Erectile dysfunction can be the source of much embarrassment for men. Sexual performance is so closely associated with masculinity that when there’s an issue many men will refuse to discuss it. In fact, from a recent survey conducted, a third of men questioned said they had not told anyone about their problem, 43% said they could not discuss it with family or friends, 23% would not discuss it with a GP and 27% said they would rather break up with their partner than go to a GP. However, the solution doesn’t have to involve invasive procedures or reliance on aphrodisiacs. Talk therapies, and in particular Cognitive Behavioural Therapy (CBT) have proved to be incredibly effective in reversing the effects of performance anxiety in men. Here’s a closer look at how the process works.
When you meet your Therapist for the first time, they will help familiarise you with the working of the process, and what your role and responsibilities are in achieving the most positive outcome.
Understand When and Why the Problem Began
The first stage of your therapy involves figuring out when the erectile dysfunction and anxiety around sexual performance began. It could have been after an unhappy sexual experience, during a stressful time in your life, or it could have always been there for as long as you can remember. Emotional well being and sexual health aren’t often associated in terms of the effect they can give on one another, however, the chance for your sexual confidence to be affected by outside influences is a very real one. After all, the act of sex itself is an emotional as well as physical act.
The next step involves goal setting and is a core aspect of any form of CBT regardless of the condition. First, we establish what the end goal is – being completely free of erectile dysfunction – and from there, we work towards that goal by creating smaller, more achievable goals that are more attainable in the short-term. So, for example, if your erectile dysfunction is causing you not to approach women you feel attracted to, this would be the first step. However, if you already have a partner, the first step might be using relaxation and refocusing techniques.
Tools and Exercises
There are a number of tools and exercises that can be used to alleviate issues around sexual performance. An effective one to use during the build-up to intercourse is called sensate touching. This is an intimate form of touch intended to bring on arousal without the pressure of having to perform full sexual intercourse. Another technique that can be used are pelvic floor exercises. These serve to strengthen the PC (pubcoccygeus) muscle, which helps to achieve stronger and better erections when performed consistently.
Monitoring Your Progress
It will largely be up you to monitor your own progress and relies on your being completely honest about where you’re with achieving your goals. You will discuss how far along you are with your Therapist every week, and as you complete the goals you set for yourself will gradually increase the expectation placed on yourself as you move towards achieved your end goal. This process of escalation is commonly referred to as exposure therapy, named quite literally as you’re exposing yourself to the situations that the source of your anxiety.
Here are some steps you can take in your own time to begin the process of becoming more comfortable and accustomed to gaining and maintaining an erection.
Before moving ahead with any of the stages proper, you must be able to fully relax to give yourself the best chance of success with the rest of the exercises. Move to a comfortable place where you won’t be disturbed
- lying on your back on your bed is recommended – and focus your attention on your breath.
- Breath in deeply, tensing the muscles in your feet by curling your toes and holding them in this position. Hold this for several seconds before releasing.
- Next, move your focus to your ankles, bending your feet upwards. Take another deep breath, holding this position for 2-3 seconds, and gently release as your breath out.
- Now, tense the muscle in your calves. Breathing in, holding for 2-3 seconds before releasing the hold and as you exhale.
- Now, do the same with your thigh muscles, by closing your legs in on one another. Hold for several seconds and exhale once more.
- Clench the muscles in your buttocks. Tense them as you breathe in, holding for several seconds before releasing and breathing out.
- Do the same with stomach muscles. Take a deep breath in, hold it for a few seconds before releasing as you breath out.
- The next part of your body is your arms and hands. Bend your elbows and at the same time clench your fists. Breathing in, hold and release as before.
- Hunch your shoulders, raising them as high as you can, breathing in, holding and releasing.
- Move onto your facial muscles. Clench your jaw, frown, and close your eyes as tightly as possible. Breath in, hold and release.
- Finally, tense all of your muscles at once, as you take one more deep breath, holding for 2-3 seconds before letting go. Relax all of your muscles as you let go.
Body Awareness Exercise
To begin, take either a shower a bath. The tactile sensation of water hitting the body will allow you to become more aware of how touch feels on the body. Ideally, a shower would be best for this purpose, because it’s moving water… Make sure the water is warm before you step into the cubicle, and when you enter, make sure you’re standing completely underneath the shower, allowing each part of your body to connect with the water in turn. Move through each part of your body, starting with: your head, then moving to your shoulders, chest, back, buttocks, arms and legs. Engage with your sense of touch, using a sponge, caressing yourself, noticing how you respond to each sensation.
After you’ve completed your shower and are fully dried off, use some oil or lotion and massage it into your skin. Start with your shoulders, arms and hands. Use a variety of techniques to rub the oil into skin. Experiment with what feels good, take your time, allowing yourself to explore each body part. When you’re satisfied, move onto your chest and breast area. Focus on these areas, and take note of whether your nipples change in response to touch. Continue and move down to the stomach. Then, move onto your crotch, and run your hands through your pubic hair. Take note of its texture. Then, do the same with your penis. Feel the weight, the texture, the colour and size – and caress it. Turn your attention to your scrotum, repeating the steps before moving onto the top of your penis.
For this step, you’ll need a full-length mirror or at least one that you can see your most of your body. After taking your shower, stand in front of the mirror and massage yourself with the oil or lotion of your choice. Go through the same process as you did in the shower, focusing on one area of the body at a time. Use the mirror to guide your actions. Take note. What do you like about how this looks? Then, simply observe yourself standing still. What are your best/most attractive features? Examine yourself thoroughly, giving yourself permission to appreciate your own body. Give each part of body full attention in turn; what defines that area of your body? How would you describe it? Continue your observations until you have moved through every part of your body. When you have finished, sit down and think about what thoughts cam up for you. Focus only on the good points. Repeat this process several times until you are completely comfortable and accepting of yourself.
This step can be done by itself, but you may find you have more success having gone through the other ones, first. Lie down on your bed, or somewhere comfortable. This part of the process is not only about how you are touching yourself but also about the actual part of the body you’re touching. Once again, experimentation and finding what works for you is key. You may find that closing your eyes is a useful aid to allow to focus solely on the physical sensations you’re feeling without distraction. Start with your shoulders, chest, stomach, arms and hands. Use a variety of different forms of touch, including light stroking, heavier kneading, squeezing and rubbing. Then, move onto your genitals. Focus first on the penis, taking your time to explore it fully. Move onto the scrotum, giving it equal time and attention before moving onto the perineum – the skin between your scrotum and anus. Alternate between each area with varying touch. Where are you more sensitive? If you become aroused, take note of what area and how you achieved this.
- Lie down where ever you have chosen to do these exercises. Close your eyes and engage with the body in the way you have learned above. Pay close attention to your breathing. If it becomes too fast, bring it back down to a steady pace.
- Take things slow and relax. Be firm with your touch, but not too heavy-handed.
- Start exploring your penis, scrotum and perineum.
- As you begin to experience an erection, notice what it feels like not just in your penis, but the entire surrounding area. Vary your strokes until you achieve an erection.
- Allow yourself to lose the erection. Distract yourself, until you go limp once more.
- Now repeat the above steps twice more until you have achieved a good firm erection, letting it go before repeating the process.
- On the fourth and final time, you achieve an erection, continue stimulating yourself until you ejaculate.
- Begin as before, but this time, incorporate some lubricant into the exercise and stimulate yourself into having a full erection.
- Again, allow the erection to leave. After giving yourself a few minutes, use the lubricant again to bring yourself to erection a further two more times, letting it go in between.
- Stimulate yourself a fourth time to bring yourself to erection and ejaculate.