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Hello, and welcome to the intimacy Institute curriculum for male sexual functioning focusing on premature ejaculation my name is Daniel Leibowitz and as the co-director of the intimacy Institute I have used this curriculum for hundreds of men who have struggled in some form with male sexual functioning I use the term male sexual functioning because a lot of people talk about dysfunction and I like to focus on enhancing function rather than stigmatizing or identifying it as a dysfunction to be struggling with something. So with that I'm going to walk you through the step-by-step process to addressing premature or early ejaculation this can be an incredibly frustrating and difficult situation to deal with. It can be embarrassing and it can be something where a lot of people will seek out information that while maybe well-meaning isn't always useful or helpful. There's a lot of information out there that speaks about a variety of different methods and techniques but doesn't really connect all the dots or sometimes is off track entirely. This is a step-by-step process and as much as possible I encourage you to follow through with each step and be consistent in the practices that I describe and the homework that is assigned. In this course, the more you practice, the more results you will see. In addition I also want to emphasize that whenever working with sexual functioning it is always useful to consult your doctor general practitioner or physician who's in charge of your health. Because sometimes there can be complicating, health factors that are creating some of the situation around sexual functioning. Premature ejaculation, as I said can be a very challenging and embarrassing situation to deal with. I've heard the stories of many men working through it and trying to figure out solutions. The first piece to understand is that premature ejaculation is the result of your central nervous system functioning in a way that while maybe well-meaning is not serving you in the moment. Our bodies are very elaborately designed with lots of programming. That were not always in control of, or even aware of, but are always having an influence on us. What I mean by that is that our central nervous system is, what is responsible for a fight, or flight nervous system response. Great evolutionary mechanism, that has allowed us to avoid being eaten, by saber-toothed tigers. But, In a modern context, usually isn't serving us because our bodies can't distinguish between a life-threatening situation or a situation in the bedroom where you feel level of pressure or expectation either put on yourself or by your partner that is resulting in a negative outcome with regards to sexual functioning. When we experience something that is anxiety-provoking or Stressful or we feel level of tension or fear, our central nervous system has a number of physiological, changes that start to take place first. As a way of protecting the most essential parts of your body. Blood is going to pool to your brain, your heart and your lungs to make sure that those continue to function. This is one of the reasons why you're nervous often times. Your fingers will be white rather than filled with blood. In those moments All of that blood pooling to the heart, the brain and the lungs results in less ability to regulate the blood flow in your penis. And as a result, there's another physiological change that starts to take place. Your body, usually will start to tighten up as you're worried as you're stressed, people talk about tension headaches. Usually, this is the result of carrying a lot of stress. and tension in your shoulders. Meaning that your shoulder muscles are engaged. The same thing happens in your pelvic floor. Your pelvic floor is going to contract, and in that tension again, it's going to be more difficult to regulate blood flow, which is going to affect your ability to regulate arousal. And therefore last longer, another part of the central nervous system activation is to understand that one of the ways premature ejaculation is trying to serve you is that if you are in a nerve-racking situation, your body is going to say get in and out as quickly as possible. Obviously, that isn't what you want to have happen, but your body thinks it's trying to help you. And as a result getting in and out, as quickly as possible means that if you feel that stress, you'll be able to deal with whatever the situation is that your body is telling you to be stressed about, even if it isn't really what you want in the moment. another part of the activation of the central nervous system is that your breathing tends to shift, Breathing shifts into short, shallow breaths up into the chest. As a result of short shallow breaths up in your chest, you aren't getting a full exhalation of are what happens in those moments is that your body sends a little signal to your brain that you still have toxins build up in your body. And as a result, your brain starts scanning for all the reasons why things might be wrong as your brain starts scanning about all the possibilities of what might be wrong. Your body starts to pick up more of that stress and tension and you're going to breathe faster. And shallower in the chest, it ends up creating a feedback loop where less and less of an ability to regulate, your nervous system is possible often times men who struggle with premature ejaculation report that there's a lot of short shallow breaths up in the chest. There's a lot of tension in their bodies and they notice that their bodies don't feel very connected to their minds. There tends to be a lack of awareness of what is happening. As you're trying to engage in a sexual situation. men are often times, told that thinking with the other head means not thinking at all and what I found through my hours and hours of talking with men is that the exact opposite is true Think of your penis, as a lightning rod, for picking up anything, that might be going on in the back of your mind, stress, or tension around work, worry about financial situation or directly related to things going on with your partner. How comfortable is your partner What might be going on in their life and you are picking up on their level of tension and stress and anxiety. How comfortable of a sexual situation is it with your partner? Is this a one-night stand Is this somebody that you feel completely safe with is this a situation where your body is able to relax and say I'm safe with you or is your body trying to tell you something about the situation? This doesn't mean that you're always with the wrong partner. What it might mean is that you have to understand what is needed to build a sense of safety within your body to be able to relax and let your body feel comfortable engaging in sex. So if you've ever been told just think with the other head ignore that. And instead realize that your penis is actually trying to give you fantastic information, just in a really frustrating way. So now that we have a better idea of how your nervous system is impacting, your ability to have relaxed and positive sexual functioning, we're going to begin to identify ways for you to increase the level of control and influence you have over your central nervous system or that fight or flight response that's playing out. What I find and I want to be clear, I'm not ignoring the role of psychological factors, we're going to get to those in a moment. We're going to address different ways to think about the situation and really finding a different way of interacting sexually. But first, we have to build up some tools around how to regulate your body. I find for men, It's much easier to find ways to hijack, your body than it is your brain. Your brain has a lot more elaborate defense mechanisms than your body and when you understand why you're trying to do something different physically, usually you're able to achieve a much faster outcome in terms of making a shift. So the first place that I want to focus on in terms of changing the way you interact with your central nervous system is through breathing. We're trying to engage what is called the parasympathetic nervous system, which is known as the rest and digest system. Or it's also been jokingly referred to as the feed and breed system you're trying to make breeding, whether you're trying for a child or not part of what your body, feels relaxed and comfortable enough to do. Basically, what that means is that your body says, this is a relaxed comfortable enough environment that I don't have to track or be aware of anything in the outside environment. And therefore, I can be lost around this specific task. Because if I'm distracted having sex and I'm about to eat be eaten by a tiger. That doesn't work out too well, right? So your body has to say, all of these systems are saying, this is a safe environment to get focused on. Another central nervous system activation indicator is that usually people who are nervous will get a dry mouth because your digestion is going to stop. That's important to recognize because if all of your body is tense and feeling like it's preparing to fight or run away, it's not going to be in a position where it's comfortable to have sex, one of the easiest ways to recognize how strong of an impact that your central nervous system can have on sexual functioning is that almost every grown man remembers being a boy, who is hit puberty, and is getting spontaneous erections all the time and is bored sitting in math class, you're not really, paying attention, you're tired and as a result as your kind of head nodding, you probably got an erection at some point. I'm willing to bet the same has never happened playing sports or during a math test. If you feel a level of stress and anxiety, your body is going to shut off sexual functioning to take care of addressing the threat at hand. And so, if you think of all the times you've had a math class and you had to take a test, you probably have never gotten an erection, then you've never gotten an erection working out in the gym. You've never gotten an erection when there's a level of stress or anxiety going on in your local environment. So as I said, the starting point to begin to hijack and retrain, your central nervous system to engage that rest and digest or feed and breed parasympathetic nervous system is through breath. Now, you can't do this too much. It's something that if you practice this all day, you would probably be better at work at home and life pretty much across the board. But for now we're just focusing on sexual situations. So, what I want you to do is you're going to sit here. And I like to track right where my rib cage ends At the top of my stomach, which is right where my diaphragm is and when we're taking full diaphragmatic or belly breaths, what happens is that it's next to impossible to have a panic attack in those moments when you're breathing fully with your belly, couple reasons, one, you're releasing tension in your stomach so you're not engaging the armor of your muscles and instead you're saying it's safe to relax and let your body unwind. Another part is also that you can get a much fuller breath and a much better exhalation through a belly breath which again, exhales all of those toxins and and CO2 that otherwise would accumulate if you're taking short, shallow breaths up and up in your chest. If you ever watched how a baby breathes, they'll naturally breathe with their whole diaphragm, as opposed to, as you shift how you breathe the older you get it tends to shift more up towards your chest. So we're going to retrain how you breathe What I want you to do is I want you to put your hand right on that spot where your rib cage ends and highlight where that diaphragm is. I like to close my eyes. So I just focus on that. So I'm going to close my eyes. I'm going to breathe in through my nose and out through my mouth. I'm going to see how full of a breath I can take that will allow my hand to expand as far as possible and then I'm going to breathe out and see how far I can let my hand fall. I'm not going to actually be able to touch my spine, but I like to imagine breathing out. So, completely that my hand is going to touch my spine and my belly is just in the way what that will do is just make sure that you can get that full exhalation and really begin to regulate your nervous system. So it looks like this I'm just going to demonstrate about maybe three of them so you have an idea of what this looks like. I'm going to add another detail which is one that at the beginning Oftentimes find a little strange but I'll say makes a big difference to really double check that you're getting a full exhalation and also that each time you breathe out you're releasing as much tension as possible in your body. What I want you to do is you're going to actually vocalize that breath out and let the sound of your voice reverberate through your body and just sort of melt any tension, you might be experiencing What that looks like is this. It's a movement, or a way of breathing that can make men feel a little uncomfortable or self-conscious, But it goes a long way. There's usually a few things that people notice. So first, when you are getting that full exhalation, you'll notice how much more are you can push out and that allows for that full exhalation. And really, then allows for a full expansion of breathing in and taking in fresh clean air. That makes a huge difference. The reverberations also help because as you get that full exhalation you can tell if you have a little bit more air and really push it out. One way, you can tell that this is shifting you out of central nervous system activation and instead into the parasympathetic nervous system or that feed and breed system is by. When you open your eyes, you'll notice that everything in the room, looks a little foggy. you might feel the desire to yawn, you might feel a little sleepy, everything just sort of softens and when everything softens. That's your parasympathetic nervous system kicking in. It's the feeling you get right before you fall asleep. And again that's your body's way of saying, I feel safe enough that I can be off-duty. That's really what we're going for because we want you to be off duty while also really being able to enjoy the excitement of the moment because it's a safe enough environment. One of the benefits of using your hand to track the breath and making sure you're taking that full deep belly breath. Is that you always have your hands with you another way to track this. If it's hard to sort of get the feel of it in the beginning or just you want to practice it a little bit more fully, is if you lie down on your couch and you put a pillow on the top of your belly, you can take those deep belly breaths. And you'll watch how much the pillow moves rather than your hand and being able to see the pillow sometimes, indicates how much movement there is rather than just relying on your hand as the visualization for that. So now that we focused on breath, as the starting point, for regulating, your nervous system which is going to allow your body to feel safe in sexual situations. The next thing we want to do is add to that sense of reassurance and relaxation that you can offer to your body. What we're going to do is something called progressive muscle relaxation. Basically, we're going to start just with our toes. We're going to tense, just our toes, and hold the The tension in our toes for three seconds, and I'll count you down and then you're going to release that tension. And then you're going to tense to your feet and your toes for 3 seconds. And then These we're going to keep adding more and more body parts to the exercise, until eventually you're tensing, your whole body and holding that tension. For 3 seconds, one of the areas that I want you to focus on specifically as we are going through, this exercise is each time you release. I want you to release tension in your whole body but I really want you to track your pelvic floor. Your pelvic floor is the group of muscles that clenches down in your groin. And it's a group of muscles that if you were to stop urinating in the middle of the stream, you would clinch that muscle group or if you're trying to squeeze in a fart. So that muscle group that you contract is your pelvic floor. This is also something that men don't always realize but involuntarily contracts meaning you don't even About it whenever you feel a level of surprise or worry. For example, if you've ever been driving, which pretty much everybody has had this situation at some point, if you ever been driving and all the sudden you have to slam on the brakes, your body's going to have a startling. and that startle response is going to clench your pelvic floor. So if you are just sit here and pull the sudden try to slam your foot on the ground, you might notice your pelvic floor. Or Contracting. We're going to try to relax your pelvic floor as much as possible because the more relaxed it is the more it can regulate arousal and let blood flow in and out as is appropriate for the situation. The benefit of this exercise is that muscles are like bungee cords. Sometimes you have to stretch them out a little bit to be able to unhook the hook and then let it go slack and that's really what we're doing with your muscles. The more your body can relax your muscles and just Lower your armor. If you think of your armor as your muscles in your body, your way, body's way of trying to protect you. What you're going to do is just release that tension as much as possible for your body. To say, this is a safe environment that I can get lost in this activity and really enjoy it. So how do we begin progressive muscle relaxation as an exercise? What I like to do is I like to close my eyes and I start with just again a few full deep belly Deep breaths. And each time I relax, I feel myself melting into the chair. Letting my whole body goes slack, and releasing any