Development of cognitive-behavioral therapy intervention for patients with Dhat syndrome
This patient was a 25-year-old single male teacher presented with from middle socioeconomic status and rural background. Patient complained of bodily weakness, pains and aches all over the body, lack of concentration, nocturnal emissions and excessive masturbation. He reported premature ejaculation since last 1 year. He was anxious about performing adequately sexually after getting married. He attributed all these symptoms to loss of semen (‘vital energy’, as considered by him). The components of CBT module draft was applied on this patient. Results [] indicated clinically significant improvement in sexual knowledge, somatic and depressive symptoms. However, there were no clinically significant improvements on the other measures.\nIt was also understood that sex education alone is not sufficient. The patient could intellectually understand that loss of semen was harmless. However, his beliefs about loss of semen were triggered again when he experienced pain and weakness the next time semen was lost through either masturbation or nocturnal emissions. It was, then, when the importance of cognitive processes and factors (especially selective attention to symptoms) was realized. It was found that the core belief of the patient was related to the cultural concept of ‘masculinity’. His idea was that if a person was not ‘sexually adequate’; he was not a ‘real man’. All the depressive cognitions and lack of self-esteem was intrinsically related to this concept. The importance of addressing this core belief to bring about any therapeutic change was realized. It was thus decided to address the core schema systematically and vigorously related to masculinity to effect any change in subsequent patients. With these insights, it was decided that emphasis would be given to cognitive restructuring, addressing and modification of cognitive errors in the subsequent patients. There have been no studies earlier, which had utilized cognitive restructuring in the management of patients with Dhat syndrome.[]