Dhat syndrome is associated with the idea of loss of vitality upon ejaculation. Affected individuals are mostly from the Indian subcontinent and culturally suffer from Dhat neurosis. Cognitive behavioral therapy is available for treatment.
What is Dhat syndrome?
The neuroses form a group of purely nervous disorders with functional impairments. Since Freud, neuroses have been described as mild mental illnesses, distinguishing them from the more severe psychoses. In modern psychology neuroses play only a subordinate role. According to the concept of learning theory, most neuroses are now described as learned maladaptations. The triggering environmental factors are now better known as stressors. According to ICD-10, Dhat syndrome is a neurotic disorder. The ancient Indian Sanskrit term “Dhatu” literally means “elixir of life.” The elixir of life in various cultures is considered to be the semen of the male. The Dhat syndrome is therefore associated with the conviction that a part of one’s own life energy is lost during ejaculation. This fearful notion of ejaculation leads patients to attempt to withhold ejaculation in order to secure long life and strong health. Some patients also fear involuntary ejaculation or the loss of semen through urine. The neurosis was first described in 1960 and came from Narendra Wig.
Causes
Dhat syndrome is culturally determined. Affected individuals are usually from areas of the Indian subcontinent. Sexually regular activity or masturbation was seen by ancient and Asian ascetics as an unnecessary drain on energy. The same was true for the Catholic Church. The fact that the syndrome today predominantly affects India and Nepal is due to the Hindu belief in the vital energy in seminal fluid. According to the beliefs, 40 drops of blood are needed to form one drop of bone marrow. Finally, 40 drops of bone marrow equals a single drop of semen. These connections result in the fear of powerlessness when semen is lost. Against the background of the tantric practices, the dhat syndrome is based elsewhere. Fear, however, remains a key word in this context. To want to preserve one’s own life in the long run is doomed to failure. With this knowledge, fear of one’s own death arises again and again, which the patients try to compensate for and ultimately deny. These cultural backgrounds correspond to the typical stressors of the syndrome and evoke the learned maladaptation.
Symptoms, complaints, and signs
Patients with Dhat syndrome suffer from variegated symptoms. In addition to psychological symptoms, physical symptoms usually occur as well. Thus, on the psychological side, the syndrome manifests itself mainly in anxiety to depression and physical weakness or easy exhaustibility. The weakness is psychosomatic within the syndrome and stems from the firm belief that vitality is lost with the semen. In addition, many patients suffer from lack of appetite, palpitations and strong feelings of guilt. Because of the psychological pressure, not only is ejaculation often refused, but especially premature ejaculation occurs. Psychosomatically caused, impotence may also occur. The feelings of guilt and fear have a negative effect on the air sensation of the affected person. The patients practically deprive themselves of excitability in order to avoid losing semen. Subjectively, patients often describe spermatorrhea. This refers to the feeling of losing seminal fluid during urination.
Diagnosis
Diagnosis for Dhat syndrome is made by a psychologist or psychotherapist. The ICD-10 clinical criteria provide the guideline in this context. A cultural background must be substantiated as part of the diagnostic process. In some cases, the syndrome is diagnosed only when impotence occurs. Those affected usually do not first turn to a psychologist with the problem, but assume a physical cause. If no evidence can be provided of such a cause, a psychosomatic basis suggests itself. The prognosis is relatively favorable for patients with Dhat syndrome.
Complications
Although Dhat syndrome is primarily a mental illness, it can also lead to physical limitations and complications.As a rule, the patient suffers from severe fatigue and anxiety. There is a general fatigue and a general feeling of weakness in the patient. Also, thinking that the loss of the semen can negatively affect the consciousness can lead to disturbances in social contacts. There is also usually severe depression and lowered self-esteem. Dhat syndrome also negatively affects sexual life. Withholding ejaculation causes cavalier pain and often premature ejaculation. This can have a negative effect on the relationship with the partner. In many cases, the affected person makes all attempts to avoid becoming aroused. Treatment is usually done by a psychologist accompanied by medication. It does not lead to further complications, although it is not always successful. Often a long period of time passes before the patient realizes that he has Dhat syndrome. Usually, behavioral therapy can combat the syndrome so that ordinary daily life can be resumed.
When should you see a doctor?