tension that I'm able to track. So And you can see my whole body, just sort of collapses. I feel that state of rest that I'm inviting my body into I'm going to start just with my toes and I'm going to tense. three two, one, and release the tension in my toes. Next, I'm going to tense my feet and my toes and tense. Three, two, one. And release that tension letting my body goes Slack. Next, I'm going to tense my calves and my shins, my ankles, and my feet, and my toes and tense. Three, two, one. And release. Next, I'm going to tense my hips. I'm going to attach my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release the tension melting into the chair or the couch, or the whatever environment you're in. Just letting your body go slack. Next, I'm going to tense my pelvic floor, that group of muscles, that we talked about, just a moment ago, my hips, my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release letting that tension go as much as possible. Next, I'm going to attend to my stomach and my lower back, my pelvic floor, my hips, my glutes, my hamstrings, my quads, my ankles shins, calves toes feet, everything from basically, the Rib Line down and tense, three two, one and release that tension letting everything go slack. Next, I'm going to have you tense your chest in your shoulder blades, your back, your stomach, your hips, the pelvic floor, your legs, your ankles your feet and your toes and tense Three, two, one, and release, letting all that tension go. Remembering to take full belly, breaths in between the moments of tension. Next, we're going to tense our hands, and our forearms, our arms, and our shoulders, our chest, our back, our stomach, our hips, the pelvic floor, our legs our feet and our toes. Everything from the neck down and tense, three, two, one and release. Letting that tension go melting into whatever. Or chair or bed, you're sitting on. As a final one, I'm going to have you bring your shoulders up to your ears. You're going to scrunch up your face in your forehead, your scalp, your neck, your arms, your hands, your shoulders, your chest, your back, your stomach, the pelvic floor, your hips, your legs, and your feet, and your toes, your whole body. And we're going to tense, 3, 2, 1, and just release all of the tension in your body might be holding. Take a few breaths before opening your eyes. a few full belly breaths. And just track this feeling in your body. This is the feeling we're trying to replicate when you're interacting in a sexual experience so that your body is relaxed and comfortable and feeling safe. Usually, when people open their eyes from this exercise, they begin to notice it again. Everything's a little bit foggy. Here, they might feel the desire to yawn, everything just sort of softens and quiets a little bit as a result, that is your body. Just saying I'm safe and comfortable. We're trying to associate that feeling as much as possible with sexual situations, which we're going to start moving into in a moment and how to integrate these exercises into improving sexual functioning. The next area that we're talking about is specifically changes to masturbation as a way of improving sexual functioning. One of the analogies I like to use is that if you want to be able to run a marathon, we have to stop training by sprinting. We're going to focus on marathon rather than sprinting by making a number of changes to how you masturbate. Masturbation often times happens in the shower or at an office desk. Depends on whatever type of masturbation you're doing. But usually, it's in an environment that isn't the same environment as you're having sex. And so what you're trying to do is have a relaxed comfortable situation in one environment, then a totally different environment where you're interacting with a partner and there's a level of uncertainty and stress because you haven't, Your body to be as familiar and relaxed as possible with being in the bed rather than in the shower. The other thing that also tends to happen for men who masturbate in the shower is it's usually a lot more for efficiency. It's not about Marathon masturbation. It's instead very functional and just cleaning the pipes, if you will. The problem with that is you are training your body to respond quickly. Rather than be able to last longer. So the first change, you're going to make to how you masturbate is to shift from masturbating at a desk, or in the shower, or the bathroom to the bedroom. And I want you to be in bed lying down when you masturbate. If you already use lubrication great, if you don't, I want you to start using lubrication for masturbation. What you're going to do by adding lubrication is approximate the sensation of intercourse? More closely than if you were to masturbate just by friction alone we're trying to get your body. Used to the sensations, you experience as much as possible and lubrication is going to help with that quite a bit. Another part around masturbation is taking a break from porn. If you don't use porn great. If you do use porn, what I'll say is that I'm pretty the middle of the road in terms of the role of porn overall. If it works for you, great, if it doesn't work for you, great. But for now, we're going to take a break from it for a couple of reasons. First, what happens when men tend to watch porn is that they're letting the screen regulate their arousal, rather than being in touch with their own body and noticing their own arousal as a result. And so, if the screen is regulating arousal, when you're in a sexual situation with a partner, it's going to be much harder to be aware of when your body is shifting and arousal levels. And so I want you to take a break from porn because it gives you access to as much information as possible. The other thing that also happens with porn is That it can create an unrealistic expectation of what you're trying to live up to. And as a result it feels reassuring to watch a successful and scripted sexual experience. But the downside of that is you're creating a comparison to what you're experiencing and that comparison can add a level of pressure and expectation of how you think you're supposed to be able to quote unquote, perform. So taking a break from porn. I would suggest for at least a few months is going to help you get in touch with your own ability to regulate arousal and notice what your stimulated by the other reason, we're taking a break from porn, is that in just a moment we're going to go over a guided imagery exercise that is going to give you a step-by-step experience that you're going to think through and that is what I want you to focus on as the erotic material. Rather than getting lost in screen. now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing Any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes after The 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. Premature ejaculation, as I said can be a very challenging and embarrassing situation to deal with. I've heard the stories of many men working through it and trying to figure out solutions. The first piece to understand is that premature ejaculation is the result of your central nervous system functioning in a way that while maybe well-meaning is not serving you in the moment. Our bodies are very elaborately designed with lots of programming. That were not always in control of, or even aware of, but are always having an influence on us. What I mean by that is that our central nervous system is, what is responsible for a fight, or flight nervous system response. Great evolutionary mechanism, that has allowed us to avoid being eaten, by saber-toothed tigers. But, In a modern context, usually isn't serving us because our bodies can't distinguish between a life-threatening situation or a situation in the bedroom where you feel level of pressure or expectation either put on yourself or by your partner that is resulting in a negative outcome with regards to sexual functioning. When we experience something that is anxiety-provoking or Stressful or we feel level of tension or fear, our central nervous system has a number of physiological, changes that start to take place first. As a way of protecting the most essential parts of your body. Blood is going to pool to your brain, your heart and your lungs to make sure that those continue to function. This is one of the reasons why you're nervous often times. Your fingers will be white rather than filled with blood. In those moments All of that blood pooling to the heart, the brain and the lungs results in less ability to regulate the blood flow in your penis. And as a result, there's another physiological change that starts to take place. Your body, usually will start to tighten up as you're worried as you're stressed, people talk about tension headaches. Usually, this is the result of carrying a lot of stress. and tension in your shoulders. Meaning that your shoulder muscles are engaged. The same thing happens in your pelvic floor. Your pelvic floor is going to contract, and in that tension again, it's going to be more difficult to regulate blood flow, which is going to affect your ability to regulate arousal. And therefore last longer, another part of the central nervous system activation is to understand that one of the ways premature ejaculation is trying to serve you is that if you are in a nerve-racking situation, your body is going to say get in and out as quickly as possible. Obviously, that isn't what you want to have happen, but your body thinks it's trying to help you. And as a result getting in and out, as quickly as possible means that if you feel that stress, you'll be able to deal with whatever the situation is that your body is telling you to be stressed about, even if it isn't really what you want in the moment. another part of the activation of the central nervous system is that your breathing tends to shift, Breathing shifts into short, shallow breaths up into the chest. As a result of short shallow breaths up in your chest, you aren't getting a full exhalation of are what happens in those moments is that your body sends a little signal to your brain that you still have toxins build up in your body. And as a result, your brain starts scanning for all the reasons why things might be wrong as your brain starts scanning about all the possibilities of what might be wrong. Your body starts to pick up more of that stress and tension and you're going to breathe faster and shallower in the chest, it ends up creating a feedback loop where less and less of an ability to regulate, your nervous system is possible often times men who struggle with premature ejaculation report that there's a lot of short shallow breaths up in the chest. There's a lot of tension in their bodies and they notice that their bodies don't feel very connected to their minds. There tends to be a lack of awareness of what is happening. As you're trying to engage in a sexual situation. men are often times, told that thinking with the other head means not thinking at all and what I found through my hours and hours of talking with men is that the exact opposite is true Think of your penis, as a lightning rod, for picking up anything, that might be going on in the back of your mind, stress, or tension around work, worry about financial situation or directly related to things going on with your partner. How comfortable is your partner What might be going on in their life and you are picking up on their level of tension and stress and anxiety. How comfortable of a sexual situation is it with your partner? Is this a one-night stand Is this somebody that you feel completely safe with is this a situation where your body is able to relax and say I'm safe with you or is your body trying to tell you something about the situation? This doesn't mean that you're always with the wrong partner. What it might mean is that you have to understand what is needed to build a sense of safety within your body to be able to relax and let your body feel comfortable engaging in sex. So if you've ever been told just think with the other head ignore that. And instead realize that your penis is actually trying to give you fantastic information, just in a really frustrating way. So now that we have a better idea of how your nervous system is impacting, your ability to have relaxed and positive sexual functioning, we're going to begin to identify ways for you to increase the level of control and influence you have over your central nervous system or that fight or flight response that's playing out. What I find and I want to be clear, I'm not ignoring the role of psychological factors, we're going to get to those in a moment. We're going to address different ways to think about the situation and really finding a different way of interacting sexually. But first, we have to build up some tools around how to regulate your body. I find for men, It's much easier to find ways to hijack, your body than it is your brain. Your brain has a lot more elaborate defense mechanisms than your body and when you understand why you're trying to do something different physically, usually you're able to achieve a much faster outcome in terms of making a shift. So the first place that I want to focus on in terms of changing the way you interact with your central nervous system is through breathing. We're trying to engage what is called the parasympathetic nervous system, which is known as the rest and digest system. Or it's also been jokingly referred to as the feed and breed system you're trying to make breeding, whether you're trying for a child or not part of what your body, feels relaxed and comfortable enough to do. Basically, what that means is that your body says, this is a relaxed comfortable enough environment that I don't have to track or be aware of anything in the outside environment. And therefore, I can be lost around this specific task. Because if I'm distracted having sex and I'm about to eat be eaten by a tiger. That doesn't work out too well, right? So your body has to say, all of these systems are saying, this is a safe environment to get focused on. Another central nervous system activation indicator is that usually people who are nervous will get a dry mouth because your digestion is going to stop. That's important to recognize because if all of your body is tense and feeling like it's preparing to fight or run away, it's not going to be in a position where it's comfortable to have sex, one of the easiest ways to recognize how strong of an impact that your central nervous system can have on sexual functioning is that almost every grown man remembers being a boy, who is hit puberty, and is getting spontaneous erections all the time and is bored sitting in math class, you're not really, paying attention, you're tired and as a result as your kind of head nodding, you probably got an erection at some point. I'm willing to bet the same has never happened playing sports or during a math test. If you feel a level of stress and anxiety, your body is going to shut off sexual functioning to take care of addressing the threat at hand. And so, if you think of all the times you've had a math class and you had to take a test, you probably have never gotten an erection, then you've never gotten an erection working out in the gym. You've never gotten an erection when there's a level of stress or anxiety going on in your local environment. So as I said, the starting point to begin to hijack and retrain, your central nervous system to engage that rest and digest or feed and breed parasympathetic nervous system is through breath. Now, you can't do this too much. It's something that if you practice this all day, you would probably be better at work at home and life pretty much across the board. But for now we're just focusing on sexual situations. So, what I want you to do is you're going to sit here. And I like to track right where my rib cage ends At the top of my stomach, which is right where my diaphragm is and when we're taking full diaphragmatic or belly breaths, what happens is that it's next to impossible to have a panic attack in those moments when you're breathing fully with your belly, couple reasons, one, you're releasing tension in your stomach so you're not engaging the armor of your muscles and instead you're saying it's safe to relax and let your body unwind. Another part is also that you can get a much fuller breath and a much better exhalation through a belly breath which again, exhales all of those toxins and and CO2 that otherwise would accumulate if you're taking short, shallow breaths up and up in your chest. If you ever watched how a baby breathes, they'll naturally breathe with their whole diaphragm, as opposed to, as you shift how you breathe the older you get it tends to shift more up towards your chest. So we're going to retrain how you breathe What I want you to do is I want you to put your hand right on that spot where your rib cage ends and highlight where that diaphragm is. I like to close my eyes. So I just focus on that. So I'm going to close my eyes. I'm going to breathe in through my nose and out through my mouth. I'm going to see how full of a breath I can take that will allow my hand to expand as far as possible and then I'm going to breathe out and see how far I can let my hand fall. I'm not going to actually be able to touch my spine, but I like to imagine breathing out. So, completely that my hand is going to touch my spine and my belly is just in the way what that will do is just make sure that you can get that full exhalation and really begin to regulate your nervous system. So it looks like this I'm just going to demonstrate about maybe three of them so you have an idea of what this looks like. I'm going to add another detail which is one that at the beginning Oftentimes find a little strange but I'll say makes a big difference to really double check that you're getting a full exhalation and also that each time you breathe out you're releasing as much tension as possible in