Careful evaluation is required to determine that the cause of retarded orgasmic responses is not psychiatric, organic or illicit drug- or medication-related.
The adequacy (intensity, involvement and duration) and expectations of sexual stimulation need to be considered. It is possible for a delay in the orgasmic response to reflect inadequate sexual stimulation, which may in turn reflect inadequacies in sexual behavior, partner involvement or some other distracting process.
All the approaches designed to heighten sexual arousal in the female arousal disorders can be applied to the male patient: detailed mental rehearsal of successful sexual arousal; increased absorption and amplification of initially small sexual responses; metaphors of arousal and lubrication such as an analogy with sweating and a healthy journey of discovery through the sexual organs and finding the sites of sexual pleasure.
Dramatic (e.g. television or theatre techniques) and cartoon rehearsal of arousing sexual behavior that the patient is reluctant to relate to themselves may be used as a model and assist in the patient giving themselves approval for sexual involvement and pleasure.
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