grown up with this type of parenting they will often have been made feel shame or guilt as a result of having emotional needs, for instance you might have been fed messages such as "big boys don't cry".

Another type of parenting that can lead to some fears of intimacy is where the parent presents themselves as being emotionally fragile, such as worrying excessively or becoming over emotional when a child expresses a problem. As a result the child does not learn to deal well with difficult emotions, and learns to sweep them under the carpet. 

So how does all this affect intimacy? 

In terms of intimacy a person with this background will try to avoid experiencing negative emotions and will try to only experience positive or neutral emotions towards another person, which gets in the way of building true intimacy. Unless this is dealt with at source then they will not let people in properly, often resulting in PE.

What type of mothers do men with PE tend to have?

Often men with PE will have smothering, overbearing mothers, and, ironically, whilst he most likely won't want to repeat this experience he will often be attracted to someone who's similar to his mother. This creates a push-pull effect, where he will be initially be attracted to a partner with similar personality traits to his mother, but will also despise these traits in her and as a result will want to push her away. 

Why do men with PE often overcompensate? 

As we talked about earlier, this problem, which is highly treatable, is taboo, and undercuts our patriarchal macho society. This can lead to lots of shame and embarrassing in men, and some men will try to overcompensate in order ways, becoming exceptionally good at manual or oral foreplay. This is due to the man's belief of "I'm not good enough", so he makes extreme efforts to prove to himself he is good enough. 

Can medication help for PE, which is caused by psychological factors? 

Some men turn to medications which they find helpful in the very short term, but I don't recommend this as it only masks the underlying cause.

It's understandable that men often want a quick fix to this problem by taking a pill, but if the problem is psychological it's far better to tackle the root of the problem, rather than trying to go for the medicinal cure, which will always only give temporary relief.

I'd compare taking medication for PE to taking a shot of vodka if you are nervous in a social situation. The same problem comes back the next time, only next time you may become dependant on having that as a crutch.

Medication also has a lot of side effects, and it's often hard to get the benefit without suffering other uncomfortable side effects that just aren't worth it (nausea, headache, and withdrawal symptoms when the man stops taking them). 

So how do I overcome this difficulty? 

A therapist with a good psychodynamic understanding is beneficial in helping you uncover where the difficulties started.

This should be followed by strategies to help you break your current cycles, such as breaking your patterns of avoiding conflict, identifying and sitting with difficult emotions, developing communications skills, working on self esteem and letting people get emotionally close to you (allowing people to see you for who you really are).

Some Cognitive Behavioural Therapy style strategies can also work to improve the problem, but it's best to get to the root of the cause to overcome the problem once and for all. 

If you have questions about this article feel free to get in touch with Dr Becky Spelman on Twitter @drbeckyspelman

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