your body. What I want you to do is you're going to actually vocalize that breath out and let the sound of your voice reverberate through your body and just sort of melt any tension, you might be experiencing What that looks like is this. It's a movement, or a way of breathing that can make men feel a little uncomfortable or self-conscious, But it goes a long way. There's usually a few things that people notice. So first, when you are getting that full exhalation, you'll notice how much more are you can push out and that allows for that full exhalation. And really, then allows for a full expansion of breathing in and taking in fresh clean air. That makes a huge difference. The reverberations also help because as you get that full exhalation you can tell if you have a little bit more air and really push it out. One way, you can tell that this is shifting you out of central nervous system activation and instead into the parasympathetic nervous system or that feed and breed system is by. When you open your eyes, you'll notice that everything in the room, looks a little foggy. you might feel the desire to yawn, you might feel a little sleepy, everything just sort of softens and when everything softens. That's your parasympathetic nervous system kicking in. It's the feeling you get right before you fall asleep. And again that's your body's way of saying, I feel safe enough that I can be off-duty. That's really what we're going for because we want you to be off duty while also really being able to enjoy the excitement of the moment because it's a safe enough environment. One of the benefits of using your hand to track the breath and making sure you're taking that full deep belly breath. Is that you always have your hands with you another way to track this. If it's hard to sort of get the feel of it in the beginning or just you want to practice it a little bit more fully, is if you lie down on your couch and you put a pillow on the top of your belly, you can take those deep belly breaths. And you'll watch how much the pillow moves rather than your hand and being able to see the pillow sometimes, indicates how much movement there is rather than just relying on your hand as the visualization for that. So now that we focused on breath, as the starting point, for regulating, your nervous system which is going to allow your body to feel safe in sexual situations. The next thing we want to do is add to that sense of reassurance and relaxation that you can offer to your body. What we're going to do is something called progressive muscle relaxation. Basically, we're going to start just with our toes. We're going to tense, just our toes, and hold the The tension in our toes for three seconds, and I'll count you down and then you're going to release that tension. And then you're going to tense to your feet and your toes for 3 seconds. And then These we're going to keep adding more and more body parts to the exercise, until eventually you're tensing, your whole body and holding that tension. For 3 seconds, one of the areas that I want you to focus on specifically as we are going through, this exercise is each time you release. I want you to release tension in your whole body but I really want you to track your pelvic floor. Your pelvic floor is the group of muscles that clenches down in your groin. And it's a group of muscles that if you were to stop urinating in the middle of the stream, you would clinch that muscle group or if you're trying to squeeze in a fart. So that muscle group that you contract is your pelvic floor. This is also something that men don't always realize but involuntarily contracts meaning you don't even About it whenever you feel a level of surprise or worry. For example, if you've ever been driving, which pretty much everybody has had this situation at some point, if you ever been driving and all the sudden you have to slam on the brakes, your body's going to have a startling. and that startle response is going to clench your pelvic floor. So if you are just sit here and pull the sudden try to slam your foot on the ground, you might notice your pelvic floor. Or Contracting. We're going to try to relax your pelvic floor as much as possible because the more relaxed it is the more it can regulate arousal and let blood flow in and out as is appropriate for the situation. The benefit of this exercise is that muscles are like bungee cords. Sometimes you have to stretch them out a little bit to be able to unhook the hook and then let it go slack and that's really what we're doing with your muscles. The more your body can relax your muscles and just Lower your armor. If you think of your armor as your muscles in your body, your way, body's way of trying to protect you. What you're going to do is just release that tension as much as possible for your body. To say, this is a safe environment that I can get lost in this activity and really enjoy it. So how do we begin progressive muscle relaxation as an exercise? What I like to do is I like to close my eyes and I start with just again a few full deep belly Deep breaths. And each time I relax, I feel myself melting into the chair. Letting my whole body goes slack, and releasing any tension that I'm able to track. So And you can see my whole body, just sort of collapses. I feel that state of rest that I'm inviting my body into I'm going to start just with my toes and I'm going to tense. three two, one, and release the tension in my toes. Next, I'm going to tense my feet and my toes and tense. Three, two, one. And release that tension letting my body goes Slack. Next, I'm going to tense my calves and my shins, my ankles, and my feet, and my toes and tense. Three, two, one. And release. Next, I'm going to tense my hips. I'm going to attach my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release the tension melting into the chair or the couch, or the whatever environment you're in. Just letting your body go slack. Next, I'm going to tense my pelvic floor, that group of muscles, that we talked about, just a moment ago, my hips, my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release letting that tension go as much as possible. Next, I'm going to attend to my stomach and my lower back, my pelvic floor, my hips, my glutes, my hamstrings, my quads, my ankles shins, calves toes feet, everything from basically, the Rib Line down and tense, three two, one and release that tension letting everything go slack. Next, I'm going to have you tense your chest in your shoulder blades, your back, your stomach, your hips, the pelvic floor, your legs, your ankles your feet and your toes and tense Three, two, one, and release, letting all that tension go. Remembering to take full belly, breaths in between the moments of tension. Next, we're going to tense our hands, and our forearms, our arms, and our shoulders, our chest, our back, our stomach, our hips, the pelvic floor, our legs our feet and our toes. Everything from the neck down and tense, three, two, one and release. Letting that tension go melting into whatever. Or chair or bed, you're sitting on. As a final one, I'm going to have you bring your shoulders up to your ears. You're going to scrunch up your face in your forehead, your scalp, your neck, your arms, your hands, your shoulders, your chest, your back, your stomach, the pelvic floor, your hips, your legs, and your feet, and your toes, your whole body. And we're going to tense, 3, 2, 1, and just release all of the tension in your body might be holding. Take a few breaths before opening your eyes. a few full belly breaths. And just track this feeling in your body. This is the feeling we're trying to replicate when you're interacting in a sexual experience so that your body is relaxed and comfortable and feeling safe. Usually, when people open their eyes from this exercise, they begin to notice it again. Everything's a little bit foggy. Here, they might feel the desire to yawn, everything just sort of softens and quiets a little bit as a result, that is your body. Just saying I'm safe and comfortable. We're trying to associate that feeling as much as possible with sexual situations, which we're going to start moving into in a moment and how to integrate these exercises into improving sexual functioning. The next area that we're talking about is specifically changes to masturbation as a way of improving sexual functioning. One of the analogies I like to use is that if you want to be able to run a marathon, we have to stop training by sprinting. We're going to focus on marathon rather than sprinting by making a number of changes to how you masturbate. Masturbation often times happens in the shower or at an office desk. Depends on whatever type of masturbation you're doing. But usually, it's in an environment that isn't the same environment as you're having sex. And so what you're trying to do is have a relaxed comfortable situation in one environment, then a totally different environment where you're interacting with a partner and there's a level of uncertainty and stress because you haven't, Your body to be as familiar and relaxed as possible with being in the bed rather than in the shower. The other thing that also tends to happen for men who masturbate in the shower is it's usually a lot more for efficiency. It's not about Marathon masturbation. It's instead very functional and just cleaning the pipes, if you will. The problem with that is you are training your body to respond quickly. Rather than be able to last longer. So the first change, you're going to make to how you masturbate is to shift from masturbating at a desk, or in the shower, or the bathroom to the bedroom. And I want you to be in bed lying down when you masturbate. If you already use lubrication great, if you don't, I want you to start using lubrication for masturbation. What you're going to do by adding lubrication is approximate the sensation of intercourse? More closely than if you were to masturbate just by friction alone we're trying to get your body. Used to the sensations, you experience as much as possible and lubrication is going to help with that quite a bit. Another part around masturbation is taking a break from porn. If you don't use porn great. If you do use porn, what I'll say is that I'm pretty the middle of the road in terms of the role of porn overall. If it works for you, great, if it doesn't work for you, great. But for now, we're going to take a break from it for a couple of reasons. First, what happens when men tend to watch porn is that they're letting the screen regulate their arousal, rather than being in touch with their own body and noticing their own arousal as a result. And so, if the screen is regulating arousal, when you're in a sexual situation with a partner, it's going to be much harder to be aware of when your body is shifting and arousal levels. And so I want you to take a break from porn because it gives you access to as much information as possible. The other thing that also happens with porn is That it can create an unrealistic expectation of what you're trying to live up to. And as a result it feels reassuring to watch a successful and scripted sexual experience. But the downside of that is you're creating a comparison to what you're experiencing and that comparison can add a level of pressure and expectation of how you think you're supposed to be able to quote unquote, perform. So taking a break from porn. I would suggest for at least a few months is going to help you get in touch with your own ability to regulate arousal and notice what your stimulated by the other reason, we're taking a break from porn, is that in just a moment we're going to go over a guided imagery exercise that is going to give you a step-by-step experience that you're going to think through and that is what I want you to focus on as the erotic material. Rather than getting lost in screen. now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing Any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes after The 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. Men are often times, told that thinking with the other head means not thinking at all and what I found through my hours and hours of talking with men is that the exact opposite is true Think of your penis, as a lightning rod, for picking up anything, that might be going on in the back of your mind, stress, or tension around work, worry about financial situation or directly related to things going on with your partner. How comfortable is your partner What might be going on in their life and you are picking up on their level of tension and stress and anxiety. How comfortable of a sexual situation is it with your partner? Is this a one-night stand Is this somebody that you feel completely safe with is this a situation where your body is able to relax and say I'm safe with you or is your body trying to tell you something about the situation? This doesn't mean that you're always with the wrong partner. What it might mean is that you have to understand what is needed to build a sense of safety within your body to be able to relax and let your body feel comfortable engaging in sex. So if you've ever been told just think with the other head ignore that and instead realize that your penis is actually trying to give you fantastic information, just in a really frustrating way. So now that we have a better idea of how your nervous system is impacting, your ability to have relaxed and positive sexual functioning, we're going to begin to identify ways for you to increase the level of control and influence you have over your central nervous system or that fight or flight response that's playing out. What I find and I want to be clear, I'm not ignoring the role of psychological factors, we're going to get to those in a moment. We're going to address different ways to think about the situation and really finding a different way of interacting sexually. But first, we have to build up some tools around how to regulate your body. I find for men, It's much easier to find ways to hijack, your body than it is your brain. Your brain has a lot more elaborate defense mechanisms than your body and when you understand why you're trying to do something different physically, usually you're able to achieve a much faster outcome in terms of making a shift. So the first place that I want to focus on in terms of changing the way you interact with your central nervous system is through breathing. We're trying to engage what is called the parasympathetic nervous system, which is known as the rest and digest system. Or it's also been jokingly referred to as the feed and breed system you're trying to make breeding, whether you're trying for a child or not part of what your body, feels relaxed and comfortable enough to do. Basically, what that means is that your body says, this is a relaxed comfortable enough environment that I don't have to track or be aware of anything in the outside environment. And therefore, I can be lost around this specific task. Because if I'm distracted having sex and I'm about to eat be eaten by a tiger. That doesn't work out too well, right? So your body has to say, all of these systems are saying, this is a safe environment to get focused on. Another central nervous system activation indicator is that usually people who are nervous will get a dry mouth because your digestion is going to stop. That's important to recognize because if all of your body is tense and feeling like it's preparing to fight or run away, it's not going to be in a position where it's comfortable to have sex, one of the easiest ways to recognize how strong of an impact that your central nervous system can have on sexual functioning is that almost every grown man remembers being a boy, who is hit puberty, and is getting spontaneous erections all the time and is bored sitting in math class, you're not really, paying attention, you're tired and as a result as your kind of head nodding, you probably got an erection at some point. I'm willing to bet the same has never happened playing sports or during a math test. If you feel a level of stress and anxiety, your body is going to shut off sexual functioning to take care of addressing the threat at hand. And so, if you think of all the times you've had a math class and you had to take a test, you probably have never gotten an erection, then you've never gotten an erection working out in the gym. You've never gotten an erection when there's a level of stress or anxiety going on in your local environment. So as I said, the starting point to begin to hijack and retrain, your central nervous system to engage that rest and digest or feed and breed parasympathetic nervous system is through breath. Now, you can't do this too much. It's something that if you practice this all day, you would probably be better at work at home and life pretty much across the board. But for now we're just focusing on sexual situations. So, what I want you to do is you're going to sit here. And I like to track right where my rib cage ends At the top of my stomach, which is right where my diaphragm is and when we're taking full diaphragmatic or belly breaths, what happens is that it's next to impossible to have a panic attack in those moments when you're breathing fully with your belly, couple reasons, one, you're releasing tension in your stomach so you're not engaging the armor of your muscles and instead you're saying it's safe to relax and let your body unwind. Another part is also that you can get a much fuller breath and a much better exhalation through a belly breath which again, exhales all of those toxins and and CO2 that otherwise would accumulate if you're taking short, shallow breaths up and up in your chest. If you ever watched how a baby breathes, they'll naturally breathe with their whole diaphragm, as opposed to, as you shift how you breathe the older you get it tends to shift more up towards your chest. So we're going to retrain how you breathe What I want you to do is I