Various procedures for distraction are employed by the anxious husband. He fantasies such non sexual material as work at the office, an unbalanced family budget, an argument with a neighbour, a fishing trip, counting backward from one hundred, etc.
When the fantasy material has been proved ineffectual, the next step is to initiate some form of physical distress. The husband may bite his lip, contract the rectal sphincter, pinch himself, pull his hair, or use any other means of physical distraction.
All techniques, subjective or objective, are designed, of course, to enhance ejaculatory control by reducing the level of the sensate input during the coital process.
The wife meanwhile is thrusting frantically in a vain attempt to achieve orgasmic release before her partner ejaculates. The rapid transition from the mutually agreed upon "don't touch" approach in precoital play to a rushed mounting episode and immediate contention with a demanding, thrusting, highly excited woman usually provides sufficiently forceful stimuli to initiate ejaculation before the wife possibly can obtain sexual release.
Premature Ejaculator Frustration
When all distraction techniques fail, the warmth of the couple's interpersonal relationship slowly ebbs away. As the wife's level of cold personal disinterest reflecting her sexual frustration increases, and denunciations (verbal or silent) of her husband's sexual dysfunction continue, the next step taken by the now anxious, self-effacing husband, "the man who just can't get the job done," is one of slow but definite withdrawal from the unit's established frequency of sexual contact.
Usually this action is temporarily acceptable to his frustrated wife. His withdrawal from sexual exposure continues despite the fact that the one thing the premature ejaculator cannot tolerate and still maintain any semblance of control is increasing periods of sexual continence.
He frequently sleeps on the sofa or in another room; she visits her family and stays longer than planned, or simply refuses sexual contact for increasing periods of time.
The longer the periods of continence, regardless of source, the more rapid and severe the husband's ejaculatory response on those rare occasions when sexual contact is permitted.
Granted that the premature ejaculator may exhibit little significant control at the usual once or twice-a-week rate of exposure, yet he certainly will have no control at all when the coital exposures are reduced to once, twice, or thrice a month.
Over a period of years with no obvious improvement in her husband's sexual performance, the wife loses confidence in her partner's consideration for or appreciation of her as an individual, and concomitantly some degree of confidence in herself as a woman.
For effective sexual performance are continuously verbalized or acted out by the female partner over an extended period, the complication of erective inadequacy may appear. The husband, questioning his own sexual prowess time and again, abetted in this frightful concern by his wife's specific verbal derogation of his masculinity, frequently is enveloped by anticipatory fears of performance whenever sexual expression is imminent.
Fears of performance
Combined with techniques for avoiding direct penile stimulation during precoital play and his wife's obvious disinterest in active sexual functioning, not only make the man increasingly conscious of his inadequacies of sexual performance but also raise psychologically crippling questions as to his very maleness.
In short, all these factors plus his fantasy patterns of trying to distract himself from subjective pleasure during active sexual functioning finally place the man in the spectator role in his own marital bed. There is a slow transition from the role of physical self-distraction during coition to that of a fear-ridden spectator at his own sexual performance.
Thus, the husband assumes the psychological stature of a secondarily impotent male with all of the well-established concerns for sexual performance and the constant retreat to a spectator role. Time and time again premature ejaculators of many years standing not only lose confidence in their own sexual performance but also, unable to respond positively while questioning their own masculinity, terminate their sexual functioning with secondary impotence.
This stage of functional involution is, of course, the crowning blow to husband and wife as individuals and usually to the marital relationship.