Archive for March 11th, 2009


Today, in our rapidly changing society, old people tend to be discarded as unproductive, unable to adapt to change, often sick, a liability both to society and to their family.

It is ironic, too, that middle-aged people have a much greater ambivalence to old people than do young people, and their relationship to the old is much less understanding. A middle-aged man has been taught to treat the old with respect, and he fulfils what he sees as a duty. At the same time, he considers the older person physically and mentally inferior, a person whom he expects to conform to society’s image of age. If the old person shows that he will not, he is condemned as an ‘extraordinary’ old man, an old ‘duffer’ or a ‘dirty’ old man.

It is important, today, to ask ourselves why we treat the old in this way; why the old are so alienated; why so many old people are condemned by society to relative poverty, to exploitation, to loneliness, and to inferior living conditions. Goethe wrote, ‘Age takes hold of us by surprise’. Today, because of better nutrition, better sanitation, and better health care, an increasing proportion of the population is surviving to become old. In many Western countries, 12 per cent of the population is over the age of 65, and by the year 2000 one person in six will be over that age. Many of us will be among them, so it is to our own advantage to think about growing old. We must avoid age taking hold of us by surprise.


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To what extent do homosexuals see themselves as oppressed by society? An American study by Dr Weinberg and Dr Williams of the Institute for Sex Research is revealing. They surveyed over iooo male homosexuals in the U.S.A., over iooo in the Netherlands, and over 300 in Denmark. The American men were more fearful about being known as homosexual than were the Europeans, because of the greater acceptance of homosexuality in Europe. When asked what would result if their erotic preference were known by heterosexuals, over 60 per cent of American men believed it would lead to problems at work, and nearly 50 per cent believed some of their heterosexual friends would break off the friendship.

This perception of what heterosexuals would think of them made them less happy than heterosexuals and reduced their faith in others; it also-led, in a proportion of the homosexual men, to anxiety and shame. This is because a person’s feelings about himself are influenced by how he imagines other people perceive him, regardless of whether those perceptions are accurate or not.


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It is obvious that the man who comes for treatment is far more personally insecure, and has far greater anxiety, than a man with one of the other sexual problems. His deep conviction that his manhood is suspect, and that he is a sexual failure, is augmented by his anxiety that other people will learn of his sexual inadequacy. He may fear that his wife has told her friends of his defective sexuality.

The man’s partner is also frustrated. She has tried comfort, she has tried sympathy, she has tried aggression, in an effort to help her man, with no effect. She, too, becomes tense and anxious, as she thinks that his impotence is due to her lack of physical appeal, or that he is obtaining sexual relief with another woman while denying her any sexual experience. She may be worried that he is a latent homosexual.

The essence of the therapy is to restore the man’s belief in his sexuality, not just to treat his symptoms of impotence. At the same time his partner’s fears for her man’s sexual ability need to be changed. Sex therapists seek to replace the fears by pleasure. They seek to enable the couple to re-establish that human sexual contact is pleasurable. They seek to enable the couple to re-establish (or to establish for the first time) communication with each other about sexual matters. They seek to remove inhibitions and childhood or adolescent hang-ups.


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None of these theories fits the clinical situation as well as the theory that premature ejaculation is an anxiety-induced response to early unsatisfactory and stressful sexual experiences. Because of these unsatisfactory experiences the man has learned that sex is furtive, quick, and guilt-ridden. It is something which is pleasurable, but also shameful. It is something which should be done quickly and is stressful. He has learned a pattern of response to sexual stimulation, in which he is rapidly aroused and is unable to damp down the arousal, keeping it in the late plateau stage. He has lost his voluntary control over his sexual response because of his anxiety about his sexuality. He has pushed the anxiety into his subconscious where it reinforces his quick response pattern, until it becomes the only way he responds to sexual arousal. His sexual impulse has escaped his brain control.

In other instances, premature ejaculation occurs because the man is over-anxious or over-sensitive about his ability to satisfy his partner sexually. He may be unaware that many women fail to reach orgasm during penile thrusting and may feel that because his partner does not, he is a sexual failure. He may be over-sensitive about his relationship with his partner. This can induce anxiety and lower his self-esteem so that, paradoxically, he loses his own ejaculatory control, and comes increasingly quickly.


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The condition, which is an advanced form of retarded ejaculation, is uncommon. But if a man has it, it can be desperately worrying. The most complete study is from Belgium where Dr Geboes and his colleagues have treated seventy-five men with the problem. They found that most successful therapy was the use of an electrovibrator. The vibrator (which is often used to help women reach orgasm) is placed against the glans of the penis. Within five or six minutes the man has his first conscious orgasm. A few of these vibrator-induced orgasms, with ejaculations, convince the man that he is normal. Many men will then be able to reach orgasm and ejaculate during sexual intercourse, but those who fail and only ejaculate with the aid of the vibrator can be helped. Their semen can be collected and their wife artificially inseminated with it, provided that it is of good quality. These are uncommon causes of infertility.

In most cases the man ejaculates normally but his semen contains no spermatozoa or only a few million, instead of the 200 million or more which are usually found. In other words the quality is poor.


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