want you to put your hand right on that spot where your rib cage ends and highlight where that diaphragm is. I like to close my eyes. So I just focus on that. So I'm going to close my eyes. I'm going to breathe in through my nose and out through my mouth. I'm going to see how full of a breath I can take that will allow my hand to expand as far as possible and then I'm going to breathe out and see how far I can let my hand fall. I'm not going to actually be able to touch my spine, but I like to imagine breathing out. So, completely that my hand is going to touch my spine and my belly is just in the way what that will do is just make sure that you can get that full exhalation and really begin to regulate your nervous system. So it looks like this I'm just going to demonstrate about maybe three of them so you have an idea of what this looks like. I'm going to add another detail which is one that at the beginning Oftentimes find a little strange but I'll say makes a big difference to really double check that you're getting a full exhalation and also that each time you breathe out you're releasing as much tension as possible in your body. What I want you to do is you're going to actually vocalize that breath out and let the sound of your voice reverberate through your body and just sort of melt any tension, you might be experiencing What that looks like is this. It's a movement, or a way of breathing that can make men feel a little uncomfortable or self-conscious, But it goes a long way. There's usually a few things that people notice. So first, when you are getting that full exhalation, you'll notice how much more are you can push out and that allows for that full exhalation. And really, then allows for a full expansion of breathing in and taking in fresh clean air. That makes a huge difference. The reverberations also help because as you get that full exhalation you can tell if you have a little bit more air and really push it out. One way, you can tell that this is shifting you out of central nervous system activation and instead into the parasympathetic nervous system or that feed and breed system is by. When you open your eyes, you'll notice that everything in the room, looks a little foggy. you might feel the desire to yawn, you might feel a little sleepy, everything just sort of softens and when everything softens. That's your parasympathetic nervous system kicking in. It's the feeling you get right before you fall asleep. And again that's your body's way of saying, I feel safe enough that I can be off-duty. That's really what we're going for because we want you to be off duty while also really being able to enjoy the excitement of the moment because it's a safe enough environment. One of the benefits of using your hand to track the breath and making sure you're taking that full deep belly breath. Is that you always have your hands with you another way to track this. If it's hard to sort of get the feel of it in the beginning or just you want to practice it a little bit more fully, is if you lie down on your couch and you put a pillow on the top of your belly, you can take those deep belly breaths. And you'll watch how much the pillow moves rather than your hand and being able to see the pillow sometimes, indicates how much movement there is rather than just relying on your hand as the visualization for that. So now that we focused on breath, as the starting point, for regulating, your nervous system which is going to allow your body to feel safe in sexual situations. The next thing we want to do is add to that sense of reassurance and relaxation that you can offer to your body. What we're going to do is something called progressive muscle relaxation. Basically, we're going to start just with our toes. We're going to tense, just our toes, and hold the The tension in our toes for three seconds, and I'll count you down and then you're going to release that tension. And then you're going to tense to your feet and your toes for 3 seconds. And then These we're going to keep adding more and more body parts to the exercise, until eventually you're tensing, your whole body and holding that tension. For 3 seconds, one of the areas that I want you to focus on specifically as we are going through, this exercise is each time you release. I want you to release tension in your whole body but I really want you to track your pelvic floor. Your pelvic floor is the group of muscles that clenches down in your groin. And it's a group of muscles that if you were to stop urinating in the middle of the stream, you would clinch that muscle group or if you're trying to squeeze in a fart. So that muscle group that you contract is your pelvic floor. This is also something that men don't always realize but involuntarily contracts meaning you don't even About it whenever you feel a level of surprise or worry. For example, if you've ever been driving, which pretty much everybody has had this situation at some point, if you ever been driving and all the sudden you have to slam on the brakes, your body's going to have a startling. and that startle response is going to clench your pelvic floor. So if you are just sit here and pull the sudden try to slam your foot on the ground, you might notice your pelvic floor. Or Contracting. We're going to try to relax your pelvic floor as much as possible because the more relaxed it is the more it can regulate arousal and let blood flow in and out as is appropriate for the situation. The benefit of this exercise is that muscles are like bungee cords. Sometimes you have to stretch them out a little bit to be able to unhook the hook and then let it go slack and that's really what we're doing with your muscles. The more your body can relax your muscles and just Lower your armor. If you think of your armor as your muscles in your body, your way, body's way of trying to protect you. What you're going to do is just release that tension as much as possible for your body. To say, this is a safe environment that I can get lost in this activity and really enjoy it. So how do we begin progressive muscle relaxation as an exercise? What I like to do is I like to close my eyes and I start with just again a few full deep belly Deep breaths. And each time I relax, I feel myself melting into the chair. Letting my whole body goes slack, and releasing any tension that I'm able to track. So And you can see my whole body, just sort of collapses. I feel that state of rest that I'm inviting my body into I'm going to start just with my toes and I'm going to tense. three two, one, and release the tension in my toes. Next, I'm going to tense my feet and my toes and tense. Three, two, one. And release that tension letting my body goes Slack. Next, I'm going to tense my calves and my shins, my ankles, and my feet, and my toes and tense. Three, two, one. And release. Next, I'm going to tense my hips. I'm going to attach my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release the tension melting into the chair or the couch, or the whatever environment you're in. Just letting your body go slack. Next, I'm going to tense my pelvic floor, that group of muscles, that we talked about, just a moment ago, my hips, my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release letting that tension go as much as possible. Next, I'm going to attend to my stomach and my lower back, my pelvic floor, my hips, my glutes, my hamstrings, my quads, my ankles shins, calves toes feet, everything from basically, the Rib Line down and tense, three two, one and release that tension letting everything go slack. Next, I'm going to have you tense your chest in your shoulder blades, your back, your stomach, your hips, the pelvic floor, your legs, your ankles your feet and your toes and tense Three, two, one, and release, letting all that tension go. Remembering to take full belly, breaths in between the moments of tension. Next, we're going to tense our hands, and our forearms, our arms, and our shoulders, our chest, our back, our stomach, our hips, the pelvic floor, our legs our feet and our toes. Everything from the neck down and tense, three, two, one and release. Letting that tension go melting into whatever. Or chair or bed, you're sitting on. As a final one, I'm going to have you bring your shoulders up to your ears. You're going to scrunch up your face in your forehead, your scalp, your neck, your arms, your hands, your shoulders, your chest, your back, your stomach, the pelvic floor, your hips, your legs, and your feet, and your toes, your whole body. And we're going to tense, 3, 2, 1, and just release all of the tension in your body might be holding. Take a few breaths before opening your eyes. a few full belly breaths. And just track this feeling in your body. This is the feeling we're trying to replicate when you're interacting in a sexual experience so that your body is relaxed and comfortable and feeling safe. Usually, when people open their eyes from this exercise, they begin to notice it again. Everything's a little bit foggy. Here, they might feel the desire to yawn, everything just sort of softens and quiets a little bit as a result, that is your body. Just saying I'm safe and comfortable. We're trying to associate that feeling as much as possible with sexual situations, which we're going to start moving into in a moment and how to integrate these exercises into improving sexual functioning. The next area that we're talking about is specifically changes to masturbation as a way of improving sexual functioning. One of the analogies I like to use is that if you want to be able to run a marathon, we have to stop training by sprinting. We're going to focus on marathon rather than sprinting by making a number of changes to how you masturbate. Masturbation often times happens in the shower or at an office desk. Depends on whatever type of masturbation you're doing. But usually, it's in an environment that isn't the same environment as you're having sex. And so what you're trying to do is have a relaxed comfortable situation in one environment, then a totally different environment where you're interacting with a partner and there's a level of uncertainty and stress because you haven't, Your body to be as familiar and relaxed as possible with being in the bed rather than in the shower. The other thing that also tends to happen for men who masturbate in the shower is it's usually a lot more for efficiency. It's not about Marathon masturbation. It's instead very functional and just cleaning the pipes, if you will. The problem with that is you are training your body to respond quickly. Rather than be able to last longer. So the first change, you're going to make to how you masturbate is to shift from masturbating at a desk, or in the shower, or the bathroom to the bedroom. And I want you to be in bed lying down when you masturbate. If you already use lubrication great, if you don't, I want you to start using lubrication for masturbation. What you're going to do by adding lubrication is approximate the sensation of intercourse? More closely than if you were to masturbate just by friction alone we're trying to get your body. Used to the sensations, you experience as much as possible and lubrication is going to help with that quite a bit. Another part around masturbation is taking a break from porn. If you don't use porn great. If you do use porn, what I'll say is that I'm pretty the middle of the road in terms of the role of porn overall. If it works for you, great, if it doesn't work for you, great. But for now, we're going to take a break from it for a couple of reasons. First, what happens when men tend to watch porn is that they're letting the screen regulate their arousal, rather than being in touch with their own body and noticing their own arousal as a result. And so, if the screen is regulating arousal, when you're in a sexual situation with a partner, it's going to be much harder to be aware of when your body is shifting and arousal levels. And so I want you to take a break from porn because it gives you access to as much information as possible. The other thing that also happens with porn is That it can create an unrealistic expectation of what you're trying to live up to. And as a result it feels reassuring to watch a successful and scripted sexual experience. But the downside of that is you're creating a comparison to what you're experiencing and that comparison can add a level of pressure and expectation of how you think you're supposed to be able to quote unquote, perform. So taking a break from porn. I would suggest for at least a few months is going to help you get in touch with your own ability to regulate arousal and notice what your stimulated by the other reason, we're taking a break from porn, is that in just a moment we're going to go over a guided imagery exercise that is going to give you a step-by-step experience that you're going to think through and that is what I want you to focus on as the erotic material. Rather than getting lost in screen. now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing Any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes after The 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. So now that we have a better idea of how your nervous system is impacting your ability to have relaxed and positive sexual functioning, we're going to begin to identify ways for you to increase the level of control and influence you have over your central nervous system or that fight or flight response that's playing out. What I find and I want to be clear, I'm not ignoring the role of psychological factors we're going to get to those in a moment. We're going to address different ways to think about the situation and really finding a different way of interacting sexually. But first, we have to build up some tools around how to regulate your body. I find for men, It's much easier to find ways to hijack, your body than it is your brain. Your brain has a lot more elaborate defense mechanisms than your body and when you understand why you're trying to do something different physically, usually you're able to achieve a much faster outcome in terms of making a shift. So the first place that I want to focus on in terms of changing the way you interact with your central nervous system is through breathing. We're trying to engage what is called the parasympathetic nervous system which is known as the rest and digest system. Or it's also been jokingly referred to as the feed and breed system You're trying to make breeding, whether you're trying for a child or not, part of what your body, feels relaxed and comfortable enough to do. Basically, what that means is that your body says, this is a relaxed comfortable enough environment that I don't have to track or be aware of anything in the outside environment. And therefore, I can be lost around this specific task. Because if I'm distracted having sex and I'm about to eat be eaten by a tiger. That doesn't work out too well, right? So your body has to say, all of these systems are saying, this is a safe environment to get focused on. Another central nervous system activation indicator is that usually people who are nervous will get a dry mouth because your digestion is going to stop. That's important to recognize because if all of your body is tense and feeling like it's preparing to fight or run away, it's not going to be in a position where it's comfortable to have sex, one of the easiest ways to recognize how strong of an impact that your central nervous system can have on sexual functioning is that almost every grown man remembers being a boy, who is hit puberty, and is getting spontaneous erections all the time and is bored sitting in math class, you're not really, paying attention, you're tired and as a result as your kind of head nodding, you probably got an erection at some point. I'm willing to bet the same has never happened playing sports or during a math test. If you feel a level of stress and anxiety, your body is going to shut off sexual functioning to take care of addressing the threat at hand. And so, if you think of all the times you've had a math class and you had to take a test, you probably have never gotten an erection, then you've never gotten an erection working out in the gym. You've never gotten an erection when there's a level of stress or anxiety going on in your local environment. So as I said, the starting point to begin to hijack and retrain, your central nervous system to engage that rest and digest or feed and breed parasympathetic nervous system is through breath. Now, you can't do this too much. It's something that if you practice this all day, you would probably be better at work at home and life pretty much across the board. But for now we're just focusing on sexual situations. So, what I want you to do is you're going to sit here. And I like to track right where my rib cage ends At the top of my stomach, which is right where my diaphragm is and when we're taking full diaphragmatic or belly breaths, what happens is that it's next to impossible to have a panic attack in those moments when you're breathing fully with your belly, couple reasons, one, you're releasing tension in your stomach so you're not engaging the armor of your muscles and instead you're saying it's safe to relax and let your body unwind. Another part is also that you can get a much fuller breath and a much better exhalation through a belly breath which again, exhales all of those toxins and and CO2 that otherwise would accumulate if you're taking short, shallow breaths up and up in your chest. If you ever watched how a baby breathes, they'll naturally breathe with their whole diaphragm, as opposed to, as you shift how you breathe the older you get it tends to shift more up towards your chest. So we're going to retrain how you breathe What I want you to do is I want you to put your hand right on that spot where your rib cage ends and highlight where that diaphragm is. I like to close my eyes. So I just