Up for the challenge

Up for the challenge

Before turning to medication, try relaxing and focusing to beat erectile dysfunction

By Patti Carmalt-Vener 02/22/2012

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Dear Patti,
I’m 27 and up until now have always had a confident, normal sex life. (Previous girlfriends have told me I’m a great lover.) When I met my current girlfriend, Helena, it was love at first sight. She’s not perfect, but I know she’s perfect for me and we love each other very much. The problem is that the first time I had sex with her, I partially lost my erection and couldn’t perform like I wanted to. An ongoing anxiety that it could happen again has just made it worse.
Helena insists it’s no big deal, that she enjoys having sex with me and that we should just take it slow, so as not to put any pressure on me. I want to reach new emotional and sexual heights with her but can’t help feeling insecure when I can’t satisfy her. I can keep a strong erection when I masturbate or when I’m with another woman, but not Helena. This is so ironic, because I find her sexier than any other woman.

A recent medical exam revealed nothing physically wrong, and so my doctor referred me to a sex therapist who said I was just nervous in my new relationship. Meditation and relaxation techniques were recommended, along with a suggestion to temporarily try Viagra until my confidence returns. The relaxation exercises help, but I’m still unable to shake the worry about keeping my erection long enough to please Helena. I’ve never felt like this before. What’s your take on this? — Chad

Dear Chad,
What you’re describing is erectile dysfunction (ED), the medical term for difficulties achieving and keeping an erection. I’m glad your physician ruled out physical problems that cause or contribute to ED, like high blood pressure, high cholesterol and diabetes. Since you have no past history of ED and it only happens when you’re with Helena, I’d say there’s a strong possibility you’re suffering from performance anxiety. 

Performance anxiety arises in events involving great consequence — a job interview, an academic exam, an athletic competition or sex for the first time with someone who takes your breath away. In your relationship with Helena, the stakes are high, you really want to please her and your concern and worry can impact performance. When you have a strong need to perform and become so afraid of failure, your confidence can leave and all you feel is fear. You’ll only perform your best when you feel safe.

Imagine your sexual experience with Helena as having radio channels. One is a channel to all your thoughts, the second is to all the senses (smell, taste, sight, touch and hearing) that connect you to Helena and the third is to all the physical and emotional feelings in your body. Since it’s difficult to listen to three radio stations simultaneously, it’s important to focus right now on each channel separately. Start by concentrating on your thoughts. When you’re making love and your worst fears keep surfacing, practice turning off the channel. It’s important to face these uncomfortable, scary and embarrassing thoughts, but not while you’re making love. Instead, focus on your senses that connect you to your sexual feelings. Use your eyes to see how sexy and beautiful she is. Focus on how she feels, tastes, smells and sounds. Train yourself to focus on your loving, sexual feelings rather than focusing on your fear, and you’ll automatically become more aroused, allowing your erections to become stronger and more consistent.
At home alone, think about making love to Helena and focus on your physical and emotional feelings. Do you have physical anxiety symptoms, such as knots or butterflies in your stomach, a racing heartbeat, shallow breathing or tense muscles? Focus on your physical symptoms until they begin to relax or until you start to feel emotional. Are you sad or angry? In these private moments, allow yourself to cry or experience anger. Memories might yield clues about the origins of your insecurity. Explore your fears and worries, but when you’re with Helena, stay focused on the second channel — giving full attention to your senses.

Traditional psychotherapy might uncover psychological reasons behind deep-seated fears involving feelings of deep love, intimacy and worthiness. Medication is an option, but since you’re so young and healthy and your erectile dysfunction is compartmentalized, I’d encourage psychotherapy and the exercises described above as the first step. 

Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at (626) 584-8582 or email pcarmalt@aol.com. Visit her Web site: patticarmalt-vener.com.

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