Lee A Edwards, PhD

Psychologist, Austin Texas

Erectile Dysfunction

I see some men in their 20's who fairly often aren't able to get an erection and sustain it. Often something physical caused it initially, such as a reaction to a medication, but then the man starts to worry about it, and the insecurity causes further problems. It's the old self-fulfilling prophecy: "It's not gonna work" leads to: It doesn't work.

So, what can you do if this is happening to you?

* De-catastrophize. Fancy word for: realize it's not going to be the end of the world. The fear of how horrible this could be is probably a huge part of the problem, so get that fear "out on the table," called up into consciousness. What's your version of it? No one will ever love you? You'll never have any fun sexually? Or something less extreme, but still scary? Once you've clarified the fear, think it through very, very careful and very, very realistically. My guess is that, even if the problem continues, its impact on your will be moderate, not horrific. Nobody wants this problem, and it's a hassle, but you and your relationships will probably be okay even if it continues. If a lover has been mean about it...we'll get to that in a minute.

* Focus on something much more enjoyable than "My Performance." When it's time to fool around, thinking about erectile problems might just be the least sexy thing you could do...so don't. Think instead about what you want and what's going on right now. In other words, focus on your pleasure. Sound good? I know that, in straight relationships, some men would do well to focus more on the woman's pleasure, but that's a different issue. With erectile dysfunction, you want to avoid worrying too much about whether your performance is going to be adequate for her. So, yes, be sensitive to your partner, but what'll help you with erections is to focus fairly much on what you are enjoying or would enjoy. Get out of your head and into your body!

* Don't evaluate yourself...or if you can't resist, make the evaluations positive. A lot of people get the advice of: Tell yourself it's gonna be great, and you're gonna be great. I get the power of positive predictions, but the problem (how many p's in one sentence?) they present is that they focus you on your performance...which usually increases anxiety. If you can't resist talking to yourself about how you're going to do, at least make it positive, e.g., "It'll probably go fine." Give yourself realistic reassurance, not something like "Everything will be perfect and amazing!" Stick with something you'll believe, like the "It'll probably go fine."

* Choose kind partners. Some people are a lot kinder and more accepting than others. That's who you want. Skip the competitive, judgmental folks because they're much more likely to be harsh and unforgiving if you don't perform exactly as they expect. A kind, accepting partner is more likely to take a perspective of, "Well, you're not shy about giving me pleasure, and it's good being with you, and maybe the other stuff will work out next time."

* Practice self-acceptance in general. It'll help with this specific issue. Check out the separate article on self-acceptance.

* See a urologist. On a different level, make sure there's not something physical going on. If it's physical, there's likely a physical remedy or cure! In Austin I like Koushik Shaw, MD, with Austin Urology. I went through prostate cancer and surgery and ended up learning more about urology than I ever wanted to. After a few (good) urologists, I settled on him because he's knowledgeable and very easy to talk to.

Summarizing: Yeah, it's a hassle. It can be embarassing. But limit the embarrassment by not being harsh with yourself or choosing harsh partners. Take some of the power out of your fears by looking straight at them. Focus on what isenjoyable rather than what's not going well. And, as with any problem, a big dash of self-acceptance goes a long way. We're all human; we've all got problems; and somehow life still goes on, often pretty enjoyable. Hope this helps a little.

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Licensed psychologist, Austin

(512) 694-1322

4403 Manchaca Rd, Suite A, South Austin, TX 78745