focus on that. So I'm going to close my eyes. I'm going to breathe in through my nose and out through my mouth. I'm going to see how full of a breath I can take that will allow my hand to expand as far as possible and then I'm going to breathe out and see how far I can let my hand fall. I'm not going to actually be able to touch my spine, but I like to imagine breathing out. So, completely that my hand is going to touch my spine and my belly is just in the way what that will do is just make sure that you can get that full exhalation and really begin to regulate your nervous system. So it looks like this I'm just going to demonstrate about maybe three of them so you have an idea of what this looks like. I'm going to add another detail which is one that at the beginning Oftentimes find a little strange but I'll say makes a big difference to really double check that you're getting a full exhalation and also that each time you breathe out you're releasing as much tension as possible in your body. What I want you to do is you're going to actually vocalize that breath out and let the sound of your voice reverberate through your body and just sort of melt any tension, you might be experiencing What that looks like is this. It's a movement, or a way of breathing that can make men feel a little uncomfortable or self-conscious, But it goes a long way. There's usually a few things that people notice. So first, when you are getting that full exhalation, you'll notice how much more are you can push out and that allows for that full exhalation. And really, then allows for a full expansion of breathing in and taking in fresh clean air. That makes a huge difference. The reverberations also help because as you get that full exhalation you can tell if you have a little bit more air and really push it out. One way, you can tell that this is shifting you out of central nervous system activation and instead into the parasympathetic nervous system or that feed and breed system is by. When you open your eyes, you'll notice that everything in the room, looks a little foggy. you might feel the desire to yawn, you might feel a little sleepy, everything just sort of softens and when everything softens. That's your parasympathetic nervous system kicking in. It's the feeling you get right before you fall asleep. And again that's your body's way of saying, I feel safe enough that I can be off-duty. That's really what we're going for because we want you to be off duty while also really being able to enjoy the excitement of the moment because it's a safe enough environment. One of the benefits of using your hand to track the breath and making sure you're taking that full deep belly breath. Is that you always have your hands with you another way to track this. If it's hard to sort of get the feel of it in the beginning or just you want to practice it a little bit more fully, is if you lie down on your couch and you put a pillow on the top of your belly, you can take those deep belly breaths. And you'll watch how much the pillow moves rather than your hand and being able to see the pillow sometimes, indicates how much movement there is rather than just relying on your hand as the visualization for that. So now that we focused on breath, as the starting point, for regulating, your nervous system which is going to allow your body to feel safe in sexual situations. The next thing we want to do is add to that sense of reassurance and relaxation that you can offer to your body. What we're going to do is something called progressive muscle relaxation. Basically, we're going to start just with our toes. We're going to tense, just our toes, and hold the The tension in our toes for three seconds, and I'll count you down and then you're going to release that tension. And then you're going to tense to your feet and your toes for 3 seconds. And then These we're going to keep adding more and more body parts to the exercise, until eventually you're tensing, your whole body and holding that tension. For 3 seconds, one of the areas that I want you to focus on specifically as we are going through, this exercise is each time you release. I want you to release tension in your whole body but I really want you to track your pelvic floor. Your pelvic floor is the group of muscles that clenches down in your groin. And it's a group of muscles that if you were to stop urinating in the middle of the stream, you would clinch that muscle group or if you're trying to squeeze in a fart. So that muscle group that you contract is your pelvic floor. This is also something that men don't always realize but involuntarily contracts meaning you don't even About it whenever you feel a level of surprise or worry. For example, if you've ever been driving, which pretty much everybody has had this situation at some point, if you ever been driving and all the sudden you have to slam on the brakes, your body's going to have a startling. and that startle response is going to clench your pelvic floor. So if you are just sit here and pull the sudden try to slam your foot on the ground, you might notice your pelvic floor. Or Contracting. We're going to try to relax your pelvic floor as much as possible because the more relaxed it is the more it can regulate arousal and let blood flow in and out as is appropriate for the situation. The benefit of this exercise is that muscles are like bungee cords. Sometimes you have to stretch them out a little bit to be able to unhook the hook and then let it go slack and that's really what we're doing with your muscles. The more your body can relax your muscles and just Lower your armor. If you think of your armor as your muscles in your body, your way, body's way of trying to protect you. What you're going to do is just release that tension as much as possible for your body. To say, this is a safe environment that I can get lost in this activity and really enjoy it. So how do we begin progressive muscle relaxation as an exercise? What I like to do is I like to close my eyes and I start with just again a few full deep belly Deep breaths. And each time I relax, I feel myself melting into the chair. Letting my whole body goes slack, and releasing any tension that I'm able to track. So And you can see my whole body, just sort of collapses. I feel that state of rest that I'm inviting my body into I'm going to start just with my toes and I'm going to tense. three two, one, and release the tension in my toes. Next, I'm going to tense my feet and my toes and tense. Three, two, one. And release that tension letting my body goes Slack. Next, I'm going to tense my calves and my shins, my ankles, and my feet, and my toes and tense. Three, two, one. And release. Next, I'm going to tense my hips. I'm going to attach my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release the tension melting into the chair or the couch, or the whatever environment you're in. Just letting your body go slack. Next, I'm going to tense my pelvic floor, that group of muscles, that we talked about, just a moment ago, my hips, my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release letting that tension go as much as possible. Next, I'm going to attend to my stomach and my lower back, my pelvic floor, my hips, my glutes, my hamstrings, my quads, my ankles shins, calves toes feet, everything from basically, the Rib Line down and tense, three two, one and release that tension letting everything go slack. Next, I'm going to have you tense your chest in your shoulder blades, your back, your stomach, your hips, the pelvic floor, your legs, your ankles your feet and your toes and tense Three, two, one, and release, letting all that tension go. Remembering to take full belly, breaths in between the moments of tension. Next, we're going to tense our hands, and our forearms, our arms, and our shoulders, our chest, our back, our stomach, our hips, the pelvic floor, our legs our feet and our toes. Everything from the neck down and tense, three, two, one and release. Letting that tension go melting into whatever. Or chair or bed, you're sitting on. As a final one, I'm going to have you bring your shoulders up to your ears. You're going to scrunch up your face in your forehead, your scalp, your neck, your arms, your hands, your shoulders, your chest, your back, your stomach, the pelvic floor, your hips, your legs, and your feet, and your toes, your whole body. And we're going to tense, 3, 2, 1, and just release all of the tension in your body might be holding. Take a few breaths before opening your eyes. a few full belly breaths. And just track this feeling in your body. This is the feeling we're trying to replicate when you're interacting in a sexual experience so that your body is relaxed and comfortable and feeling safe. Usually, when people open their eyes from this exercise, they begin to notice it again. Everything's a little bit foggy. Here, they might feel the desire to yawn, everything just sort of softens and quiets a little bit as a result, that is your body. Just saying I'm safe and comfortable. We're trying to associate that feeling as much as possible with sexual situations, which we're going to start moving into in a moment and how to integrate these exercises into improving sexual functioning. The next area that we're talking about is specifically changes to masturbation as a way of improving sexual functioning. One of the analogies I like to use is that if you want to be able to run a marathon, we have to stop training by sprinting. We're going to focus on marathon rather than sprinting by making a number of changes to how you masturbate. Masturbation often times happens in the shower or at an office desk. Depends on whatever type of masturbation you're doing. But usually, it's in an environment that isn't the same environment as you're having sex. And so what you're trying to do is have a relaxed comfortable situation in one environment, then a totally different environment where you're interacting with a partner and there's a level of uncertainty and stress because you haven't, Your body to be as familiar and relaxed as possible with being in the bed rather than in the shower. The other thing that also tends to happen for men who masturbate in the shower is it's usually a lot more for efficiency. It's not about Marathon masturbation. It's instead very functional and just cleaning the pipes, if you will. The problem with that is you are training your body to respond quickly. Rather than be able to last longer. So the first change, you're going to make to how you masturbate is to shift from masturbating at a desk, or in the shower, or the bathroom to the bedroom. And I want you to be in bed lying down when you masturbate. If you already use lubrication great, if you don't, I want you to start using lubrication for masturbation. What you're going to do by adding lubrication is approximate the sensation of intercourse? More closely than if you were to masturbate just by friction alone we're trying to get your body. Used to the sensations, you experience as much as possible and lubrication is going to help with that quite a bit. Another part around masturbation is taking a break from porn. If you don't use porn great. If you do use porn, what I'll say is that I'm pretty the middle of the road in terms of the role of porn overall. If it works for you, great, if it doesn't work for you, great. But for now, we're going to take a break from it for a couple of reasons. First, what happens when men tend to watch porn is that they're letting the screen regulate their arousal, rather than being in touch with their own body and noticing their own arousal as a result. And so, if the screen is regulating arousal, when you're in a sexual situation with a partner, it's going to be much harder to be aware of when your body is shifting and arousal levels. And so I want you to take a break from porn because it gives you access to as much information as possible. The other thing that also happens with porn is That it can create an unrealistic expectation of what you're trying to live up to. And as a result it feels reassuring to watch a successful and scripted sexual experience. But the downside of that is you're creating a comparison to what you're experiencing and that comparison can add a level of pressure and expectation of how you think you're supposed to be able to quote unquote, perform. So taking a break from porn. I would suggest for at least a few months is going to help you get in touch with your own ability to regulate arousal and notice what your stimulated by the other reason, we're taking a break from porn, is that in just a moment we're going to go over a guided imagery exercise that is going to give you a step-by-step experience that you're going to think through and that is what I want you to focus on as the erotic material. Rather than getting lost in screen. now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing Any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes after The 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. So as I said, the starting point to begin to hijack and retrain, your central nervous system to engage that rest and digest or feed and breed parasympathetic nervous system is through breath. Now, you can't do this too much. It's something that if you practice this all day, you would probably be better at work at home and life pretty much across the board. But for now we're just focusing on sexual situations. So, what I want you to do is you're going to sit here. And I like to track right where my rib cage ends At the top of my stomach, which is right where my diaphragm is and when we're taking full diaphragmatic or belly breaths, what happens is that it's next to impossible to have a panic attack in those moments when you're breathing fully with your belly, couple reasons, one, you're releasing tension in your stomach so you're not engaging the armor of your muscles and instead you're saying it's safe to relax and let your body unwind. Another part is also that you can get a much fuller breath and a much better exhalation through a belly breath which again, exhales all of those toxins and and CO2 that otherwise would accumulate if you're taking short, shallow breaths up and up in your chest. If you ever watched how a baby breathes, they'll naturally breathe with their whole diaphragm, as opposed to, as you shift how you breathe the older you get it tends to shift more up towards your chest. So we're going to retrain how you breathe What I want you to do is I want you to put your hand right on that spot where your rib cage ends and highlight where that diaphragm is. I like to close my eyes. So I just focus on that. So I'm going to close my eyes. I'm going to breathe in through my nose and out through my mouth. I'm going to see how full of a breath I can take that will allow my hand to expand as far as possible and then I'm going to breathe out and see how far I can let my hand fall. I'm not going to actually be able to touch my spine, but I like to imagine breathing out. So, completely that my hand is going to touch my spine and my belly is just in the way what that will do is just make sure that you can get that full exhalation and really begin to regulate your nervous system. So it looks like this I'm just going to demonstrate about maybe three of them so you have an idea of what this looks like. I'm going to add another detail which is one that at the beginning Oftentimes find a little strange but I'll say makes a big difference to really double check that you're getting a full exhalation and also that each time you breathe out you're releasing as much tension as possible in your body. What I want you to do is you're going to actually vocalize that breath out and let the sound of your voice reverberate through your body and just sort of melt any tension, you might be experiencing What that looks like is this. It's a movement, or a way of breathing that can make men feel a little uncomfortable or self-conscious, But it goes a long way. There's usually a few things that people notice. So first, when you are getting that full exhalation, you'll notice how much more are you can push out and that allows for that full exhalation. And really, then allows for a full expansion of breathing in and taking in fresh clean air. That makes a huge difference. The reverberations also help because as you get that full exhalation you can tell if you have a little bit more air and really push it out. One way, you can tell that this is shifting you out of central nervous system activation and instead into the parasympathetic nervous system or that feed and breed system is by. When you open your eyes, you'll notice that everything in the room, looks a little foggy. you might feel the desire to yawn, you might feel a little sleepy, everything just sort of softens and when everything softens. That's your parasympathetic nervous system kicking in. It's the feeling you get right before you fall asleep often times. And again that's your body's way of saying, I feel safe enough that I can be off-duty. That's really what we're going for because we want you to be off duty while also really being able to enjoy the excitement of the moment because it's a safe enough environment. One of the benefits of using your hand to track the breath and making sure you're taking that full deep belly breath. Is that you always have your hands with you another way to track this. If it's hard to sort of get the feel of it in the beginning or just you want to practice it a little bit more fully, is if you lie down on your couch and you put a pillow on the top of your belly, you can take those deep belly breaths. And you'll watch how much the pillow moves rather than your hand and being able to see the pillow sometimes, indicates how much movement there is rather than just relying on your hand as the visualization for that. So now that we focused on breath, as the starting point, for regulating, your nervous system which is going