You can caress the genitals with baby oil or mineral oil before you do an oral-genital caress. Getting baby oil or mineral oil on your mouth won’t hurt you. However, some people prefer to use flavored gels or lotions on the genitals. All adult stores sell these, and they come in a huge number of flavors. If you decide to buy flavored lubricants, make sure the packaging says that the product is safe for oral sex.
Think of sensate-focus oral sex with your partner as simply using your tongue instead of your hand to do the genital caress. The same instructions apply, and, if you have been doing the sensate-focus exercises and learning from them, you are probably already anticipating what I am going to say next. (Remember that behavior therapy is all about repetition.)
• Do the caress for your own pleasure.
• Do the caress slowly and to explore.
• When you are the passive partner, remain totally passive.
• When you are active, do the caress for your own pleasure.
• When you are active, do not pressure your partner to respond.
• Do the caress in a sensuous manner, to make your tongue feel good rather than to turn your partner on.
Begin this exercise with spoon breathing and focusing caresses. Then decide who will be active first. The active partner should do a front caress for five minutes or so. Then use some lubricant and caress your partner’s genitals with your fingers for a few minutes.
To begin the oral part of the caress, if your passive partner is a woman, be sure both of you are in comfortable positions. Your partner should either lie down on her back with your face between her legs or sit leaning back against a wall or headboard with her legs spread comfortably apart.
Now, slowly move your lips and tongue along her inner thighs, outer vaginal lips, inner vaginal lips, clitoris, and in and out of her vagina. Do this for ten or fifteen minutes. Focus on the exact point of contact and explore how the different parts of your partner’s genitals feel and taste to the different parts of your mouth.
If your tongue, chin, or neck starts to get tired or sore, change positions and relax. You may be holding your tongue too stiffly in an effort to please your partner. Your tongue should be relaxed.
Do not stiffen your tongue and rub it forcefully against your partner’s clitoris. Do not forcefully suck or slurp at your partner’s inner or outer lips. Do not insert a finger into your partner’s vagina or rub her clitoris with your finger while you lick her vaginal opening. Your partner will be likely to interpret any of these actions as a demand to respond, which will cause her to remain anxious and be unable to relax. The point of the oral sex exercise is for you to enjoy sensations in your mouth and for your partner to be able to enjoy herself with no demands on her to show how much she likes it.
If your passive partner is a man, spend about five minutes on a front caress. Then caress your partner’s genitals with some lubricant on your hand for a few minutes until you are both focused and relaxed. Next, slowly use your tongue and lips to lick all over his penis and scrotum and thighs. You may want to take his whole penis into your mouth and slowly let it back out again. Explore freely, and do what makes your tongue feel good. Lick the area behind his testicles. Insert your tongue into the creases between his thighs and scrotum. Experience how each different area feels or tastes to your lips and tongue.
Do not suck on your partner’s penis in such a way that your head moves up and down. Only your tongue and lips should move during this exercise. If your neck or tongue becomes tired or sore, move to a different position. Your tongue should remain relaxed and not stiff. If you feel pressured to perform, stop and caress some other part of your partner’s body until you feel that you are focused enough to enjoy the oral sex again. It is best if you respond to what you want rather than to what you think your partner wants.
If your partner indicates that he is about to ejaculate, decide whether to take the semen in your mouth or whether to temporarily stop the caress while your partner ejaculates. If you have not done the caress for the full fifteen minutes, wipe off the semen and continue the caress.
Do not use your hand to masturbate your partner during this caress. Remember, you are doing this caress only for your own pleasure. It doesn’t matter whether your partner gets aroused or not or whether he gets an erection or not or whether he ejaculates or not. What does matter is that you do what feels good for you and that you focus on the feelings in your mouth during the caress.
As with all of the other sensate-focus partner exercises, finish with spoon breathing, and be sure to both give feedback after the exercise.
Part IV
HEALING SPECIFIC SEXUAL PROBLEMS
In this section you’ll find chapters containing healing exercises for each of the nine sexual dysfunctions described in Part II. It is important to read the background material in Parts I and II and to do the preliminary exercises in Part III before plunging into this portion of the program.
chapter 23
Healing Premature Ejaculation
Premature ejaculation, also called rapid ejaculation, is not defined by how long you last (whether in seconds or minutes), how many strokes you can take before ejaculation, or whether your partner has an orgasm. Rather, premature ejaculation occurs when you ejaculate before you want to, and when you don’t feel you are in control of your ejaculation.
Some experts believe that it should not matter how long a man’s erection lasts. They believe how long a man is able to have intercourse before he ejaculates is not important—if he ejaculates before he wants to, he can simply continue to have intercourse with a flaccid penis. After spending many years treating men with premature ejaculation, I get upset when I read these ideas. I have seen too many men psychologically devastated by this problem. They find the condition intolerable because they want to last longer when making love—both to more fully please their partner and to spend a longer time enjoying lovemaking without worry and without pressure. In addition, I find that the length of time a man lasts during lovemaking can affect his opportunity to experience the healing touch of his partner. Premature ejaculation can be a serious sexual problem if it detracts from the ability to heal and be healed sexually.
