Psychotherapeutic training at STOS - Part 4

Good time, dear readers! It's time to return to the topic that we are analyzing throughout the three articles: treating the syndrome of anxious expectation of sexual failure. Previously, we sorted out probable causes of the disease, frequency of occurrence and some methods of treatment from cover to cover. Today we will pay attention to psychotherapeutic training, and we will consider such types of it as:

• autogenic training;
• systematic desensitization;
• self-training, aimed at self-assertion.

So, let's get started.

Autogenic training

Under the method of autogenic training we mean training to achieve general relaxation, together with autogenic forms of autosuggestion. With this method, a man learns to cause states of mental rest, reduce nervous tension, consciously regulate his mental tone and change some vegetative reactions. To some extent, autogenic training is a special form of simplified meditative practice.

In classic form, autogenic training for psychological disorders of erection is carried out for three months. This system was developed in Germany, in Russia by MS Lebedinsky.was created and tested a shortened program, designed for 5-6 weeks of work.

Some domestic therapists recommend the use of special autosuggestions, aimed at strengthening the erection. For example, Liebig SS.suggested using the following:

1. is felt warmly in the lower abdomen;
2. the penis is warm and enlarges.

Under the leadership of Andrianov VVin the Moscow Research Institute of Psychiatry was created a unique technique for group autogenous training, consisting of several blocks. Briefly enumerate them:

• group achieves a state of relaxation, caused individually by each member;
• each focuses on activating suggestions that help to achieve confidence in their ability( some of them: "each lesson makes me calmer and more confident", "my will increases and grows self-confidence", "I'm healthy, strong, real man"and some others);
• after is produced the ideal image of himself in a well-flowing sexual intercourse;
• now repeats the first phase, but now the formulas for auto-suggestion have a different character( "the sexual act was successful and now it will always be so", "we both liked it");
• and in the end used activating the conclusion, mobilizing resources( "I am full of energy").

Now let's proceed to the second method.

Systematic desensitization of

Initially, this technique was used in psychotherapy of phobias, but over time it migrated to sexological practice. The idea of ​​the method is that a man helps with systematic relaxation to learn to overcome the fear of unsuccessful sexual intercourse.

In the initial stages, a man is literally taught to relax, and at the same time the client makes a list of what exactly scares him, after which the most serious fears are highlighted. Then, during a certain number of sessions, the therapist inspires the patient with a hierarchical picture of his fears, while starting "from afar" - from the weakest fears.

The whole procedure is based on the client's presentation of the suggested situation and, if he feels fear, signals this with a conventional palm sign, then deepens the relaxation again. This is how each individual stage of fear is worked out, while for certain psychological mechanisms they cease to be frightening for a man. This method was used by many therapists in the treatment of STOs based on fear that the partner will not be satisfied, or that the sexual act is deliberately doomed to failure.

However, there is a modification of this technique. Desensitization in the client's ideas and thoughts is replaced by work in vivo( in "field conditions"), when the client in the format of "homework" gets used to the situation of sexual contact in the friendly and safe environment created by the partner. In this case, the unconditional consent of the partner for such a method of treatment should be obtained. Here, fear is not destroyed by relaxation, but by achieving an erection.

This technique is a subset of modern sexual therapy, based on the joint work of partners. In theory - this is a promising direction in the fight against STOSN and psychological disorders of erection.

Autogenous training of confidence and self-assertion

Strange as it may sound, but the fear of sexual failure and the development of STOS are often the result of a wider social phobia - fear of social failure and failure, inability to translate their desires into reality. In these cases, patients are advised not only to work directly with the impaired function, but also to teach the art of communication. In particular, the following skills are subject to development:

• how to express your own desires and desires?
• how to say "no" to unacceptable offers?
• how correctly to express positive and negative assessments to close people?
• how to start and exit the dialog?

And this is not all thematic blocks, which are subject to development in the framework of training productive communication skills.

Psychodrama, in fact, is a role-playing game with prescribed roles within the psychotherapeutic group. Shy men, for example, are encouraged to act out roles when they are active on a date, confidently talking to the opposite sex, without hiding expressing their fears and fears about sexuality. All this helps to try on "other people's shoes" and, probably, learn to work with new roles in life. Excessively submissive and constrained men can develop skills of self-assertive behavior in interaction with the wife.

It is obvious that aggression in solving sexual problems is inappropriate, its place should be attention, tenderness, praise and sense of complicity. However, many men use aggressive strategies when facing a problem, which only exacerbates STOS.Psychodrama helps to see new ways of overcoming the old problem.

Some therapists eventually encourage patients to learn the skills of interaction, not only within the psychotherapeutic group, but also in the real world. It can be and help to strangers, and acquaintances in public places, and simple big openness to the environment.

The use of group sessions in the mainstream of psychodrama helps not only to accelerate the process of getting rid of STOSN, but also improves the overall social status of men. After all, communication is the basis of any interaction, including sexual. The development of social skills is potentially a powerful tool in overcoming some of the underlying causes of STOS.

Completing the cycle

So, it's time to take stock of our work. What did we learn about the problem of anxious expectation of sexual failure in four articles? Let's briefly describe the contents of each of them:

1. Here we identified the problem itself, talked about functional sexual disorders( which include STOSN), identified some of the causes and told about two types of erectile dysfunction;
2. This article was devoted to treatment with medication, a critical analysis of this method, and also a dosage of some medicines was given. Immediately we talked about the methods of rational psychotherapy of STOSN and gave concrete recommendations for working with a partner;
3. This material was devoted to the method of hypnosuggestive therapy and pathogenetic treatment, based on the understanding and conscious correction of its problem;
4. And the closing article revealed to us methods for overcoming STOS using "indirect" methods of influence with the use of auto-trainings.

We hope that the problem of STOS became clearer to our readers and we showed that treatment is not only possible, but also extremely diverse - it is only necessary to recognize the problem in time.

Doctor-psychologist Borisov OB B.

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