to allow your body to feel safe in sexual situations. The next thing we want to do is add to that sense of reassurance and relaxation that you can offer to your body. What we're going to do is something called progressive muscle relaxation. Basically, we're going to start just with our toes. We're going to tense, just our toes, and hold the The tension in our toes for three seconds, and I'll count you down and then you're going to release that tension. And then you're going to tense to your feet and your toes for 3 seconds. And then These we're going to keep adding more and more body parts to the exercise, until eventually you're tensing, your whole body and holding that tension. For 3 seconds, one of the areas that I want you to focus on specifically as we are going through, this exercise is each time you release. I want you to release tension in your whole body but I really want you to track your pelvic floor. Your pelvic floor is the group of muscles that clenches down in your groin. And it's a group of muscles that if you were to stop urinating in the middle of the stream, you would clinch that muscle group or if you're trying to squeeze in a fart. So that muscle group that you contract is your pelvic floor. This is also something that men don't always realize but involuntarily contracts meaning you don't even About it whenever you feel a level of surprise or worry. For example, if you've ever been driving, which pretty much everybody has had this situation at some point, if you ever been driving and all the sudden you have to slam on the brakes, your body's going to have a startling. and that startle response is going to clench your pelvic floor. So if you are just sit here and pull the sudden try to slam your foot on the ground, you might notice your pelvic floor. Or Contracting. We're going to try to relax your pelvic floor as much as possible because the more relaxed it is the more it can regulate arousal and let blood flow in and out as is appropriate for the situation. The benefit of this exercise is that muscles are like bungee cords. Sometimes you have to stretch them out a little bit to be able to unhook the hook and then let it go slack and that's really what we're doing with your muscles. The more your body can relax your muscles and just Lower your armor. If you think of your armor as your muscles in your body, your way, body's way of trying to protect you. What you're going to do is just release that tension as much as possible for your body. To say, this is a safe environment that I can get lost in this activity and really enjoy it. So how do we begin progressive muscle relaxation as an exercise? What I like to do is I like to close my eyes and I start with just again a few full deep belly Deep breaths. And each time I relax, I feel myself melting into the chair. Letting my whole body goes slack, and releasing any tension that I'm able to track. So And you can see my whole body, just sort of collapses. I feel that state of rest that I'm inviting my body into I'm going to start just with my toes and I'm going to tense. three two, one, and release the tension in my toes. Next, I'm going to tense my feet and my toes and tense. Three, two, one. And release that tension letting my body goes Slack. Next, I'm going to tense my calves and my shins, my ankles, and my feet, and my toes and tense. Three, two, one. And release. Next, I'm going to tense my hips. I'm going to attach my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release the tension melting into the chair or the couch, or the whatever environment you're in. Just letting your body go slack. Next, I'm going to tense my pelvic floor, that group of muscles, that we talked about, just a moment ago, my hips, my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release letting that tension go as much as possible. Next, I'm going to attend to my stomach and my lower back, my pelvic floor, my hips, my glutes, my hamstrings, my quads, my ankles shins, calves toes feet, everything from basically, the Rib Line down and tense, three two, one and release that tension letting everything go slack. Next, I'm going to have you tense your chest in your shoulder blades, your back, your stomach, your hips, the pelvic floor, your legs, your ankles your feet and your toes and tense Three, two, one, and release, letting all that tension go. Remembering to take full belly, breaths in between the moments of tension. Next, we're going to tense our hands, and our forearms, our arms, and our shoulders, our chest, our back, our stomach, our hips, the pelvic floor, our legs our feet and our toes. Everything from the neck down and tense, three, two, one and release. Letting that tension go melting into whatever. Or chair or bed, you're sitting on. As a final one, I'm going to have you bring your shoulders up to your ears. You're going to scrunch up your face in your forehead, your scalp, your neck, your arms, your hands, your shoulders, your chest, your back, your stomach, the pelvic floor, your hips, your legs, and your feet, and your toes, your whole body. And we're going to tense, 3, 2, 1, and just release all of the tension in your body might be holding. Take a few breaths before opening your eyes. a few full belly breaths. And just track this feeling in your body. This is the feeling we're trying to replicate when you're interacting in a sexual experience so that your body is relaxed and comfortable and feeling safe. Usually, when people open their eyes from this exercise, they begin to notice it again. Everything's a little bit foggy. Here, they might feel the desire to yawn, everything just sort of softens and quiets a little bit as a result, that is your body. Just saying I'm safe and comfortable. We're trying to associate that feeling as much as possible with sexual situations, which we're going to start moving into in a moment and how to integrate these exercises into improving sexual functioning. The next area that we're talking about is specifically changes to masturbation as a way of improving sexual functioning. One of the analogies I like to use is that if you want to be able to run a marathon, we have to stop training by sprinting. We're going to focus on marathon rather than sprinting by making a number of changes to how you masturbate. Masturbation often times happens in the shower or at an office desk. Depends on whatever type of masturbation you're doing. But usually, it's in an environment that isn't the same environment as you're having sex. And so what you're trying to do is have a relaxed comfortable situation in one environment, then a totally different environment where you're interacting with a partner and there's a level of uncertainty and stress because you haven't, Your body to be as familiar and relaxed as possible with being in the bed rather than in the shower. The other thing that also tends to happen for men who masturbate in the shower is it's usually a lot more for efficiency. It's not about Marathon masturbation. It's instead very functional and just cleaning the pipes, if you will. The problem with that is you are training your body to respond quickly. Rather than be able to last longer. So the first change, you're going to make to how you masturbate is to shift from masturbating at a desk, or in the shower, or the bathroom to the bedroom. And I want you to be in bed lying down when you masturbate. If you already use lubrication great, if you don't, I want you to start using lubrication for masturbation. What you're going to do by adding lubrication is approximate the sensation of intercourse? More closely than if you were to masturbate just by friction alone we're trying to get your body. Used to the sensations, you experience as much as possible and lubrication is going to help with that quite a bit. Another part around masturbation is taking a break from porn. If you don't use porn great. If you do use porn, what I'll say is that I'm pretty the middle of the road in terms of the role of porn overall. If it works for you, great, if it doesn't work for you, great. But for now, we're going to take a break from it for a couple of reasons. First, what happens when men tend to watch porn is that they're letting the screen regulate their arousal, rather than being in touch with their own body and noticing their own arousal as a result. And so, if the screen is regulating arousal, when you're in a sexual situation with a partner, it's going to be much harder to be aware of when your body is shifting and arousal levels. And so I want you to take a break from porn because it gives you access to as much information as possible. The other thing that also happens with porn is That it can create an unrealistic expectation of what you're trying to live up to. And as a result it feels reassuring to watch a successful and scripted sexual experience. But the downside of that is you're creating a comparison to what you're experiencing and that comparison can add a level of pressure and expectation of how you think you're supposed to be able to quote unquote, perform. So taking a break from porn. I would suggest for at least a few months is going to help you get in touch with your own ability to regulate arousal and notice what your stimulated by the other reason, we're taking a break from porn, is that in just a moment we're going to go over a guided imagery exercise that is going to give you a step-by-step experience that you're going to think through and that is what I want you to focus on as the erotic material. Rather than getting lost in screen. now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing Any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes after The 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. So now that we focused on breath, as the starting point for regulating, your nervous system which is going to allow your body to feel safe in sexual situations. The next thing we want to do is add to that sense of reassurance and relaxation that you can offer to your body. What we're going to do is something called progressive muscle relaxation. Basically, we're going to start just with our toes. We're going to tense, just our toes, and hold the tension in our toes for three seconds, and I'll count you down and then you're going to release that tension. And then you're going to tense to your feet and your toes for 3 seconds. And then release. These we're going to keep adding more and more body parts to the exercise, until eventually you're tensing, your whole body and holding that tension. For 3 seconds, one of the areas that I want you to focus on specifically as we are going through, this exercise is each time you release. I want you to release tension in your whole body but I really want you to track your pelvic floor. Your pelvic floor is the group of muscles that clenches down in your groin. And it's a group of muscles that if you were to stop urinating in the middle of the stream, you would clinch that muscle group or if you're trying to squeeze in a fart. So that muscle group that you contract is your pelvic floor. This is also something that men don't always realize but involuntarily contracts meaning you don't even About it whenever you feel a level of surprise or worry. For example, if you've ever been driving, which pretty much everybody has had this situation at some point, if you ever been driving and all the sudden you have to slam on the brakes, your body's going to have a startling. and that startle response is going to clench your pelvic floor. So if you are just sit here and pull the sudden try to slam your foot on the ground, you might notice your pelvic floor. Or Contracting. We're going to try to relax your pelvic floor as much as possible because the more relaxed it is the more it can regulate arousal and let blood flow in and out as is appropriate for the situation. The benefit of this exercise is that muscles are like bungee cords. Sometimes you have to stretch them out a little bit to be able to unhook the hook and then let it go slack and that's really what we're doing with your muscles. The more your body can relax your muscles and just Lower your armor. If you think of your armor as your muscles in your body, your way, body's way of trying to protect you. What you're going to do is just release that tension as much as possible for your body. To say, this is a safe environment that I can get lost in this activity and really enjoy it. So how do we begin progressive muscle relaxation as an exercise? What I like to do is I like to close my eyes and I start with just again a few full deep belly Deep breaths. And each time I relax, I feel myself melting into the chair. Letting my whole body goes slack, and releasing any tension that I'm able to track. So And you can see my whole body, just sort of collapses. I feel that state of rest that I'm inviting my body into I'm going to start just with my toes and I'm going to tense. three two, one, and release the tension in my toes. Next, I'm going to tense my feet and my toes and tense. Three, two, one. And release that tension letting my body goes Slack. Next, I'm going to tense my calves and my shins, my ankles, and my feet, and my toes and tense. Three, two, one. And release. Next, I'm going to tense my hips. I'm going to attach my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense. Three, two, one and release the tension melting into the chair or the couch, or the whatever environment you're in. Just letting your body go slack. Next, I'm going to tense my pelvic floor, that group of muscles, that we talked about, just a moment ago, my hips, my glutes, my hamstrings, my quads, my calves, my shins, my ankles, my feet, and my toes and tense Three, two, one and release letting that tension go as much as possible. Next, I'm going to attend to my stomach and my lower back, my pelvic floor, my hips, my glutes, my hamstrings, my quads, my ankles shins, calves toes feet, everything from basically, the Rib Line down and tense three, two, one and release that tension letting everything go slack. Next, I'm going to have you tense your chest in your shoulder blades, your back, your stomach, your hips, the pelvic floor, your legs, your ankles your feet and your toes and tense Three, two, one, and release, letting all that tension go. Remembering to take full belly, breaths in between the moments of tension. Next, we're going to tense our hands, and our forearms, our arms, and our shoulders, our chest, our back, our stomach, our hips, the pelvic floor, our legs our feet and our toes. Everything from the neck down and tense, three, two, one and release. Letting that tension go melting into whatever. Or chair or bed, you're sitting on. As a final one, I'm going to have you bring your shoulders up to your ears. You're going to scrunch up your face in your forehead, your scalp, your neck, your arms, your hands, your shoulders, your chest, your back, your stomach, the pelvic floor, your hips, your legs, and your feet, and your toes, your whole body. And we're going to tense, 3, 2, 1, and just release all of the tension in your body might be holding. Take a few breaths before opening your eyes. a few full belly breaths. And just track this feeling in your body. This is the feeling we're trying to replicate when you're interacting in a sexual experience so that your body is relaxed and comfortable and feeling safe. Usually, when people open their eyes from this exercise, they begin to notice it again. Everything's a little bit foggy. Here, they might feel the desire to yawn, everything just sort of softens and quiets a little bit as a result, that is your body. Just saying I'm safe and comfortable. We're trying to associate that feeling as much as possible with sexual situations, which we're going to start moving into in a moment and how to integrate these exercises into improving sexual functioning. The next area that we're talking about is specifically changes to masturbation as a way of improving sexual functioning. One of the analogies I like to use is that if you want to be able to run a marathon, we have to stop training by sprinting. We're going to focus on marathon rather than sprinting by making a number of changes to how you masturbate. Masturbation often times happens in the shower or at an office desk. Depends on whatever type of masturbation you're doing. But usually, it's in an environment that isn't the same environment as you're having sex. And so what you're trying to do is have a relaxed comfortable situation in one environment, then a totally different environment where you're interacting with a partner and there's a level of uncertainty and stress because you haven't, Your body to be as familiar and relaxed as possible with being in the bed rather than in the shower. The other thing that also tends to happen for men who masturbate in the shower is it's usually a lot more for efficiency. It's not about Marathon masturbation. It's instead very functional and just cleaning the pipes, if you will. The problem with that is you are training your body to respond quickly. Rather than be able to last longer. So the first change, you're going to make to how you masturbate is to shift from masturbating at a desk, or in the shower, or the bathroom to the bedroom. And I want you to be in bed lying down when you masturbate. If you already use lubrication great, if you don't, I want you to start using lubrication for masturbation. What you're going to do by adding lubrication is approximate the sensation of intercourse? More closely than if you were to masturbate just by friction alone we're trying to get your body. Used to the sensations, you experience as much as possible and lubrication is going to help with that quite a bit. Another part around masturbation is taking a break from porn. If you don't use porn great. If you do use porn, what I'll say is that I'm pretty the middle of the road in terms of the role of porn overall. If it works for you, great, if it doesn't work for you, great. But