When male sexual dysfunction enters the clinical room, technique alone is rarely enough. This training offers a nervous system-informed, shame-first framework that changes how clinicians enter the conversation, sequence treatment, and support lasting change across all three major presenting concerns.
In this 3-hour intensive, sex therapist Michelle Fischler walks clinicians through her shame-first framework applied to erectile dysfunction, early ejaculation, and delayed ejaculation. Participants will leave with a structured assessment approach, a sequenced treatment model, and concrete interventions for each condition, grounded in current research and applicable in the next session.
When Shame Runs the Room:
Treatment of Male Sexual Dysfunction
Wednesday, September 09, 2026, 1:45 PM EDT - 4:45 PM EDT
Presenter: Michelle Fischler
Course Length: 3 Hours
This workshop Offers 3 Live Interactive Continuing Education Credits
When male sexual dysfunction enters the clinical room, technique alone is rarely enough. This training offers a nervous system-informed, shame-first framework that changes how clinicians enter the conversation, sequence treatment, and support lasting change across all three major presenting concerns.
In this 3-hour intensive, sex therapist Michelle Fischler walks clinicians through her shame-first framework applied to erectile dysfunction, early ejaculation, and delayed ejaculation. Participants will leave with a structured assessment approach, a sequenced treatment model, and concrete interventions for each condition, grounded in current research and applicable in the next session.
0:00 - 0:15 | Opening: The Unifying Argument. Why technique fails when shame leads. The nervous system framework applied to male sexual dysfunction. How this lens changes clinical entry across all three conditions.
0:15 - 0:45 | Module 1: Erectile Dysfunction. The shame spiral and performance anxiety cycle. Medical vs. psychological sorting and red flag referrals. Concrete clinical interventions for psychogenic ED. Guided discussion.
0:45 - 1:40 | Module 2: Early Ejaculation. Shame-first assessment: five clinical questions. Shame vs. guilt distinction and treatment sequencing. Research-backed techniques: stop-start, sensate focus, diaphragmatic breathing, pelvic floor physio, mindfulness, SSRIs off-label. Partner and relational dynamics. Case example.
1:40 - 2:05 | Module 3: Delayed Ejaculation. Shame presentation in reverse. Masturbation retraining framework. Psychological and relational layer: applying the shame-first model to a frequently misunderstood presentation.
2:05 - 3:00 | Integration and Q&A. Cross-condition clinical patterns. Case consultation. How you know when the work is done. Open discussion.