Erectile dysfunction in therapy


Erectile dysfunction is one of the sexual dysfunctions that affect more men. However, luckily, it can be treated effectively both from medicine and from sexual therapy based on the findings of Psychology and the methods of emotional regulation.

In this article you will find an overview of how erectile dysfunction is addressed through psychosexual therapy, as well as the factors that can cause this problem.

What is erectile dysfunction?

Also popularly known as "impotence," erectile dysfunction is the inability to maintain a full erection during sexual activity. It is, along with premature ejaculation, the most common sexual dysfunction in men.

Erectile dysfunction can be caused or facilitated by a large number of organic disorders; basically, all those that directly or indirectly affect the physiological process linked to sexual arousal and the triggering of the changes it produces in the male genitalia. This includes injuries from bumps, burns or cuts, as well as diseases that damage nerve cells involved in erection, as well as those that alter the production of certain hormones.

In practice, however, and if we look at the statistics, the pathologies with easily identifiable organic causes with which erectile dysfunction is most associated are cardiovascular diseases and benign prostatic hyperplasia. That is, two phenomena that directly influence the functioning of the genitals (it should not be forgotten that an erection occurs when the corpora cavernosa fill with blood) and their surrounding areas.

On the other hand, as we advance, erectile dysfunction is a problem that is statistically closely linked to age; it affects about 7% of men under 40, 22% of those in their 40s, and one in two of those in their 70s.

However, it would be simplistic to assume that erectile dysfunction is basically a medical problem. Many times the main causes are psychological, and even in cases where there is an organic disease, emotional disturbances tend to overlap with the symptoms of the latter. That is why when therapy is offered to men with problems to achieve erections, in the first phases great importance is given to determining the cause or causes of what happens to them, and from there, offering personalized solutions in which they are not ignore the cognitive, emotional and behavioral processes that play a possible role in the appearance of this phenomenon.

Among the psychological aspects that can cause or favor the appearance and maintenance of erectile dysfunction, the following should be highlighted:

  • Depression
  • Anxiety during sex
  • Intrusive thoughts related to failure to get an erection
  • Insecurity with one's own nudity and sexuality
  • Conflicting relational dynamics with the last sexual partners one has had

How is erectile dysfunction treated in sex therapy?

These are the main areas of intervention in patients with erectile dysfunction, although they are always used or not depending on the specific needs of each person.

1. Psychoeducation and sex education

Something as simple as informing about aspects related to sexuality, managing emotions and healthy habits that must be followed to prevent sexual dysfunction is very useful to combat erectile dysfunction, especially in cases where it occurs mainly because of fears and the belief in myths that circulate about sex.

2. Imagery exercises in therapy

The imagery is based on the realization of imagination exercises, having previously practiced so that these mental images and their associated sensations are very vivid, very similar to the real world. They allow you to control emotions during the course of key actions, in this case, focused on sexuality and sexual arousal. In this way, it is possible to practice managing anxiety and other emotions in a "controlled environment" in which it is easier to start making progress with a few relatively simple first challenges.

In this way, you lose your fear of the type of experiences associated with an erection. In addition, the patient is trained in the ability to let go of worry about whether or not an erection is being achieved (these fears often hinder the process) and focus instead on satisfaction.

3. Neurofeedback

Neurofeedback is used in a wide variety of problems that are totally or partially caused by poor regulation of anxiety. It consists of inducing the patient to a certain mental state at the same time that he receives information about his nervous activity in real time, thanks to a series of sensors applied to his skin. In this way he learns to encourage those psychological operations that bring him closer to a certain goal, and to discard the rest.

4. Improvement of self-esteem through cognitive restructuring

Low self-esteem is closely linked to sexual dysfunctions, both as a cause and as a consequence. For this reason, it is common for therapy to work to help the person have a more adequate level of self-esteem.

This involves a wide variety of techniques and strategies, but one of the most important is cognitive restructuring, which consists of leading the patient to question dysfunctional beliefs that they have been clinging to and that have been causing problems, replacing them with others that allow have a more constructive mentality and not fall again and again in the avoidance of experiences.

5. Making a calendar of challenges

Between therapy sessions, patients are required to carry out a number of tasks in their private lives. These goals to be achieved throughout the week are temporally distributed and designed following an ascending difficulty curve and adjusting to the level of progress of the person; The fact of having short-term objectives to be met (within days or hours) makes it easier for the patient to feel motivated to continue improving.

When we reason about a problem, we tend to use a simple and useful outline most of the time. This way of thinking is what is known as linear thinking.

In couple relationships there is always a certain degree of commitment and, of course, seeking the company of the person you love. However, some people have an excessive emotional dependence on their partners .