for now, we're going to take a break from it for a couple of reasons. First, what happens when men tend to watch porn is that they're letting the screen regulate their arousal, rather than being in touch with their own body and noticing their own arousal as a result. And so, if the screen is regulating arousal, when you're in a sexual situation with a partner, it's going to be much harder to be aware of when your body is shifting and arousal levels. And so I want you to take a break from porn because it gives you access to as much information as possible. The other thing that also happens with porn is That it can create an unrealistic expectation of what you're trying to live up to. And as a result it feels reassuring to watch a successful and scripted sexual experience. But the downside of that is you're creating a comparison to what you're experiencing and that comparison can add a level of pressure and expectation of how you think you're supposed to be able to quote unquote, perform. So taking a break from porn. I would suggest for at least a few months is going to help you get in touch with your own ability to regulate arousal and notice what your stimulated by the other reason, we're taking a break from porn, is that in just a moment we're going to go over a guided imagery exercise that is going to give you a step-by-step experience that you're going to think through and that is what I want you to focus on as the erotic material. Rather than getting lost in screen. now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing Any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes after The 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. The next area that we're talking about is specifically changes to masturbation as a way of improving sexual functioning. One of the analogies I like to use is that if you want to be able to run a marathon, we have to stop training by sprinting. We're going to focus on marathon rather than sprinting by making a number of changes to how you masturbate. Masturbation often times happens in the shower or at an office desk. Depends on whatever type of masturbation you're doing. But usually, it's in an environment that isn't the same environment as you're having sex. And so what you're trying to do is have a relaxed comfortable situation in one environment, then a totally different environment where you're interacting with a partner and there's a level of uncertainty and stress because you haven't trained your body to be as familiar and relaxed as possible with being in the bed rather than in the shower. The other thing that also tends to happen for men who masturbate in the shower is it's usually a lot more for efficiency. It's not about Marathon masturbation. It's instead very functional and just cleaning the pipes, if you will. The problem with that is you are training your body to respond quickly. Rather than be able to last longer. So the first change, you're going to make to how you masturbate is to shift from masturbating at a desk, or in the shower, or the bathroom to the bedroom. And I want you to be in bed lying down when you masturbate. If you already use lubrication great, if you don't, I want you to start using lubrication for masturbation. What you're going to do by adding lubrication is approximate the sensation of intercourse? More closely than if you were to masturbate just by friction alone we're trying to get your body. Used to the sensations, you experience as much as possible and lubrication is going to help with that quite a bit. Another part around masturbation is taking a break from porn. If you don't use porn great. If you do use porn, what I'll say is that I'm pretty the middle of the road in terms of the role of porn overall. If it works for you, great, if it doesn't work for you, great. But for now, we're going to take a break from it for a couple of reasons. First, what happens when men tend to watch porn is that they're letting the screen regulate their arousal, rather than being in touch with their own body and noticing their own arousal as a result. And so, if the screen is regulating arousal, when you're in a sexual situation with a partner, it's going to be much harder to be aware of when your body is shifting and arousal levels. And so I want you to take a break from porn because it gives you access to as much information as possible. The other thing that also happens with porn is That it can create an unrealistic expectation of what you're trying to live up to. And as a result it feels reassuring to watch a successful and scripted sexual experience. But the downside of that is you're creating a comparison to what you're experiencing and that comparison can add a level of pressure and expectation of how you think you're supposed to be able to quote unquote, perform. So taking a break from porn. I would suggest for at least a few months is going to help you get in touch with your own ability to regulate arousal and notice what your stimulated by the other reason, we're taking a break from porn, is that in just a moment we're going to go over a guided imagery exercise that is going to give you a step-by-step experience that you're going to think through and that is what I want you to focus on as the erotic material Rather than getting lost in screen. now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing Any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes after The 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. Now that we've identified that taking a break from porn using lubrication and laying down in your bed is the best way to begin to masturbate. We're going to add some other details around how to make changes so that your training can be for a marathon rather than a Sprint. What I want you to do is I want you to start off by lying in your bed and you're going to just start tracking your breathing. Using that deep belly breathing technique that we just talked about. And then you're going to walk through the full body muscle relaxation, exercise by walking through that. You're going to create as relaxed and positive of a sexual environment as possible for your body to associate with. And when that's possible, that's going to carry over into sexual situations with your partner. You want to create that relaxed sense of comfort and ease to be able to show up in a way that doesn't have the same level of pressure or expectation or anxiety that may be setting you back from having a sexual experiences you want after you've worked through the muscle relaxation and you feel like your body is at a very relaxed state of being, I'm going to have you start touching yourself in bed using lubrication as you begin, touching yourself using lubrication. What I'm going to have you do is I'm going to use this pen to demonstrate. I'm going to have you begin to just make contact with your penis and begin stroking. What we're going to do is we're going to think of your arousal spectrum, as a scale of one to ten. One being this is starting to feel good 10, being the point of ejaculation, There's an area of arousal that's usually about the level 3 to level 7 that I like to call the murky metal and the murky middle usually is hard to track in the beginning. It's the area where men tend to get caught off guard. What I mean by that is, you'll start enjoying the experience and pretty quickly. What you'll notice is you'll jump up to a level seven or an eight. You'll get to that level 9 really easily, and quickly, which is kind of the point of no return. And we want to build up as much awareness of each level of arousal. In that murky, middle to avoid getting caught off, guard by it, and by being able to track it as that arousal is increasing. So, as you get to that level 3, you can continue to stroke. And then, once you jump up to more of the six, Maybe to a 7 range. I want you to practice one of three options, either you slow down the stroke. If you can stay in the 6 range or even drop down to a level 5, then great continue the sensation of stroking yourself. If you need to just hold without moving or stroking at all, then that's totally fine as well. And then the third option, if the arousal is too strong and it's hard to be able to stay at that six or seven range, is to take your hand off of yourself entirely and wait. Until you feel like your arousal level is back down to a three or a four. Once you're back down to a three or four, I want you to start making contact with yourself again, continuing to stroke yourself until you jump up again to that six or seven range. And then practice one of the three options to just get used to hanging out in that murky middle as much as possible and noticing which a level of arousal your app. What you'll notice is that at the beginning of practicing this, You might have to take longer breaks, you might have your hand off of your penis, for 30 seconds, or a minute, or even longer. And as you practice this, you'll notice that you'll be able to maintain more consistent sensation with firmer more vigorous strokes. And as a result, you will be able to handle the level of arousal without crossing that point of no return or jumping up to a level beyond that, murky middle. And then having things go right from there. as you noticed, that level of arousal increasing, I want you to check in with your breathing and any tension that you notice in your body often times what happens is men will notice that that level of arousal increasing corresponds to holding your breath or muscles beginning to tense up and if you can retrain your body to start breathing again, or taking full deep belly breaths or also relaxing any other body part that might begin to tense up You're going to be able to regulate that arousal and decrease what level you're at. So that you can sustain the experience for a longer. What I want you to do is set a timer for 15 to 20 minutes, ideally on your phone, so that you don't have to track it. And you're going to just continue to stimulate yourself for those 15 to 20 minutes After the 15 to 20 minutes if you want to ejaculate. Great. If you don't feel like it great, there's no expectation or requirement either way. But it's just a matter of building up that sensation of of, in of enjoying stimulation for 15 to 20 minutes. What I will say in terms of frequency of practice is ideally men practice this three to five times a week if you get 7 times in a week. Great, if you get three that's totally fine but practice will definitely build up that awareness. And you'll begin to notice more and more increased stimulation and sensation without Crossing those thresholds of Sensation that are too intense. And you'll notice that the ability to breathe and relax tension will also allow you to unwind and not cross those point of no return. There's a lot of different information out there. One thing that a lot of people ask about is does it ever make sense to not masturbate what I think of masturbation as is really training for sexual experiences and it's also your own relationship to your body. So building up that awareness is incredibly beneficial but the other thing is also that the more you are masturbating, the more likely you are to increase the number of erections, you're getting and the strength of erections because sex is a use-it-or-lose-it skill. If your body is not used to sexual experiences on your own or with a partner. What's going to happen is it's not going to know how to respond as efficiently or effectively. As if it is very familiar with erections and ejaculation and arousal and by being familiar with that, you know, how to adjust the situation. To accommodate the outcome, you want. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax and enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you So you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable. Relax. Most private setting, what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up, and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's And Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using Vacation lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse, relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. Now, that you have an idea of how we're going to make changes around masturbation. We're going to start to add in some of the mental adjustment to you're going to make so that you can relax nd enjoy the experience as much as possible. And when pleasure is present, it's a lot harder to be stressed and anxious about the sexual situation. One analogy, I like to use to make sense of this is Imagine That you have the best steak in the world. If you don't like steak, imagine that it's any other food that you absolutely love. But let's use steak for now. So you have the best steak in the world, it is world class and it's right in front of you. But I'm going to make a number of rules around how you eat that steak first, you have to eat that steak and exactly one minute and 38 seconds and you're going to have to chew 232. Two times per bite of steak and the whole time you're chewing. You have to look to the right, but when you're not chewing, you have to look to the left and you can't look at the steak after you've put the bite in your mouth. If I made all those rules, I'm willing to bet you wouldn't even be able to taste the steak as you're trying to track all of the different things you have to pay attention to. That's a pretty good analogy for what happens for men with regards to sexual functioning, when they're trying to have sex because they're tracking all sorts of different situations. They're wondering if their partners having a good time. They're wondering if they're hard enough, they're wondering, if their partner likes their body, they're wondering if premature ejaculation is going to happen. They're stressed and worried about the situation. And when you're stressed and worried about the situation, you can't relax and enjoy the experience. So what we're trying to do mentally is instead shift to enjoying that steak as much as possible. So how would you enjoy that steak as much as possible? You would slow down and focus on all of Different sensations that you can engage in all of the different parts of that experience. So, with the steak, if you were to cut it first, you're going to take a look at it. You're going to notice visually what you see, you're going to notice the marbling you're going to notice how well it's seared, you're going to notice the steam rising off of it, all the little details that make your mouth water, just thinking about it, and as you move, It closer, you're going to start to smell the steak. You're going to notice all of the smells that start to fill your nose. You're going to immerse yourself in that part of the experience. And then, once you put it in your mouth, you begin to taste. You begin to feel the temperature of the steak you're going to notice all of your taste buds engaged and then you're going to chew it. And you're going to notice all the flavor that begins to take place and you're going to just notice all of those different parts of the Vision that you otherwise wouldn't track or pay attention to, if you're rushing through the experience, hoping to avoid something going wrong. Instead what we're going to do is we're going to try to slow it down as much as possible and soak up as much pleasure as possible because that's one of the ways your body is going to relax unwind and say I'm here to enjoy this rather than I'm here to get through this. so during this next exercise, there's a number of times where I'm going to intentionally slow down and mention the different senses that I'm engaging, as a way of relaxing my body, This exercise that we're moving into. Next is a guided imagery exercise or a visualization exercise. We're actually borrowing from sports psychology here. What we're doing is we're looking at some of the studies that have You can place around the power of visualization used in sports. So one very well-known study was that they took three groups of basketball players, one group of basketball players, practiced free throws for two weeks every single day for 2 hours a day. Another group of basketball players, didn't practice free throws at all for those two weeks. A last group, the third group, sat in a classroom and visualized real successful, free throws. And if they imagined missing, they imagined getting the ball again. And instead making the next one, what they found was that the group that practiced the free throws for two weeks improved, which makes sense practice makes perfect right. The group that didn't practice didn't get any better, which also makes sense if you don't actually try it, something you're not going to improve on it. The part that we're going to really emphasize for the sake of this guided imagery exercise, is that the group that sat in a classroom and visualized successful, free throws got 90% of the benefit of the basketball players who practiced the successful free throws. So if by going through a guided Imagery or visualization exercise. With regards to sex we can get 90% of the benefit of having a relaxed and positive and pleasurable sexual experience. I think that's fantastic. And we're going to really try to add some details to make that as positive and of an experience as possible for you and the more you can visualize it the easier it is to access it when you're interacting with a partner. And if we pair the visualization exercise with the masturbation, exercise that we just described what you can do is get the physical sensations of a relaxed and positive sexual experience and add the visualization component and we're getting even more benefit as a result. And the more you can build up positive and relaxed and enjoyable, sexual experiences, it serves as a counterbalance to the worry and the stress that often times, builds up for men, as a result of having had difficult, or disappointing sexual experiences. So now that we've identified that visualization or guided imagery