You don’t have to be a marathon man, but you should have enough ejaculation control that you can last as long as you wish about 75 percent of the time. If you have a high sex drive, it is normal to ejaculate before you want to some of the time, especially if you are young, if you don’t have sex regularly, or if you are with a new partner. This is not a cause for alarm and it is nothing to be ashamed of. If you have ever had control, you have the ability to gain it back, and for life.
It is also important to remember that the quality of lovemaking is not dependent on the amount of time or amount of activity. I believe in teaching ejaculation control for life rather than encouraging men to make love for a certain period of time. Sometimes you and your lover may want to spend long periods of time in intercourse, and at other times you may just want a quickie. Both ways of making love celebrate your intimacy, so you should have the pleasure of these options, but with premature ejaculation, you don’t.
Premature ejaculation is a straightforward problem to treat, especially when your partner is willing to help you. You will need to make a time commitment of about three hours a week to tap into the sexual power that the exercises in this chapter develop. By the end of about six weeks your control should be much better.
In order for a man to be healed of premature ejaculation problems, three things are necessary:1. He must learn full-body relaxation. Body tension is a direct contributor to premature ejaculation.
2. He must learn to gain voluntary control of his PC muscle. Premature ejaculation happens when your anxiety level goes so high that your PC muscle spasms out of control. The PC muscle exercises you learned in Chapter 18 will prove to be very important here. Pay special attention to the relaxation phase of each PC muscle squeeze. You will need to learn how to recognize when your PC muscle is tense and how to v
oluntarily relax it.
3. Finally, and most importantly, in order to heal premature ejaculation, a man must learn to accept and recognize the sensations he is feeling in his genitals at every step of a sexual encounter. You can only control that which you own and accept.
The sensate-focus exercises in this chapter will help you accomplish all three of these goals.
Outdated Treatments for Premature Ejaculation
Before I give you some exercises to help premature ejaculation, I want to tell you a little bit about the development of behavioral techniques to treat this problem. In the 1950s, a physician named James Semans developed what he called the stop-start technique. In this technique, which was primarily designed to be used during intercourse, the woman would be on top. She would thrust until the man reached a point when he felt he was close to ejaculation. He would then say, “Stop,” and his partner would stop thrusting until he felt his arousal go down to a comfortable level, and then he would say “Start” and she would start thrusting again. They would repeat this process for several minutes until he decided to ejaculate. I think you can see some of the problems with this technique. It doesn’t fit my criterion of teaching you to be aware of your arousal. The only two arousal levels this technique teaches are level 1 and level 9, or level 1 and, “Oops, too late!”
One of the main things to remember about premature ejaculation is that, by definition, the man with premature ejaculation does not know when he is close to ejaculation. If you think about it in terms of the 1-to-10 arousal scale, he does not have any awareness of the lower levels like 2, 3, 4, and 5. So the Semans technique really only works with men who have some awareness of their arousal scale, and most men with premature ejaculation do not.
Then, in the 1960s, Masters and Johnson developed treatment for premature ejaculation based on their research on the human sexual response cycle (which I described in Chapter 2). They noticed that when a man was close to ejaculation, his testicles and scrotum would rise up close to his body. They reasoned that if they could figure out a way to keep a man’s testicles away from his body, this would delay ejaculation. So they invented a technique called testicle tugging. The technique is meant to be used during sexual intercourse in the missionary position. When the man feels that he is close to ejaculation, he tells his partner, and she reaches underneath him, grabs his scrotum, and pulls it down and holds it. You can see that this technique has the same problem as the stop-start technique: It doesn’t teach you the difference in feelings at each arousal level. In addition, it has the added downside of potentially being very painful.
Masters and Johnson also developed the “squeeze technique.” This can be used with intercourse or with manual or oral stimulation. The woman stimulates her partner, and when he says he is close to ejaculation, she puts her thumbs and the first two fingers of both hands under the head of his penis and squeezes as hard as she can. This supposedly decreases a man’s urge to ejaculate (no kidding!). Obviously this technique doesn’t help you learn arousal levels. In addition, it can be painful and is difficult to use, because by the time the man becomes aware that he is close to ejaculation, the woman really doesn’t have time to visually locate the penis, position her hands, and squeeze, especially if they have been having intercourse with her on top. Nevertheless, I have included a description of the squeeze technique at the end of this chapter in case you want to try it. Some men have responded well to it, especially after they have gained some degree of ejaculatory control.
What Else Doesn’t Work
There are some other techniques that men have used to try to last longer. I call them “quick-fix” techniques. Please don’t think you can take a shortcut by using any of them. They don’t work (although they might help you last longer during one episode of intercourse), and they tend to make the problem worse in the long run.
