Men’s Health
The Connection Between Thought, Feeling, and Having an Erection
Understanding the emotional impact of erectile dysfunction
Erectile dysfunction (ED) is commonly talked about as an issue mainly older men experience. Although it is more common with increasing age, it really can happen to men at any stage of their adult lives. The danger of ascribing this experience to a certain age group is:
1. Men younger than 40 will not seek the help they need, believing that they are somehow faulty or that it will go away by itself.
2. Men over the age of 40 can feel helpless, believing that it is part of the ageing process and there is no useful help to be had.
In my experience as a psychosexual therapist, both groups of men also talk about the feeling of being the only one with erectile problems. This can be a very lonely experience which is enhanced by the embarrassment a lot of men feel at the prospect of talking about their erection problems.
It seems that ascribing an age group to the condition of ED is helping men to stay silent. Having worked with many men who have waited years before seeking help with ED, specifically for the reasons above, I see a need for us to talk about ED in general terms, removing the age constrictions.
Should any man be lucky to not experience ED until they are over 40, they have done well. And, let’s face it, being 40+ is hardly old, is it?
Why erections are so important
Being able to get and maintain an erection, and to sexually satisfy his partner, is for most men closely linked to their idea of masculinity and their identity. Research shows that men with ED generally feel emasculated, resulting in low self-esteem and sexual inadequacy. This frequently leads to avoidance of intimacy, even kisses, and hugs¹.
In his book The New Male Sexuality² Dr. Zilbergeld talks in detail about how the idea of men as stallions has stopped many from experiencing intimacy as nurturing because the emphasis is on hard erections and sexual performance.
With the focus on the quality of their erection, satisfying their partner, and the highlight of the orgasm, some men confuse their emotional needs with the quality of their sexual performance.
When erection and sexual satisfaction is the focus of intimacy, it is understandable that the impact of ED can bring on self-doubt, the possibility of depression, and emotional detachment from their partner even in loving relationships¹.In these situations, anxiety can then easily replace the focus on the erection.
Understanding the link between the emotional factors and the physical functioning of an erection can greatly help the healing process.
The thought-feeling — erection connection
It is said that the brain is the biggest sexual organ any of us possess. Thoughts and emotions, or desires, are possibly more important than you might think. Desire, sexual thoughts or imagination, in a healthy body will send signals through the central nervous system to encourage the blood vessels to open and the penis to fill with blood³.
It sounds simple, but the possibility of something interfering with this system is high, even if only temporarily. For example, if the following are not performing at their best, there could be issues with getting or keeping an erection:
- Central nervous system
- Blood supply
- Libido — the desire for sex
Interference with the central nervous system or blood supply could have physical causes — please see 6 Ways to Treat Erection Problems⁴. Low libido might occasionally be caused by medication, though its likely cause can be more emotional or psychological:
- Depression
- Anxiety
- Stress
- Other mental health conditions
- Relationship issues
- Feelings of sexual inadequacy
If you have become unable to find the thought of sex exciting, or if you have daily stresses or are too anxious to consider sexual intimacy, it is likely your penis will not get or maintain adequate hardness when you want it to.
Of course, it is possible to get an erection even if you feel no sexual desire. For example, your penis might be hard when waking first thing in the morning, but it doesn’t mean you are turned on. Likewise, it is likely your penis will become hard on and off throughout the night. This is healthy as the blood flow through the penis caused by this automatic stimulation will regenerate the penis³.
The cycle of sexual anxiety
One of the most common issues, when there are no physical causes for ED, is sexual anxiety. If anxiety stops the messages of desire from the brain to the penis, the blood vessels will not know to open for the penile sponges to be filled with blood.
Likewise, if anxiety or stress is causing the body to tense up, there can be issues with the blood getting through to the required areas to produce an adequate hardness in the penis.
The cycle of anxiety or physical tenseness is difficult to break on your own. The initial psychological reason for ED could be:
- The feeling of sexual inadequacy
- Having previously experienced difficulties
- Relationship issues
- Low self-esteem
That is not an exhaustive list, but regardless of the reason, the cycle of feeling desire, if interfered with by the anxiety, will re-enforce the breakdown in communication between brain and penis. It works like this:
1. Desire and closeness with partner resulting in an erection
2. Increased intimacy, the point at which arousal grows
3. Anxiety creeps in, thoughts of doubt or not trusting that the erection will work this time. A message is sent to the penis desire is no longer present and to close the vessels to normal position
4. Loss of erection hardness resulting in the man pulling away, possible avoidance of intimacy.
If not treated, this cycle is likely to be shortened, cutting out the first two steps as anxiety becomes the instant reaction to any stimulation or thought. It isn’t just intimacy the man then avoids. The intimidating and uncomfortable feeling of sexual anxiety can cause men to stay away from any situation that has the potential to bring this on.
What can be done
This is not a matter of saying “don’t worry about it” or “it can happen to anyone; we’ll try again another time”. Persistent ED needs you to act and to seek help. Trying to fool the body or the brain into submission isn’t a possibility. Anxiety is incredibly powerful, and it is not always possible to control it. It can often automatically ignite itself in any intimate situation.
However, there is help at hand. Research has shown that a combination of medication together with psychosexual therapy can be a very successful treatment, and even more so if a man’s partner is willing to participate in therapy. It is likely that if this issue has been present in a relationship, both partners will have experienced doubt or loss of sexual confidence¹.
Finding a trained and qualified psychosexual therapist will be a positive step for both you and your partner. This will help with anxieties, self-doubt, and any relationship issues that may have arisen because of ED. Look for the organizations that psychosexual and relationship therapists must register with to find a therapist you can trust and who will provide appropriate talking therapy.
As with all physical symptoms, it is worth having a check-up with your physician. This is also the place to go for the right medication for your situation. There are many different types of medication and discoveries are constantly being made³. Making sure you get what is right for you is imperative for the success of the treatment of ED.
Trying to ignore ED will in the long term cause more harm to you and your relationships. Seeking professional and appropriate help will put your life back on track. ED is a much-researched area of psychology, therapy, and medicine, and there will be a solution for you out there.
You can read much more about therapy in:
References and further reading
² Zilbergeld, B. The new male sexuality. Bantam, 1999
³ The Central Mechanisms of Sexual Function
⁴ 6 Ways to Treat Erection Problems
If you liked this article you might like these too: