Cognitive Behavioral Therapy for Premature Ejaculation

Can CBT help premature ejaculation?

CBT for premature ejaculation

Premature ejaculation is a common and very unpleasant problem, for both men and their partners. Luckily, by using cognitive-behavioral therapy techniques, most men can improve their ejaculatory control and cure premature ejaculation.

In this article, I’ll review how CBT can be used to help men overcome premature ejaculation and give some practical pointers for men who want to use CBT to treat PE.

Behavioral techniques for premature ejaculation

CBT techniques can help with premature ejaculation in several ways, all contributing to better ejaculatory control.

Both lifelong premature ejaculation and acquired premature ejaculation can be caused by various underlying factors that cannot always be pinpointed.

However, regardless of the underlying factors, the “here and now” cause remains the same – an inability to identify the feelings and sensations that lead up to an orgasm in a way that is sufficient for building sexual stamina and pacing oneself during sex.

Consider the analogy of a marathon run. If you’re not mindful of the signals your body is sending you – heart rate, muscles, breath – you risk running too fast and exhausting yourself. If you consistently do that, you won’t be able to build your long-distance stamina either.

To improve your ejaculatory control you must take care of:

  • The physical aspects – develop a better awareness to feelings and sensations and then build tolerance
  • The psychological aspects – emotional distractions, such as performance anxiety, that distract you during sex and make it hard to concentrate, thereby reducing control

Here’s a rundown of the different CBT techniques that can help with either the physical or psychological aspects of PE.

Stop-start method and the squeeze technique

The stop-start method and the squeeze technique are behavioral sex therapy techniques that address the physical aspect of premature ejaculation. Their goal is to help men develop awareness of the feelings and sensations preceding orgasm.

By doing so, they can learn to pace themselves during sex and masturbation, aiding in building sexual endurance over time.

  • Stop-Start Method: This technique involves specific behavioral steps, such as stopping sexual stimulation when nearing ejaculation and then resuming after a pause. It is a behavioral intervention aimed at developing better control over the physiological aspects of sexual response.
  • Squeeze Technique: Similarly, the squeeze technique is a behavioral strategy involving the interruption of sexual activity through a physical action (squeezing the base of the penis). It is aimed at preventing premature ejaculation by providing a means to delay the climax.

premature ejaculation exercises graph

While the logic behind these exercises seems straightforward, it’s important to have a treatment protocol that includes several steps with increasing levels of intensity. Making gradual progress is the key here.

You gradually improve your stamina during structured practice sessions until you reach a point where you can control your ejaculation without stopping or squeezing mid-sex.

Use cognitive restructuring to fight performance anxiety

While the stop-start method and the squeeze technique primarily target behavioral aspects, the cognitive restructuring part involves addressing thoughts, beliefs, and attitudes related to performance anxiety and premature ejaculation.

If you’re too anxious or distracted during sex, you’re more likely miss the cues of a nearing orgasm. It’s easy to overstep yourself when you’re not ‘in the moment.’

Cognitive restructuring, a core component of cognitive-behavioral therapy, involves identifying and challenging negative thought patterns, replacing them with more balanced and realistic ones.

In the context of premature ejaculation, this may include addressing performance anxiety, fear of inadequacy, or unrealistic expectations.

This can be done by learning to first identify unhelpful thoughts, challenging them while looking at the evidence, and then developing more balanced and constructive thoughts about sexual performance.

Does CBT for premature ejaculation work?

Yes, cognitive behavioral therapy for premature ejaculation work. It’s an approach I often recommend my patients. Especially for those who prefer a natural behavioral approach as a first line of treatment for PE.

From my experience, men find it very empowering to overcome PE on their own, and not rely on medications or other external solutions.

A recent 2023 study which set out to examine the effectiveness of CBT for the treatment of PE found that 9 out of 12 patients were able to overcome PE after 8 to 12 sessions.

The program included sexual education, the stop-start and squeeze technique exercises, and CBT interventions for performance anxiety.

If you’re in a relationship, it’s always better to have a cooperative partner who is compassionate enough to support you in your journey. Nevertheless, even without a partner, results can still be achieved.

Can I do CBT on my own?

Yes, you can do CBT exercises on your own! In fact, one of the upsides of CBT is that it allows people to take therapy home with them. A lot of the work is done using exercises and techniques patients perform on their own.

Cognitive restructuring for example can be done using online apps that employ tools like journaling to recognize negative thought patterns. Another very powerful tool is mindfulness meditation-based cognitive-behavioral therapy, which can also be practiced using guided recordings.

The stop-start method and the squeeze technique can also be practiced alone, but it’s important to have a guided, structured program and not just sporadically use the techniques here and there or during sex.

Our own Premature Ejaculation Program is an online app you can use in the comfort of your own home to overcome premature ejaculation. It is based on the stop-start method and squeeze technique, and includes all the essential components of sexual education.

Summary

Premature ejaculation is a common sexual issue that can negatively impact men and their partners. Cognitive behavioral therapy (CBT) offers an effective, drug-free approach to help manage premature ejaculation.

CBT uses behavioral techniques like the stop-start and squeeze methods to increase awareness of the physical sensations leading up to orgasm. This helps men learn to better control the timing of ejaculation during sex.

CBT also incorporates cognitive strategies to address issues like performance anxiety that can contribute to premature ejaculation.

A recent 2023 study found that after 8-12 sessions of CBT, 9 out of 12 men overcame premature ejaculation.

Many men find CBT an empowering solution as they can develop techniques to overcome PE on their own, without medications.

Online CBT programs, such as the Premature Ejaculation Program, provide guided training on these behavioral and cognitive methods from home.

About Bailey Hanek PsyD

Clinical Psychologist and Certified Sex Therapist

Dr. Bailey Hanek is a clinical psychologist and an AASECT-certified sex therapist. She serves as a professional consultant for Between Us Clinic. Dr. Hanek provides sex therapy and general psychotherapy to adults in her private practice. In addition, she works to increase access to information about relationship and sexual health through her founding role in The Relationship Coaches.