ED: How to Know if its all in your Head and the Benefits of Sex Therapy

Erectile dysfunction is a common, yet distressing occurrence for men. There is a high probability of experiencing ED over the lifespan, causing personal and relationship stress. While this condition is rather common and there are numerous medical options available to improve erections and sexual dysfunction, ED continues to be among the most distressing diagnoses that men face. People want clear and concise answers and solutions for these challenges that fit their situation and comfort but often do not know where to turn.

What is ED?

Erectile dysfunction is the inability to gain and/or maintain an erection firm enough for penetrative sexual activity. Some men experience a challenge in only one stage of the erection process, while others experience challenges with gaining, maintaining and rigidity. Erectile dysfunction is only diagnosed when it occurs consistently overtime. It is normal to have a challenge with gaining or maintaining an erection at times and is generally not considered a reason for concern.

What causes ED?

Erectile dysfunction is a medical condition that can be caused by numerous health conditions that impact blood flow including diabetes, blood pressure conditions and heart issues. Sometimes, medications can interfere with sexual function and your prescriber can help assess that impact and what you can do about it. It is important to not ignore the medical side of erectile dysfunction and a person should not make any changes to medications without consulting a physician.

Erectile dysfunction is often caused by or maintained by psychological factors such as depression, anxiety, performance anxiety and relationship issues. There are deeper issues that men face with sexual function issues including beliefs about masculinity, the role of an erection in sexual activity, feelings of shame and embarrassment as well as fear of abandonment and loss of connection. In many instances that men are experiencing erectile dysfunction, both physiological and psychological factors are contributing factors.

Could ED be in my head?

The answer is absolutely. The mind has a crucial role in healthy erections. When a man wants to gain an erection the process starts in the mind. Arousing and pleasurable thoughts are an active ingredient in the erections that man seek to achieve and the absence of these thoughts, or anything that interferes with that process, can cause erectile dysfunction.

Performance anxiety is the most well known experience that contributes to erectile dysfunction and other sexual challenges. Performance anxiety occurs when a man worries and overthinks about his sexual performance, with concerns about his partner’s experience, the reliability of his erection among others. Performance anxiety is a very common occurrence especially in new relationships and after life events and transitions.

Anticipatory anxiety is when a man ruminates or worries about a future or pending sexual encounter before it commences. This can lead men to focus on avoidance strategies and lose sight of pleasure. Men can become preoccupied with the fear of sexual activity, leading to poor sexual performance and little to no interest in the experiences.

Some men struggle to be receptive to pleasurable experiences with a partner. They have become accustomed to pleasure on their own and struggle to relax when in the presence of a partner. Without pleasurable thoughts and feelings the mind is not primed to facilitate an erection process leading to increased erectile unpredictability. This is most commonly a mental block that a man is experiencing.

Is there any way to determine what is causing my ED?

Any man experiencing ED in a consistent pattern should see a primary care physician or urologist. ED is a medical condition first and foremost and ensuring that no underlying medical issues are present is a necessary first step. Once medical issues have been ruled out it can be safely assumed that the issue is psychological. Some men find that they are able to gain and maintain an erection on their own but struggle with a partner. This is generally a sign of a psychological, relational or behavioral cause and would be a good indicator that ED is in your head.

How does sex therapy help?

Sex therapy is a specialized and tailored form of talk therapy. A sex therapist should be a licensed therapist with additional training in sex therapy. Sessions generally last 45-50 minutes and involve a thorough assessment and the development of a focused treatment plan, that often combines cognitive, emotional and behavioral interventions.

When erectile dysfunction is in your head, a beneficial way to approach this is to identify and address the thoughts, feelings and beliefs that are maintaining your ED. Many distorted beliefs are predicated on misconceptions and misinformation and it is imperative that men gain access to accurate information about themselves, their bodies and realistic expectations of self and a partner.

Often times, however, information alone is not sufficient to help restructure the thought patterns that maintain the ED. Sex therapy focuses on helping men to challenge old thought patterns and establish new beliefs, increase confidence and address past events and trauma. Sex therapy can also help address relationship issues that contribute to sexual fears, distress and miscommunications.

How to find a sex therapist?

To work with a professional, you can schedule a consult with the friendly mental health therapists at the Center for Intimacy Connection and Change, or find a therapist near you can explore the official website of the American Association of Sexuality Educators, Counselors and Therapists (AASECT).