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Xuất tinh sớm là một trong những có thể điều trị các rối loạn chức năng tình dục nam giới, một loạt các đề xuất trực tiếp và gián tiếp đã được sử dụng trong điều trị của nó. Phương pháp tiếp cận đã tập trung vào giảm lo lắng là mục tiêu chính | 244 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS chapter. The control over the opening of the vagina is best left clearly in the hands of the female patient rather than being on demand of her partner. TREATMENT OF DISORDERS OF ORGASMIC RESPONSE TREATMENT OF PREMATURE EJACULATION Premature ejaculation is one of the most treatable of male sexual dysfunctions a variety of direct and indirect suggestions have been used in its treatment. Many approaches have focused on anxiety reduction as the primary goal as performance anxiety is the most common cause of a rapid ejaculatory response. Hypnotically assisted desensitization and rehearsal of appropriate sexual responding are applicable to this anxiety-driven disorder. Creative uses of healthy dissociation and distraction can also assist the male in being able to psychologically distance themselves from overarousal. Acquired oversensitivity to sexual stimulation has been implicated in those who observe their sexual responsiveness too closely. On that basis partial genital anaesthesia to reduce erotic stimulation has been used Doane 1971 with a later return of sensation during intercourse. Time distortion techniques have been applied to extend the perceived length of time of sexual activity reducing anxiety and resulting in a reduction of overarousal. TREATMENT OF RETARDED ORGASMIC RESPONSES IN THE MALE 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 .