One of the oldest suggestions for lasting longer is to think about something else when you are having intercourse. Some of the suggested topics I’ve read about include thinking about having sex with an ugly woman, doing math problems in your head, reciting baseball statistics, thinking about mowing the lawn, thinking about a bloody car accident, and thinking about having sex with your grandmother. Please don’t fall for any of these. The only way to get ejaculation control is to learn awareness of what you are feeling, not try to ignore it.
Some adult-product stores sell creams that purport to numb the penis and therefore delay ejaculation. They numb your penis all right, but the result is that you still ejaculate quickly without feeling it. Also, these creams can be transferred to your partner’s vagina during intercourse and interfere with her sexual response.
Some men use alcohol to slow down their ejaculatory reflex. This works, because alcohol slows down all of your reflexes (and does so quite well). However, engaging in this practice can easily cause you to develop tolerance to alcohol. If you start out drinking two beers to slow yourself down, before you know it you need a whole six-pack (or twelve-pack) to accomplish the same thing. The end result is that you go into a coma before you have a chance to have sex. (I’m exaggerating here, but don’t use alcohol strictly for ejaculation-control purposes.)
I’ve also read advice that suggested that a man use a condom in order to last longer because the condom desensitizes the penis so he doesn’t feel as much. That’s a problem, because the point is to develop control while still feeling as much as possible. In addition, condoms have a tolerance effect, in the sense that you may become so accustomed to using one that pretty soon you need two to gain the same degree of control.
Some men masturbate to “take the edge off” before they believe they will have an opportunity to have sexual intercourse. This works against you in the long run, because masturbating quickly for the sole purpose of ejaculating—rather than enjoying the sensations—will make your problem worse.
A Medical Solution
There is one medical solution that’s been shown to work for premature ejaculation. That’s the use of Prozac, Paxil, Zoloft, or any of the other medications called selective serotonin reuptake inhibitors (SSRIs). If you take one of these drugs for ejaculation control, you don’t take it every day. You take it on the day you are planning to have sex. I’ve seen some clients use this technique successfully, but it does nothing to help your arousal awareness. In addition, you have to watch out for this practice as you get older, because the SSRIs can negatively affect your libido—believe it or not, even in a man who’s had long-term premature ejaculation.
Some men have taken Viagra or other, similar drugs in order to last longer. The theory behind this practice is that if you take Viagra when you really don’t need it for erections (that is, you already have strong erections), even if you ejaculate quickly you’ll stay hard and be able to continue intercourse after you ejaculate. This works for some men.
Sensate-Focus Exercises for Premature Ejaculation
The mainstays of the ejaculation-control program I describe in this chapter are the peaking process and variations on it. Remember to end each exercise with five to ten minutes of spoon breathing followed by each partner giving feedback based on the questions provided in Chapter 15.
Exercise 23. AROUSAL AWARENESS WITH A PARTNER
The first step in ejaculation control is arousal awareness, which you learned to do in the chapter on self-touch. Now you will do it with your partner.
As you did in Chapter 18, think of your sexual arousal on a scale from 1 to 10, with a 1 meaning you are not aroused at all and a 10 meaning you are ejaculating. Remember, this 1-to-10 scale refers to how you feel, not to your physical response, i.e., your erection level. (For a review of how you may expect to feel at each level, see Exercise 14, Arousal Awareness During Self-Touch, in Chapter 18.)
Begin the session with focusing caresses (back caresses are recommended) for five to ten minutes each. Then you may do a front or genital caress with your partner before you begin the arousal awareness process.
Take the passive role and lie on
your back. Your partner will begin a front caress and move into a genital caress, as well as oral sex if she desires. She should do these caresses for her own pleasure, as in all of the early sensate-focus exercises. Every five minutes or so, your partner should ask you about your arousal level. She should vary the stimulation so that sometimes your arousal level is low and sometimes it is relatively high. Try to give your partner feedback that is as honest as possible, even though it may be more difficult to recognize your arousal level than it was when you did the exercise by yourself.
The first time you monitor your arousal level with your partner, you may be unable to distinguish all of the different levels between 1 and 10, or they may go by very quickly. Remember to breathe and to keep all of your muscles relaxed. Make sure you are not tightening your PC muscle. Try not to panic or fight off ejaculation. Breathe instead.
The purpose of this exercise is to learn to recognize all of your different arousal levels, even if they don’t go up in order. It doesn’t matter if you go up steadily or go up and down several times. If you go all of the way up through ejaculation, that’s fine. If you are only able to reach what you consider to be a level 2 or 3, that’s fine too.
Women, as the active partner, do the caress for your own pleasure. When you ask your partner what his arousal level is and he tells you, slow the caress and then begin again. Do the caress very slowly, especially the genital caress and oral sex, and especially if your partner has a severe problem with premature ejaculation. It is important for your partner that the stimulation be slow and predictable. In addition, touching slowly will help you focus on the sensations. If your partner holds his breath at some point during the caress or tenses his thigh muscles, stop the caress and remind him to relax.
Sexual Healing Page 22
