Understanding Your Man: Premature Ejaculation

            Years ago, I taught college-level Human Sexuality.  Every year I gave a lecture that was titled on the syllabus, “Sexuality: The Early, Dysfunctional Years.” The lecture was on Premature Ejaculation and women’s inability to have an orgasm during sex.  This lecture was always crowded and I could sense the anxiety in the room when I arrived.  As I spoke, I could actually see students exhale.  I began as follows:

            “We all begin our sexual lives as we begin every other complex skills set- clumsily. Men are born into the world Premature Ejaculators and women are born having Orgasmic Difficulties. Men have to learn how to relax and manage or delay their orgasms and women have to learn how to relax and have orgasms. That men are initially sexually ‘too fast’ and women are ‘too slow’ is definitely evidence for some kind of cosmic sense of humor. Or maybe it’s just that the universe has done it this way so that we are forced to learn to open up and talk about important things to figure all of this out as preparation for all of the other things we have to figure out to have successful relationships.”

The students seemed to relax as they heard it was completely normal for them to be struggling with their sexuality at their age. These “problems” usually go away as we have more sexual experiences and learn to trust and open up in our relationships.

But for many men and women these problems don’t go away.

In the next series of columns, I am going to talk about sexual problems that many adults—both men and women—struggle with and that should not be ignored. These problems result in disconnection and misunderstandings that can threaten the core of the relationship. 

Let’s start with discussing men with Premature Ejaculation (PE).  

Most men gradually learn to understand their arousal in ways that help them learn more control over their orgasm. PE is a very common male sexual problem where a man is unable to control his arousal resulting in his ejaculating only a short time after full arousal and erection. If you’re looking for numbers, in most sexual experiences the average man takes between five to nine minutes after penetration before coming. A man is said to have PE when, on most occasions, he takes less than two minutes after penetration to ejaculate.

            Obviously, PE can be very distressing for both the man—who wishes nothing more than to last longer—and his partner, who in her own frustration, might blame him for intentionally not attending to her needs.

There are two types of PE. The most prevalent is where the man has never learned to control his orgasm enough to allow him to last long enough for him and his partner to feel satisfied. The second situation is where PE becomes a problem later in a man’s sexual life, say after several years of a relationship where for the most part he was able to be fairly consistent in managing his orgasm.

PE is one of the most treatable sexual problems. Yet most people avoid getting help until the problem creates a crisis in their relationship.

Gerald Drose is an Atlanta-based couples’ sex therapist.  Visit Dr. Drose at Powers Ferry Psychological Associates, LLC.   

The Beginning of the End to Marital Disconnection

“I bust my ass and no one appreciates me,” they both say. 
 
In my last column, I introduced a typical two-career couple. Both are angry and resentful because they feel under-appreciated and misunderstood. Their anger has led to apathy, distance, coldness and disconnection. They long for that deep closeness they felt when they fell in love, but they’ve grown too far apart to get it. They are ripe for an affair or a divorce. 
 
I’ll tell you what their lack of connection is not about. It’s not the other’s fault. The problem is not “All men are…” or “All women are….” Making generalizations about each other based on gender allows us to avoid our role in the problem, limits our expectations of our spouse (denying them the opportunity to grow) and prevents us from finding real solutions. 
 
The problem is typically three-fold: 
 
1. A lack of focus and attention to the marriage 
2. A failure to effectively communicate needs 
3. A failure to view each other’s needs as being of equal value 
The beginning to the end of marital disconnection involves a change in thought and old patterns.
 
Change in behavior/thought #1: Recognize that a conscious, healthy marriage takes work by both partners, and it is worth it. 
 
People generally fall into two camps: they either believe the Hollywood-hype that if you find the right partner it’s wine and roses from there on out. When things get hard, they don’t think they should have to work at it. The other camp (typically children of divorce) are cynical about the institution of marriage. Since marriages are doomed to fail, why bother investing in it? 
 
Change in thought/behavior #2: You are required to know, value and express your needs and wants clearly (instructions below). 
 
This will require both insight and courage! As much as you may desire it, your spouse cannot (and should not) read your mind. 
 
Remember our couple from last week? Neither told their spouse what was important to them. She wanted him to help with chores, be more involved with the family, join her in bed and to do it all without her having to ask. She believed that if he truly loved her, he would intuitively know. “It’s not the same if I have to ask! Then he’s just placating me.” At the same time, he wants her to read his mind: to ask him about his work, to let him golf without guilt, and warmly invite him back into the fold after he’s been away. He’d never thought to actually express these wants out loud. 
 
