Development of cognitive-behavioral therapy intervention for patients with Dhat syndrome
The third case was that of a 36-year-old single male, illiterate, employed as a tailor, from lower socioeconomic status and urban background. He presented with complaints of pain all over the body, nocturnal emissions and erectile dysfunction. At the age of 20 years of age, he had an experience where he felt his penis shrunk. He started having pain during masturbation after this and he stopped the practice. He had had two failed attempts to have sexual intercourse with commercial sex workers. Results after application of the module indicated clinically significant improvements were noted in sexual knowledge, depressive and somatic symptoms. The improvement also perceived in erectile dysfunction and parameters of WHOQOL – Physical and Psychological Health [].\nAn important insight gained during the intervention in this patient was about the self-fulfilling nature of the symptoms. It was noted that the patient expected to find some pains and weakness after the loss of semen, especially after night emissions. Such a hyper-vigilance, along with the attentional bias toward symptoms, invariably ended up in him finding them. Thus, it had acquired the nature of a self-fulfilling prophecy. This cycle had to be broken to bring about any effective change. This was incorporated in interventions with subsequent patients.