Erectile Dysfunction (impotence)-what it is and how it is treated

Erectile Dysfunction (impotence)-what it is and how it is treated

Erectile dysfunction is one of the sexual problems that most concern men . It tends to occur for different reasons, although performance anxiety is one of the psychological origins that can provoke it and that turns this problem into a vicious circle from which it is difficult to get out.

Erectile dysfunction can have consequences in different areas of a person’s life: self-esteem problems, relational difficulties, etc.

Erectile dysfunction, why does it occur?

Any alteration of the mechanisms that intervene in the erection can cause erectile dysfunction . First of all, it is very important to know whether there is any alteration at an organic level (as is the case with neurological or vascular problems).

Once any affectation of organic origin has been ruled out, it is then when we can examine the problems of psychological origin, being the anxiety of execution again the protagonist of this dysfunction.

Causes: execution anxiety

Execution anxiety is a state of alert that appears as a response to the set of thoughts that connect with previous unsatisfactory results and portend a new failure.

The battery of messages related to “will I make it?”, “what if it goes wrong again?” or “what could change this time?” , leads the individual to a state of mind governed by over-analysis; demand and fear combine to find a channel of expression.

Doubting one’s own capacity added to the enormous ignorance (what is causing the problem) generates a feeling of frustration that, again, feeds the thoughts related to the alert.

How can Psychotherapy help us?

Psychotherapy works on the different areas that may trigger stress and anxiety in the patient’s life (life experiences, current work and family situation, couple’s relationship, etc.), as well as more specific aspects related to performance anxiety.

The obligation to deliver results, excessive altruism and self-observation are three key themes of performance anxiety. In order to improve self-control, therapy focuses on detecting automatic thoughts that trigger alertness. In line with the above, these types of thoughts respond to:

  • The need to give a very consistent and lasting erectile response.
  • The control of the couple’s satisfaction rather than their own and joint eroticism.
  • The continuous observation of the penis and its functioning.

Talking about these kinds of concerns offers the patient a channel of expression that will increase emotional self-knowledge. This, together with the creation of alternative thoughts, will decrease the voice of self-demanding and facilitate the work of self-empathy . Likewise, building a discourse with all the elements that remain in the “backstage” of the problem (taboos), will facilitate understanding and rapprochement within the couple.

Guidelines and tips to follow

An important point is to provide the patient with guidelines that decrease the level of nervousness and pressure in sexual experiences.

More specifically, one of the indications that is sometimes offered in sex therapy consists of “prohibiting intercourse” throughout the first sexual encounters, thus achieving that the concerns that we previously mentioned (results 10, partner satisfaction and one’s own physiological response) cease to be a source of anxiety.

There are many myths regarding the genitalization of sex or the belief that it is only complete if penetration and orgasm are achieved. It is true that the genitals are a very important part of the human body, but to reduce sexuality to genitality is to limit the experience, especially if we consider that the whole of our body is sexual. The skin is a sexual organ, and as such, it must be taken into account in our intimate relationships.

Penetration is just one more practice among the multiple possibilities we have to satisfy ourselves . There can be very pleasant sexual relations without intercourse. This connection again with pleasure is another objective within psychotherapy.

What happens if the person does not ask for help?

First of all it is important to differentiate between an isolated manifestation or an established problem.

When it is a dysfunction that is repeated over time, serious problems appear such as the impairment of self-esteem, avoidance of sexual relations and conflicts at the level of the couple. In reference to this last point, the belief that “you are increasingly distant” and “you no longer desire me”, attributes the origin of the problem to erroneous causes and ends up becoming a reason for discussion and distancing.

In couples therapy it is essential to work on communicating the fears and needs of each member, thus achieving an atmosphere of love and mutual attention. A problem that used to be experienced in solitude now goes hand in hand.

And why does premature ejaculation occur?

Premature ejaculation is the most frequent sexual problem among the male population . This lack of control may be due to a variety of causes. In fact, the origin is inaccurate. What we do know is that it depends on psychological factors and, many times, on beliefs related to men and sexuality (cultural aspects).

Among the factors that collaborate in the existence of this dysfunction we find the predisposing factors (for example, family history, the circumstances that accompanied the first sexual relations and the bad learning), the precipitating factors (among which the low sexual frequency, the demanding couple and the execution anxiety stand out), and the maintainers (where the execution anxiety, the lack of psychosexual abilities and the couple conflicts stand out again), without forgetting all those biological aspects that could exist in each case.

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