Often our desires are brought up during an argument and typically start with the words “You never….” “You always….” Usually they are generalizations that assure that the other will start defending themselves. 
 
Try this instead. 
 
Effectively Expressing Needs 101: 
 
1. Timing matters. After 20 years together, my wife has finally learned not to make significant requests before my morning coffee or in the 9th inning of a Braves game. And I’ve learned not to bring up highly charged issues as she is winding down from a long day. You have to carve out a time to talk. If your husband avoids these talks, ask him to come up with the time and commit to it. Let him know you want your talk to bring you closer and that you are not signing up for a fight. 
 
2. Watch the tone. I hear so much disdain and disgust between partners, it’s no wonder no one wants to do anything for anyone. If you make your request in the heat of an angry moment, your request will fall on deaf ears. You increase the effectiveness of your request by doing it in a calmer moment. This is true whether it’s about something as mundane as washing dishes or as intimate as how you want to be kissed. I know: when things are calm, why rock the boat? But letting your needs continue to go unmet will only add to the fire when they pop up again. 
 
3. Eliminate distractions. Make sure the kids are in bed, the technology is off, you have some energy and you are reasonably sober (a glass of wine may reduce anxiety about talking, but three glasses of wine could spell disaster). 
 
4. Be specific. “I need you to be more supportive,” means something very different to you than to him. You may be thinking, “I wish I could just vent and he’d listen and then say, “Oh man, that sucks!” Instead your husband advises you about fixing the problem because to him that is being supportive. Describe in specific terms exactly what you mean: e.g. “When I bring up a problem, I’d like you to hear me out without telling me what to do.” Or instead of saying, “I do everything for our kids,” ask if he can get the kids up and ready for school two or three days a week. We men are teachable! 
 
Change in behavior/thought #3: When your partner lets you know what he wants, listen…and do it. 
 
Ask him to be specific. It’s only fair: if you want what you want, give him what he wants. For example, if he wants to connect through sex without a long talk first or a back rub first give it a try. 
 
Being close physically may actually open up more intimate conversations. Many times men and women like to connect differently, and not always based on gender (remember the librarian and linebacker?) One may prefer a long talk to feel close: the other prefers getting close in physical ways. These are equally valid ways to achieve intimacy. 
 
If you want him to step out of his comfort zone, be willing to step out of yours. 
 

Gerald Drose is an Atlanta-based couples’ sex therapist.  Visit Dr. Drose at Powers Ferry Psychological Associates, LLC.   

Two Thriving Careers, One Dying Sex Life

“I bust my ass and no one appreciates me,” they both say.
 
Ah, the two-working-parents household, where both parents work non-stop all day, and neither feels like the other notices. There’s a silent competition going on between them for the winner of the “Most Depleted” and the “Least Appreciated” award.
 
She works a full time job and maintains the upkeep of kids, home, doctors’ appointments, homework, school forms, carpools—essentially the CEO of the home.
 
He has a very stressful job that involves frequent travel. When he’s home, he’s exhausted, burdened by decisions he’s made—and still trying to make—and feels like he doesn’t know how to fit back into the routine established by his wife and kids.
 
She believes it doesn't even cross his mind to help with mundane kid-related chores, offer to make dinner or even start a load of laundry. She knows she could ask him to help, but a part of her wishes he would just step up to the plate and consider her needs once in a while.
 
He senses her resentment and resents her right back. Does she think he likes working around the clock, fending for himself in airports when storms cancel his late night flights home? Does she think he likes feeling as though everyone at home has an easy rapport, but he’s just a visitor who’s in the way?
 
She resents that when he’s finally home on a Saturday and has some energy, his first choice is to take off with his buddies and play golf. 
 
How could he possibly care about her or the kids if, whenever he’s home, he’s preoccupied with work or running off to play golf?
 
He finds it curious she badgers him about never exercising, but when he finally has the energy to play golf, she complains.
 
When they hire a babysitter for a long awaited “date night,” they are onto their litany of charges against each other by the second glass of wine. Most times their arguments end with her telling him she feels unloved, followed by him rolling his eyes and wondering why everything is always about her.
 
“You never ask me about my day, or seem to care about what I do,” he says. “You don't appreciate the stress I feel or what I have to do to keep this family financially healthy!" Doesn’t she understand he’s doing this for the whole family?
 
