As a sex therapist, I repeatedly deal with diverse and interesting life stories. People come to my practice in Basel because they have difficulties with their sexuality and are therefore experiencing a great deal of suffering. This suffering can also affect a romantic relationship or other relationships and thus trigger even more pressure.
Pressure has significant consequences for erections . Here I will explain what erectile dysfunction is, what causes it, and how I work with it in therapy .
One thing is clear: a person's ability to have an erection changes over the course of their life. It is therefore completely normal for an erection to not work or to fluctuate!
What is erectile dysfunction?
“Erectile dysfunction is a persistent or recurring difficulty or inability to achieve or maintain a functional erection – in terms of volume and hardness.” (K. Bischof, A. Bischof-Campbell, S. Fuchs, (2020): Training in Sexocorporel, Issue 4, p. 4.
According to ICD-11, this definition is confirmed. In addition, erectile dysfunction can persist despite sexual desire and stimulation of the penis. Erectile dysfunction can be said to exist if the difficulty has existed for several months and the subjective level of suffering is increasing.
The definition also distinguishes whether an erectile dysfunction has always been present or whether it has developed over the course of a person's life. It also determines whether the erectile dysfunction occurs generally or is situation-dependent. It may be that certain people only struggle with erectile dysfunction during couple sex, but everything works perfectly during solo sex.
What does pressure have to do with erectile dysfunction?
The following scenarios are conceivable when it comes to pressure and its effects on erectile dysfunction:
The pressure…
…not being able to have sex even though you want to.
…feeling like a failure.
…not being able to satisfy the other person “properly”.
…not being a “real” man.
…no longer feeling any sexual desire because of erectile dysfunction.
These reasons can lead to people suffering from erectile dysfunction feeling considerable pressure and this can also have an impact on their general well-being or sexual desire.
Physical causes
In addition to psychological factors, physical influences also play a role in the development of an erection. If erectile dysfunction develops over time, it is advisable to consider a urological examination . If the penis shows nocturnal and morning erection reactions and also functions during solo sex, it can be assumed that everything is fine on a physical level. What emotional consequences can erectile dysfunction have?
Emotional consequences and other aftereffects of erectile dysfunction
- Thought carousel
- Suffering pressure
- shame
- speechlessness
- missing and limited connection to the body
- sexual discomfort
- sexual disinterest
The list is not complete and does not contain a hierarchical sequence. Nevertheless, many clients report these symptoms in therapy. What are the consequences?
Am I normal?
The question "Am I normal?" is what drives many people to my practice, and although the topic of erectile dysfunction is a common theme in many studies and in the media, the question seems to be central here too. Here I clearly emphasised: Yes, it is normal for the penis not to always be perfectly erect or for the hardness to fluctuate!
Clients who suffer from erectile dysfunction question their masculinity. This means that the topic is rarely discussed in men's circles or among friends, because questioning masculinity can be very personal and sometimes emotional. This means that sex therapy can have a decisive influence in counteracting the progression of erectile dysfunction.
Procedure in sexual therapy according to Sexocorporel
In my therapeutic work, I work with the Sexocorporel model. It is a model based on the unity of body and mind. In addition to talk therapy, physical and perception exercises are also taught. These can then be intensified and repeated at home. The exercises are tailored to the client's needs and support resources.
In concrete terms, this means the following: In sex therapy, I first evaluate how the erection difficulty manifests itself, how long it has been present and in which situations it occurs. I clarify medical factors and include them in the anamnesis. The intake of any medication is also taken into account and included if necessary. The following steps are central to my discussions:
Therapeutic steps
Identifying a client’s strengths and resources in order to incorporate them into therapy.
“Developing an understanding of the penis”: This means that the client understands that his actions, habits and ways of thinking influence and may even cause erection difficulties.
Once this foundation is in place, exercises can be incorporated and adapted to the client's strengths and resources.
Practice examples
- “Getting to know the penis”: incorporate mindful touching into everyday life, focus on the body and appreciate the perceptions that arise. The experience is key!
- Pelvic swing (below an example while standing)
- Play with the pelvic floor muscles (initially without arousal)
- Abdominal breathing to promote and connect emotions and the relationship to the penis
- Incorporate and play with soft and sensual movements
- Incorporating the voice for greater enjoyment
It is important to note that this implementation takes time! The body needs time to process these new movements, experiences and perceptions. When practicing solo sexuality, there can always be setbacks before you feel safe and comfortable in your body. The more repetitions there are, the more positive connections can be made between the body and the brain. Beginning to practice solo sexuality is also crucial to gaining confidence in relation to erections. When awareness of your own body increases and the client has learned to "stay with themselves", the ability to have an erection can increase and also be successful in couple sexuality.
Without any pressure, you have the power to make your erection soar!
literature
K. Bischof, A. Bischof-Campbell, S. Fuchs, (2020): Training in Sexocorporel, Issue 4
Pictures
https://unsplash.com/de
video
https://www.youtube.com
The author of this blog post
Melina Dobroka
Sexologist MA
Sexologist FSS
Maltgasse 25
4052 Basel