Dhat syndrome is considered a neurosis. Provided that the person concerned under his conviction that with the ejaculation a part of his life energy is lost, but suffers neither mentally nor physically, no treatment is also necessary. However, as soon as symptoms appear that impair the quality of life, therapy should be considered. The first signs of an impairment of well-being caused by the Dhat syndrome are feelings of anxiety, mild depression, physical weakness or permanent exhaustion. As soon as such accompanying symptoms manifest themselves, the affected person should take countermeasures. Otherwise, there is a danger that the neurosis will worsen. In severe cases, patients suffer from loss of appetite, regularly recurring strong palpitations or palpitations, and sexual disorders such as impotence or premature ejaculation. Strong feelings of guilt and the resulting severe depression are also possible. At the latest then, the affected person should seek professional help. The general practitioner is a suitable first point of contact. He or she can also treat the primarily physical symptoms. However, the neurosis should also be treated causally. This is usually done by means of cognitive behavioral therapy. In most cases, the attending physician can recommend an appropriately trained psychotherapist to the patient, who should be consulted promptly.
Treatment and therapy
Treatment of Dhat syndrome requires proper classification and resolution of the cause. Drug therapies with antidepressants do not resolve the cause, but only control the symptoms. Thus, Dhat syndrome cannot be cured in this way. Cognitive-behavioral therapy offers prospects for a cure. The therapist thus directly addresses the patient’s perception. The fear occupation of the loss of semen is ideally replaced with a normal feeling of pleasure by cognitive means. Cognition consists of perceiving, recognizing, comprehending, judging and reasoning. In therapy, patients must become aware of their own attitudes, evaluations, and beliefs in order to specifically challenge them. In the first step, cognitive therapy involves raising awareness of relevant cognitions. In the second step, the cognitions are questioned and checked for their appropriateness. Irrational attitudes are corrected before the corrections are adopted into behavior. Patients learn to consciously control their perceptual process to ejaculation. Through cognitive behavioral therapy, the patient changes his or her perception of reality. This automatically changes reality itself, which allows for behavioral changes. Patients with a strong religious background are difficult to treat.
Outlook and prognosis
Dhat syndrome usually has no effect on the health of the affected person. It is an exclusively psychological complaint that can be treated through therapy. In many cases, sufferers can also treat Dhat Syndrome themselves, and self-healing may occur. If no treatment takes place, the syndrome leads to depression and other psychological upsets. Many patients feel weak, tired and lose their zest for life, so that the quality of life is significantly reduced. During sexual intercourse, premature ejaculation occurs.However, the syndrome has no health effects, although there may be tension with the partner. The syndrome is treated by psychotherapy. It is not possible to predict in general whether this will lead to a cure or alleviation of the symptoms. The success of the treatment also strongly depends on the exact cause of the syndrome. In some cases, patients are dependent on taking medication. Therapy can also take several years before a cure is achieved. The patient’s life expectancy is not negatively affected by Dhat syndrome.
Prevention
Dhat syndrome can be prevented by consciously engaging with one’s cognition. However, since it is a culturally determined phenomenon, prevention is hardly feasible in the relevant cultural groups. All people grow up with the ideas of their culture. However, as soon as these ideas develop into a fearful issue, a psychologist should be consulted.
Aftercare
Usually, the options or measures of aftercare for Dhat syndrome prove to be very difficult or are sometimes very limited. Since it is a very specific mental illness, it must be treated by a professional doctor in the first place to avoid further complications and discomfort. After a successful treatment, it should also be recognized what the cause of the Dhat syndrome was in the affected person, so that the syndrome cannot occur again. No general prediction can be made about the further course of the disease. In most cases, the treatment of Dhat syndrome is carried out with the help of psychotherapy. The affected person should visit this regularly. It is also important that the friends and the own family are also informed about the Dhat syndrome and deal with the disease. No general prediction can be made about the duration of treatment of Dhat syndrome. However, the life expectancy of the patient is not changed by this disease. In some cases, contact with other sufferers may also be useful in alleviating symptoms.
What you can do yourself
In cultures where Dhat syndrome is common, particularly in India, Nepal and China, not only is the loss of vital energy associated with ejaculation, but it is pointed out that the woman returns this vital energy to the man during clitoral orgasm. So it is not about the man being weakened, but about the balance between ying and yang, that is, between the female and male life principles. Thus, it helps the man who is plagued by this syndrome a lot not only to deal with his cultural background, but also to thoroughly question his attitude towards women. Not only his partner, but also regular visits to self-help groups for those also affected by Dhat syndrome can be an important support. However, since it is a psychologically complex syndrome that is often accompanied by depression and strong anxiety, there are clear limits to self-help in everyday life. Under no circumstances can this replace behavioral or talk therapy by a trained sex therapist, who should also have thoroughly dealt with the cultural background of this disorder.