She wonders why he doesn’t understand all she is asking of him is to be involved?
 
They wolf down their entrées in silence, pay the bill and go home.
 
She goes to bed alone, secretly hoping he’ll join her, apologize and then they’ll make love. He opens a bottle of wine alone in the den and wishes she’d come have a glass with him. He wants to start the evening over and then make love.
 
Both are too stubborn to make the first move to reconciliation.
 
Eventually, they quit getting sitters, quit going on dates, quit having sex and become Comfortably Numb. Neither one is paying attention to how close they are to becoming another infidelity statistic.
 
At work, a new man is fascinated by something she has accomplished and tells her so. He notices her family picture and asks about her kids. As she talks, he listens to her intently. They laugh together the way she and her husband used to. Eventually they plan to meet for lunch away from work.
 
On the plane, a woman sits next to him. She too has had to change planes for the second time that week. She listens to him talk about his job. She seems to genuinely care about his life (unlike you-know-who). When the plane lands, they exchange phone numbers.
 
The couple in this column is engaged in the painful dance of many working couples. Both are consumed by their family’s needs and mounting financial pressure, all the while feeling neglected by their spouse.
 
Sound familiar?
 
I regularly see couples like this in my practice. In my next column, I will discuss the dramatic paradigm shift that needs to happen to ward off apathy, infidelity, disconnection and divorce.
 

Gerald Drose is an Atlanta-based couples’ sex therapist.  Visit Dr. Drose at Powers Ferry Psychological Associates, LLC.

Do You Want to Have More Spontaneous Sex?

Why do happy, satisfied married couples have so little spontaneous sex? (My apologies to those couples that actually do have spontaneous sex. Perhaps you can write in and let us know how you do it?) 

The first obvious impediment to spontaneous sex is lack of time. Increasingly, we live in a world where our schedules rule. Who has time for sex when you are busy rushing kids to practice, calling clients or returning one last e-mail until the very moment your head hits the pillow? 

It’s not the way we should live while trying to maintain healthy relationships, but so many of us do it anyway.

Are you ready for a change? Do you want to have more spontaneous sex? 

Here are a few suggestions:

• Make time for sex.

The first step is to make sex a priority. In my last column I suggested scheduling a time to have sex with your partner and calling it “sex night”—an evening when all of your time, energy and everything else is focused on having sex with your partner. Once you and your partner commit to a regularly scheduled time for sex, you’ll find it consuming your thoughts on those planned days. During dinner with the kids, you’ll steal glances with your partner across the table and perhaps, you’ll both begin to visualize being together. You’ll fantasize about what’s to come while you’re putting the dishes in the dishwasher, bathing the kids or folding laundry. Then, before you know it, you’ll be sneaking off earlier than planned for a tryst. Yes, a tryst of spontaneous sex.

• Let go of resentments.

To be present and totally immersed in the sexual experience you must let go of the tiny resentments that have kept you away from your lover. I’m not referring to big issues—such as adultery, financial distress, moving, conflicts with in-laws and kids. Instead, I’m talking about those small, little irritants that are a normal part of living with someone. Irritants like “I cleaned the kitchen on his night and what kind of thanks did I get?” or “I’m sick of picking up your socks!” Those little nit-picky issues can build up into an immovable barrier to intimacy. Consider letting go and trying to remember those things about your partner that made you fall in love with him so many years ago. Consciously shift your focus to the ways your partner shows his love: Did he make you coffee this morning? Did he stop at the grocery store on his way home? Did he unload the dishwasher or make the bed without you asking? Viewing him through this lens instead of the one you wear when his breathing is getting on your nerves will make it more likely you’ll want to get naked with him tonight.

• Get back in touch with your body.

Physical activity starts this process. Exercise reminds those of us who treat our bodies only like Brain-Carrying-Devices that we have a body with its own unique set of needs, desires and pleasures. By getting back into an exercise plan, you’ll get back in touch with your body and be more likely to find your way to a spontaneous encounter.

• Try to live more in the present.

Most of us tend to live too much of our lives “in our heads.” Whether ruminating about the past, worrying about the future, problem solving, making grocery lists, planning vacation or day-dreaming, we rarely actually experience the present moment. A busy, obsessed mind (unless you are lucky enough to be obsessing about sex) will decrease your awareness of the present and disconnect you from your body and your sex partner. 

