only can cause impotence in the first place, but it can undoubtedly
worsen the condition once it exists. For instance, a man who's
cheating on his wife may not be able to have an erection when he's
with his mistress, as subconsciously he's feeling guilty. A
man who has come out of a relationship where he was emotionally
scarred may suffer from impotence because he no longer trusts women.
It's a complete fallacy that men can have sex at the drop of a hat,
anytime, anywhere and with whomever. Men have just as many
tender feelings as women but society has never allowed them to be
After impotence has occurred
a few times, even the most confident guy is going to start worrying.
The longer this goes on, the worse it gets yet the
problem may be quite solvable.
For reasons of pride,
ego, embarrassment, fear, men often don't seek help immediately,
sometimes preferring to suffer in silence, even feigning other excuses
for not wanting sex. This can leave their partners bewildered
and unhappy. Worry and anxiety only compound an already difficult
situation. Worry is concern over an existing problem and anxiety
is an overall state of discomfort, often irrational. Neither
serves any worthwhile purpose whatsoever, other than pinpointing
a problem that needs to be dealt with.
What psychological condition
can cause impotence, what are the underlying factors and what does
it tell us about the belief systems of the sufferer?
Impotence sufferers often
are the first child of a family. They are commonly overachievers,
workaholics, overly-focused on duty and responsibility, too hard
on themselves, leaders and very controlled. With a profile
like that, nothing but the best is tolerated in any area of life.
As perfection requires effort and is not achievable anyway,
something has to give, and sexual dysfunction is one way in which
the body can 'break down', signalling that it's under too much strain.
I have seen this pattern time and again in clients who have consulted
me regarding impotence. What is required is a relaxing of
efforts in their lives generally so that some breathing space is
created and balance can be restored.
Anxiety and all other
negative emotions can be very destructive. They are part of
an overall belief system that is learned over many years so it can
take a while for these patterns to shift. If they are the
cause of impotence, counselling may be required to remove the power
of doubt and fear, for they are the real enemies. Sex problems
are very often other behavioural problems in disguise and they don't
disappear overnight or by themselves. Nor do they benefit
from overworking. It's like the sore that never heals because
you won't stop picking at it. If you allow yourself to become
anxious every time you want to make love because you don't think
you're going to be able to 'perform,' you're doing yourself a real
disservice. You are actually creating a new problem which
exaggerates the first.
If you feel that you
are even starting to become dysfunctional, look at your overall
lifestyle diet, sleeping, exercise, work habits, relationships,
emotional balance, smoking, alcohol intake, etc. then figure
out what needs changing. Self-help is always best and, if
done right, should reduce the need for medical intervention.
However, if you are convinced
that there's something else wrong, then check with your doctor and
look at your other options.
If you are by nature
an anxious person, you might want to enrol in a positive thinking/assertiveness
course, or read some books on these subjects. Take up yoga
or tai chi, learn to relax more, take your time with things, for
example, enjoy a bath before love-making. Experience the journey
instead of being in a hurry to proceed to the destination.
One of the worse things
you can do if you're concerned about erection is to avoid sexual
contact. Out of embarrassment, men will simply stop making
love in order to get out of having to explain impotence, even in
a marriage. Single men will either stop going out, or lose
their confidence about going to bed with a woman. This creates
a failure complex and pushes the problem further into the forefront
of the mind. This is really about self-esteem and self-image.
If you see yourself as being valuable only when you're doing well
in bed, then sexual dysfunction can be emotionally crippling and
The quality of a man's
relationship is also a crucial factor, if he's married or seeing
someone regularly. If he doesn't feel able to share his fears
and anxieties honestly with his partner, he's more inclined to hide
or play down the problem. Women often ask me how best to help
their partners in these situations and I say that large doses of
patience and tact are needed, along with a positive attitude.
Most importantly, there needs to be a de-emphasising of intercourse
as being the only worthwhile sexual pursuit. An impotent man
can still perform oral sex, touch and stroke his partner, bring
her to orgasm with his hands or mouth, use a vibrator, communicate
with her, love her, and so on. There are also specific measures
he can take to restore his erection and these we'll look at in a
One other possible cause
of impotence needs to be covered, and that is something called 'distraction'.
Researchers have found that a man is more likely to be impotent
when he is 'distracted' from sexual thoughts and feelings. So,
if he's preoccupied with work problems, feels stressed, worrying
about money or whatever, he's less likely to be interested in sex.
The body obediently follows suit and fails to perform.
If a man had to masturbate while someone was reading a dry scientific
journal to him, he would find it a lot harder to reach climax than
if, instead, it were an erotic novel.
can be done?
the suggestions I've already mentioned, a specialist can be consulted
who may want to test the patient in laboratory conditions.
For example, a device can be placed on the penis to measure erectile
activity during sleep. This is known as the 'nocturnal penile
tumescence test' and it helps distinguish organic from psychogenic
impotence. Normal male responses during sleep include several erections
over a seven to eight-hour period, so an overnight stay in hospital
can identify the cause of the problem. If none exists in the
physical area, psychological reasons can then be examined.
Another important clue
is whether a man has more difficulty becoming erect when he's on
his own or when he's with a partner. That tells us a bit more
about his mental state and helps pinpoint what needs to be worked
on. It's a process of elimination essentially as, piece by
piece, the picture becomes clearer.
Sometimes doctors give
prostaglandin injections in the penis which bring on erections,
again to determine if the cause is physical. If it definitely
is, and the impotence appears to be irreversible, penile implants
are an option. These consist of silicone rods that are inserted
into the penis and attached to a pump implanted in the scrotum.
Another type is a mechanical
device, which can be either a cylinder inserted into the penis by
a pump at the head, or one that has a spring mechanism. A
third way to go is an inflatable prosthesis which operates on an
inbuilt hydraulic system. It comprises silicone rods, a pump
in the scrotum and a reservoir of saline fluid stored elsewhere
in the body, all connected by tubes.
If you suffer from impotence,
the important thing is to identity the particular cause in your
case and to do something quickly to alleviate the symptoms
including anxiety. Some deep breathing before intercourse
will help relax you, and having the right attitude about yourself,
and sex in general, will also make all the difference.