“I thought I was becoming impotent two years into my second marriage and I panicked” says Alan, 42. “In the early days of our relationship, I had erections and enjoyed the lovemaking tremendously. Then sometimes I wouldn’t be able to get an erection or sustain it through intercourse. Dee was very understanding. She said I was pressuring myself to be a great lover for her and I should relax. Nice, but it didn’t reassure me. It’s like going to the doctor and your blood pressure is a little high. Relax he says but that’s Easy to say and much harder to do.
Actually I was freaking out about not getting it up. I didn’t tell her how frightened I was about becoming impotent, but I made an appointment with a therapist. The first therapist suggested medication after just a few minutes. Not for me, because I don’t want to be dependent on pills! Besides, those pills are expensive and when you read about possible side effects, I’m the kind of guy that ends up with them all! With the next therapist we talked through my performance problems. He said I was applying very strict standards to measuring my erections. True, I wasn’t getting many spontaneous erections, but that, he said, was not the real problem, the problem he said was the pressure I was putting on myself and obsessing about getting erections. He said worrying about sex was not exactly arousing. I was throwing off adrenaline with my anxiety and re-routing blood from my penis. When pressure and pleasure compete, he said, pressure wins! It took me a while but once I understood what was happening, I stopped worrying. I asked Dee to get me hard; and she’s very enthusiastic about doing that. If I hadn’t picked up some tips and received some reassurance, I might have worried myself into becoming permanently impotent.”
By the time men are 40 years old the majority will have experienced at least one erectile failure. It may be caused by fatigue, stress, not being in the mood (yes, that happens!) or too much to drink. This is a normal occurrence, but many men panic at the first sign of erectile problems. Now they are likely to run to a urologist and ask for one of the highly publicized erectile dysfunction (ED) pills, which they probably don’t need and may not find effective. Being in a new marriage might have intensified Alan’s responses to his perceived erotic failures. For other men it may be a new partner, stress, fatigue or a distraction that throws them off their game. Most men are sensitive to performance pressure and once they experience a failure they perpetuate it by worrying about another failure. They also try too hard and the harder they try the worse it gets.
These circumstances and a strong desire to please his partner combined with his lack of knowledge about how to deal with performance pressure set Alan up for failure. It is a classic example of what happens with most men who struggle with erectile failure. And once it happens most men obsess about failing, which makes failure more likely. Some common psychological causes of ED are the following:
Anger. Unacknowledged and unexpressed anger can sit on the end of a penis and hold it down.
Intimacy conflicts. Sometimes a man’s penis is trying to tell him something about his relationship. Conflicts that have been ignored or papered over for years can eventually cause sexual functioning problems.
Depression. Libido is often a casualty of depression, even low-level depression, especially if prolonged. A bout of ED can increase a man’s feelings of discouragement. Although antidepressants may lift the depression for some, the drugs may fail to lift the penis.
Stress. Men who don’t manage stress management face increasing bouts of ED, especially as they age.
Worry. Concerns about job security, personal finances, and family issues can also create a psychological climate for ED. If a man is feeling powerless in the world, he may convey that message to his penis. Generally, worry and stress are short-term situations. They may result in brief periods of ED that can be overcome with the proper guidance.
Intra-psychic Issues. Issues about intimacy, a hx of abuse, sexual orientation confusion and a whole host of complicated intra-psychic issues make treatment more challenging.
Performance anxiety. This is the big issue, the one that, let’s say, gets most men down. One occurrence of ED can set up a cycle of failure, anxiety, and more failure. In fact, performance anxiety is probably the most common contributing or secondary psychological cause of ED. How to deal with it, and other psych issues that impact ED: www.MindoverED.com
In Alan’s case, his erectile difficulty might have led his wife to blame herself for his lack of interest in making love and caused her to withdraw from attempts to initiate sex. If he hadn’t received good advice from a therapist he trusted and who directed him to a wellness program he could use on his own to regain his erectile capacity— www.MindoverED.com–Alan might have indeed worried himself into long-term erectile dysfunction.
The moral of Alan’s story: Don’t be so quick to jump on the pharmaceutical band wagon. Unless you are one sick puppy, the likelihood is that ED is an emotional issue, not a medical issue.
Stephan’s Side Note: This issue occurs a lot more than people realize. When it doesn’t get properly addressed it can have a very negative impact on that man and the woman he is in relationship with. The more we educate ourselves on the real issues the more we resolve them and move in a better direction.
A senior psychologist at North Shore-Long Island Jewish Health System in NY. Dr. Joel has treated thousands of individuals and couples with sexual challenges.