In this way, our sex lives are a reflection of how we live our lives: outside of the present experience. Electronic devices only make this worse. I would suggest removing the TV from your bedroom as well as making your bedroom off-limits to your computer, iPhone and Blackberry. (If this all sounds a bit Buddhist, it is!) Going to bed needs to be all about cuddling, talking and being with your lover. Nothing else. 

During the day, actively practice awareness of the present moment. As you walk down the driveway to get the newspaper in the morning, sense the moistness in the air, feel the coolness on your face, hear the birds; breathe it all in. Throughout your day, tune in to all five senses, while becoming aware of your breathing and your heart beating. This is great practice for being sexually present.

• Let the light in.

So when the moment arrives, don’t do it in the pitch dark with your eyes glued shut. Let some light in. Get into all of your senses: listen to your breathing and follow each other’s movements. Use your sense of smell and taste. Aware of all of your senses, you will be in the present, connected to your own body and to your lover. Open your eyes and look closely at your lover. If your lover is looking back, that’s a moment of Real Intimacy.

Gerald Drose is an Atlanta-based couples’ sex therapist.  Visit Dr. Drose at Powers Ferry Psychological Associates, LLC.

One is Hot, the Other is Not

Recall from last week’s column that our linebacker enjoys cuddling and having infrequent sex, while his wife, our librarian, is not happy because she wants regular and lustful sex. When they finally come to me for therapy, they are both hurt and angry and refuse to initiate any physical closeness with one another. They are no longer nurturing each other with warm, positive everyday comments because of their alienation; effectively punishing each other for having different levels of desire for sex. The problem that started in the bedroom now fills the house and over time, could be a recipe for detachment, affairs and possibly, divorce. 

How does a couple with two very different sex drives find marital happiness? 

Five things need to happen: 

• Stop the Bleeding. 

The first thing this couple needs to do (or any couple dealing with this issue) is immediately stop the on-going battle of words that is causing deep wounds to develop. One thing that might help is taking time out for an official “date” to do something mutually rewarding where you don't discuss your anger and frustrations. 

The decision to go to therapy together (as opposed to continuing the wounding) helped this couple staunch the bleeding.

• Replace Anger and Hurt with Empathy.  

For the linebacker and the librarian, empathy needed to replace anger and hurt. This took place in therapy as we explored childhood issues and their sexual histories. By doing this in front of each other, they were able to view their partner through a more accurate and forgiving lens. 

As the youngest of five children, the librarian received little attention in her family. Her father was a workaholic and her mother was overwhelmed by the demands of parenting. By the time the librarian came along, there “wasn’t much love left,” she said in a therapy session. She was a depressed teen until she discovered that flirting and having sex with boys got her a lot of attention and made her feel loved. As an adult, she (like her parents) became a worker bee. In addition to a 50-hour a week job, she volunteered for nonprofit organizations on weekends, kept a spotless house and tended a garden which required daily upkeep. 

Sex, which had saved her from loneliness as a teen, was her only respite from her non-stop work life. 

Like his wife, the linebacker was a workaholic. As a kid he was the boy who “got things done,” since his father often disappointed his mother by “promising everything and delivering nothing.” If there was a job to be done, he did it before his father could let his mother down. By making his mother’s life easier, he was rewarded with her affection and attention. 

He vowed to be different than his father, and he was. 

Through this process of uncovering their pasts, this couple could see how well they fit together, in spite of their different sexual appetites. Both gained their identity through self-reliance and hard work. The difference was the linebacker got significant attention and love within the family, while the librarian got attention and love outside the family through her sexual trysts with boys. 

• Courage. 

Insight doesn’t always fix things. Even though the couple understood the history of their differences, things still did not go well when they bumped up against their differing desires. That’s when the courage had to come into play. 

The librarian has to have the courage to initiate sex even at the risk of being turned down. The linebacker has to have the courage to initiate tender physical closeness and to say, "No," even at the risk of upsetting her. 

• Self-Care.  

Since both the librarian and the linebacker are “Do-ers,” they’re not good at just “Being.” The librarian has to learn other ways to relax such as exercise, walking and taking long baths. The linebacker needs to stop using food for comfort (since he’d gained 50 pounds which was making him feel decidedly un-sexy) and learn to chill without guilt. 

• Sex Night. (It’s Business Time)  

To help the couple with the tricky business of initiating sex, I asked them to establish a "Sex Night." (From experience, I can tell you no one likes this idea.) 

“What about spontaneous sex?” the couple asked. 