can be incredibly beneficial, I'm going to describe exactly how I want to utilize it to serve you as much as possible. So first, what we're going to do is we're going to describe and I'll have you come up with your own version. But I'm going to give you an example of one. So you have an idea of what this looks like. What I'm going to have you do is describe a relaxed and comfortable and positive actual situation. We're going to start ideally coming home from dinner, or sort of beginning to the narrative that is long before sex is actually happening. Because whenever tension or anxiety is present around sexual situations for men, that stress, that worried that tension, oftentimes begins to present itself long before sex is even actually started. So, we're going to visualize walking in through the door to a comfortable, relaxed, private setting what I want you to do as you are walking through this narrative and it actually helps to say it out loud. Even if you're entirely alone because just hearing it yourself, actually activates different parts of your brain and your able to access the information in a totally different way. So I want you to tell yourself this story out loud as you are going about the visualization exercise. I want you to make clear affirmative statements that are direct and our action items that you are involved in rather than passive or anxious or uncertain statements. An example of that would be next. I reach up and I unclasp her bra, which is very different than, next I think about seeing if she's comfortable with me trying to reach up and unhook her bra. Obviously, the first statement was simple clear and direct. Then other statement introduced a lot more doubt and uncertainty and that's going to produce more anxiety. So firm clear statements. Another thing we're going to focus on is slowing it down at specific moment, where anxiety might be present and we're going to track any tension that pops up and if there's tension. We're going to see if we can release the muscle that tends to tense up and we're going to invite that deep belly breathing back in. So you can regulate your nervous system and we might just slow down and get lost in. The sensations of what's happening in a particular moment and that's going to allow us to really get present and not be thinking about what might happen and instead be focused on how enjoyable the things that are happening really are as you're lost in the experience, as you're going through the visualization exercise, a really useful thing to pay attention to is what are the hiccup points? What are the moments, where you notice that anxiety starts to build in the narrative? Usually, those are the same moments that happened during sexual situation. So for example, with men who are struggling with erectile functioning, putting on a condom tends, to be a spot where most men has a level of anxiety and that tends to be an area of stress and that's when Ben begin to lose their erections. Or if you are struggling with premature ejaculation, a moment where that pops up for a lot of men is right at the point of entry, that's a moment where there's a lot of anxiety. And worry with the first times of feeling the sensations of being inside your partner and noticing the amount of physiological response. You have your body tenses up and in that stress and worry, there isn't the ability to relax. And regulate your nervous system. So now I'm going to run through an example of the guided imagery exercise so that you have an idea of what it looks like. So I like to have men close their eyes. It's an easier way to be able to really get lost in the story. And again, I am encouraging you to tell yourself the story out loud so that you're able to access it as much as possible. Ideally you're pairing this with masturbation using lubrication lying down in bed. So that we're approximating the experience, we're making the experience as close as possible to a real-life interaction with a partner. I walk over to my partner's car door and I open the door and let them out. And I grabbed her hand and I walk in through the front door. and, I just take a moment and I look around noticing that now we're in a relaxed private setting, and as I help my partner take off her coat. She looks at me and I look at her and I get lost in that moment of her. Looking at me with an inviting smile. I Smile Back. And I leaned over and I begin to kiss her on the lips. As she wraps her hands around me. And then it turns into a bit of a hug does. We just take a moment and sort of settled into the space. And then I lead her over to the couch and sit down on the couch. And she sits down next to me and we're cuddling and I move her legs onto mine. We're just looking at each other having a conversation, making some physical contact. My hand is on her shoulder. And then I began to kiss her with more passion. Making out. Just noticing the smell of her hair. Noticing the feel of her lips noticing her hand on my back, getting lost in the sensations of that moment without expectation or worried about where it's going. And I'm just going to really soak up all of the moments of that experience. Being really present. And then things are going to begin to increase in terms of intensity. I'm going to begin to. Unbutton her shirt. And she's going to begin looking at me and giving me a bit of a knowing smile about what's coming next. And she's going to begin to pull my shirt off of my back. has I'm describing this example, if you notice each action is clear and direct about who is doing it when and how And also I'm focused on the earlier steps, rather than rushing towards sex itself. I'm taking my time. I'm letting my body settle in and enjoy the experience early on. And really thinking of allowing that experience to be drawn out and as settled as possible. so, What I'm going to do now is I'm going to invite you to continue describing each step moving from the couch to walking to the bedroom and undressing but I'm going to speak to a few specific moments in ways to work through specific hiccups around sex itself. So, for example, an area that a lot of men get stuck in is putting on a condom if erectile functioning is an issue. So, I begin to notice myself feeling hard and we're naked in bed and she reaches down, and puts her hand on my penis and I feel myself, get harder. And I noticed that thought in the back of my mind, present itself, that you're going to have to put a condom on you, start getting worried, and if that worry starts to present itself, what I would encourage you to think about is slowing it down and instead focusing on the sensations of her touching you. And I would also invite you to direct your focus to looking at her noticing her body, noticing your body being touched. What Sensations, do you feel? What do you hear? What do you see? The more you can get lost in the sensations or less, it becomes about. what's happening next in terms of the condom and instead allows you to focus on the experience at hand, So specific to premature ejaculation an area of particular anxiety. For a lot of men is the moment of penetration and so, What we're going to do is describe ways of inviting that relaxation into that moment. So as I feel my erection strong, I'm going to begin to move towards my partner and I feel myself enter my partner and I'm just going to slow down and notice how tight my partner feels. I'm going to notice the sensations. I'm going to notice the look on their face and the look on my face that they're watching me and I'm watching them I'm going to get lost in that moment rather than Worrying about what it means or how long I'm going to last. I'm going to redirect my focus to everything that's positive and enjoyable that I'm experiencing. Another very important moment to add as you are walking through. This visualization is feeling your body during intercourse relaxed and having fun. I want you to have a moment where you notice You are lost in the sensations of having sex. You are just feeling your body relaxed and enjoying the experience as much as possible. You feel all of the tension in your body in terms of that muscle tension relax you're feeling your breathing coming online and your body is just lost in the pleasure and enjoyment of the moment. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating. You same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them. In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard. Great. If that's you're Slow. And then switching activities to something else that your partner's interested in great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself, regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. The next task is to address how to involve your partner. One of the things that I find is very useful, is that if your partner is involved with the Hands-On exercises of masturbation, you can indicate the level of arousal to your partner and they will adjust the level of stimulation or Sensation that they're offering you as a result. The benefit of this is a few things. One, you are getting familiar with your arousal levels, but it also increases the level of unpredictability because you aren't in control of the kind of sensation or stimulation that they're giving you. If you control the experience by masturbating on your own, then you are exclusively in control of the sensation and what that translates to is a lot more control, but also a lot. Less uncertainty and unpredictability the benefit of your partner. Giving you the sensation is that that unpredictable sensation, stimulation allows you to track your regulation, get caught off guard. And then re-regulate through breathing and tension as your partner is stimulating you. Same rules as before if they need to slow down. If they need to stop, if they need to stop sensation, all together, whatever is needed, the ability to communicate that can help involve your partner in the process and have an understanding of how to work with your arousal level. So that is one of the starting points, having your partner, masturbate, you, rather than you masturbating yourself. The next part that I invite men to work with in terms of involving your partner is if your partner is open to slowing down and working with intercourse as an area of navigating arousal. The same murky middle is going to present itself, but obviously there's a lot more stimulation and sensation during intercourse then masturbating with your hand. So The way I like to have men approach this is that men lie on their backs as relaxed as possible focusing on their breath. Ideally, they've talked to their partner about deep belly breathing and are able to have their partner. Invite them to take full breaths and vice versa because nervous systems regulate off of each other. If one person is anxious, the other person is going to be anxious and the more one person relaxes the more the other person is Be able to relax. If both parties are as relaxed and comfortable as possible, you're going to have a better outcome. So as you lie on your back in bed, what I want you to do is I want you to put your hand on your partner's hips, and you are going to guide them In terms of the speed and the depth of penetration that occurs, this is going to allow you to track. that arousal level not get caught off guard as easily but also have the sensations of intercourse that are obviously what we're trying to have your body, get used to and not caught off guard with, you can adjust the speed, you can adjust the depth and after a time that feels satisfactory for you and for your partner, and that might involve long periods of just steady, Contact of you being inside your partner, but not actually moving. That might involve taking a break and then coming back to intercourse or it might mean slow, but steady contact with your partner, the whole time during penetration, either way, you're going to identify when it feels like a good amount of time for both of you. And then whatever approach feels comfortable is that if that's then speeding up and Allowing yourself to get caught off guard great if that's you're going slow and then switching activities to something else that your partner's interested in, great, it doesn't actually matter. What happens after the biggest thing is, I want you to practice that feeling of your body being as relaxed as possible. Breathing, full belly breaths, during intercourse and feeling yourself regulate your arousal as your body is interacting with your partner's body and you are shifting the depth and speed of them. Moving on top of you. An added benefit of your partner being involved in the Hands-On exercises or the exercise. I just described specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around, Good when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. An added benefit of your partner being involved in the Hands-On exercises or the exercise I just described. specific to intercourse is that you get familiar and used to communicating your needs and what you're experiencing during an uncertain situation. One of the common patterns that I tend to notice for a lot of men who struggle with sexual functioning is that it's difficult articulating. Your own experience and what your own needs are. And obviously there's a much larger subject, but one thing I will say that tends to go really long way. Is practicing communicating your needs or Desires in non-sexual situations. So for example, I encourage men to notice when they tend to ask questions or track their partner and instead re-direct the focus towards themselves, it's around day-to-day decisions. So an example of this is, what do you feel like for dinner is really different than I feel like sushi tonight. How does that work for you? If you are clear about what you want, your introducing less uncertainty and ambiguity into the situation. And you also are getting used to using your voice, to let your partner know where you're at. Because if you can say that around food, when we then translate that to sex, you're able to say slow down a little bit. I'm I'm at that higher level of arousal, okay? I'm feeling good again. Alright. Now we can get back to moving faster. Let's slow down a little bit. I'm feeling a little bit too much arousal. Okay, I'm feeling really good. Let's have fun the ability to let your partner know where you're at. Is something that helps you and your partner know how to engage with the situation as positively as possible. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help. You learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also of avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid. Ejaculation my issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always check Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter. A very common question is, what good are numbing creams? Should I look into using a numbing cream for struggling with early ejaculation? What I like to tell man around that is if it helps, relieve, some of the stress and anxiety the situation then, Don't see any issue with it. In the short term, one issue that I have with it is that it doesn't help you learn how to regulate your own arousal. Instead all you're doing is just numbing out the sensation. So, in the short term, can it be used as a way of avoiding an embarrassing situation with a partner? Sure. And honestly, I think it also can be a way of just taking a little bit of pressure off of yourself. However, I will say the benefit of retraining your penis to be able to enjoy longer-term. Sensation is something that is far more beneficial than just using a cream. Because there may be situations where you want to increase the amount of sensation you can actually experience without going over the edge of arousal to the point of ejaculation. So, as much as possible, I would say use it as a stopgap measure. But also avoid letting it become a crutch and train your penis instead using these techniques. Another common technique for avoiding premature ejaculation, that is recommended is the squeeze technique where you squeeze at the base of your penis or on your perineum to avoid ejaculation. My issue with using that as a method is that you're already past the point of no return. And it's a A last-ditch effort, rather than being able to be comfortable and still enjoy the experience long before you hit that point of no return. So I would avoid using the squeeze method because it doesn't allow you to build awareness of each step of arousal and really get familiar with that murky middle. And instead it just sort of teaches you that getting to that point is inevitable, when the truth is, if you go through the exercises you will build a lot of more awareness and you'll be able to avoid getting past the point of no return without ever having to do this. Squeeze technique. Another common question around premature ejaculation, is the role of kegels. Kegels are a very popular exercise for the pelvic floor, where you tense and relax your pelvic floor to in theory. Build up the pelvic floor muscles. Whenever I hear about people talking about kegels I always Check-in. And if somebody is having bladder issues, is unable to control urination. Then that's a muscle issue, but for the most part, your pelvic floor is plenty strong. It isn't that you actually need a stronger pelvic floor. You don't need to be developing those muscles. It's that you need to learn how to relax those muscles. So kegels whenever people talk about it with regards to sexual functioning are focusing on the right area, but with building up rather than relaxing the muscles, Kegels help build awareness of that area, but aren't going to serve you in terms of lasting longer in the way that we are looking for. So I would say, kegels aren't going to be a worthwhile use of your time instead, I would focus on these other areas of relaxation and increasing your ability to enjoy stimulation. Going back to that analogy of Of the the marathon runner rather than a sprinter.