“By all means, have spontaneous sex as often as you want,” I said. “But choose a night that is your “Sex Night” and honor it. You can always be spontaneous on that night.” For busy couples or those who are avoiding sex, “Sex Night” forces you to deal with one another. 

As typically happens, the linebacker and the librarian had some bad “Sex Nights” before they fell into a pattern that worked for them. On those nights, they each took individual responsibility to be rested and relaxed which allowed both of them to cope with the disappointment of the other’s approach to their intimate life. 

Each of them learned to reduce their stress, particularly on “Sex Night.” Both became less into getting things done and more focused on taking care of their bodies, their health and just “being.” 

With their sex life in better shape, the marital bond re-emerged. The librarian was able to remember how much she appreciated the fact that her husband got so much done and was such a responsible partner. The linebacker was able to remember and admit how much he loved how comfortable his wife was sexually and how impressed he was that she valued that part of their relationship. 

The last I time I saw the librarian and the linebacker they said they were very good about honoring Saturday night as their official “Sex Night” but still had very little spontaneous sex. Both began preparing for their sexual encounter throughout the day. They would quit working earlier than before and sometimes take a nap or go for a walk—whatever they needed to do to help them shift from "doing" to "being." Both noticed they would flirt more throughout the day knowing they were going to be having sex later. This shift allowed the linebacker to find and show his sexual desire and the librarian to enjoy physical attention and deal with her frustration when the sexual experience wasn't exactly what she wanted. The result? A deeper marital bond. 

This is a case of two people who had a sexual desire discrepancy who were actually gifted lovers. At no point did either of them complain much about the other’s technique once they were having sex. This is not always the case as many times technique is at least part of the problem. 

Please watch this video and see if you can identify ways each of the lovers is contributing to sexual problems. 

HOMEWORK: After watching the video, brainstorm and list all the ways in which each lover in this video might contribute, or at least eventually contribute to the other’s lack of desire for sex.

Gerald Drose is an Atlanta-based couples’ sex therapist.   Visit Dr. Drose at Powers Ferry Psychological Associates, LLC.

The Linebacker and the Librarian

While it is completely natural for two people to vary in their level of interest and desire in sex over the course of a relationship, it is just as natural for couples to have a hard time working through the relationship strains generated by these differences.

Let’s go back to the couple I introduced last time, our linebacker and librarian. Recall that the linebacker wanted to cuddle rather than have sex, and his sexually frustrated wife was frequently upset by this.

It took several therapy sessions for them to be able to talk about their sex life in a rational way because both of them were so angry and hurt. Yes, she felt deprived sexually but what upset her more was believing his lack of interest in sex was really a lack of interest in her. She described him as “rejecting and controlling,” and even wondered if he was gay.

He felt like no matter what he did, his wife would never be satisfied sexually. He thought of her as “needy and smothering.”

Here’s how it played out in their bedroom: On nights when the librarian wanted sex, she would go to bed hoping her husband would get things rolling. She’d wait for him to initiate because she hated feeling rejected if he seemed disinterested in her advances. To her, cuddling was not foreplay; it was her husband’s endgame. She wanted him to seduce her with passion and lust, not tenderness.

On the many nights the linebacker would climb into bed and cuddle up to his wife, she would rarely take the next step—kissing or touching him because she was convinced he wanted to stop there. And that would only leave her craving more, long after he fell asleep. Even on nights when he desired sex, he wasn’t sure how to read her non-verbal signals because she showed no interest in him.

There were nights when they fell asleep without incident. But they also had just as many nights when they had loud and hurtful arguments. In the course of their clashes, she would frequently resort to name-calling and eventually threaten divorce. He would argue back before becoming quiet, withdrawn and defeated.

At the time this couple sought my help, neither partner wanted to initiate sex but their reasons for holding back were very different. Even so, the resulting arguments had upset the foundation of their relationship and rendered their sex life non-existent.

Many of us find ourselves in some version of the divide experienced between the librarian and the linebacker—frustrated by different levels of sexual desire and at an impasse.

In my next column, I will delve deeper into “the solution.” For now, let me hint that both are going to need a little bit of information about what may be going on inside each other’s heads, along with a peek into past issues that still lurk. As these things unfold, each must muster healthy doses of empathy for their partner and the courage to do the hard work necessary to fix their marriage and move forward.

Gerald Drose is an Atlanta-based couples’ sex therapist.  Visit Dr. Drose at Powers Ferry Psychological Associates, LLC.