Sex is complicated for men

When you work with relationship issues you have to get used to dealing with pretty much anything that comes your way. Now admittedly the vast majority of my clients are women, but just occasionally I get a man who decides 'enough is enough' about something important and comes to seek help. I always welcome these opportunities because male clients are often 100% ready and committed to change.

Last week, my male client wanted to deal with his erectile issues.

Now contrary to popular belief, male sexuality is not just like turning on a light switch: press the button and instant hard-on. Absolute nonsense past puberty.

The truth is male arousal is a much more complicated process and from my observations gets even more complicated with age (and self-awareness). Men are quite honestly emotionally sensitive buggers and just like women, they too need nurturance and safety when it comes to sex.

So, when my client, a healthy man in his 50s, came to see me he was quite honestly freaking out because he couldn't maintain an erection. He told me with shame and guilt that his partner was freaking out because she was convinced that he was losing desire for her. Both were basically a mess and had been avoiding the situation for several months. They had been following the age-old ostrich practice - head in sand and hope it goes away on its own. Unsurprisingly it hadn't.

What do I do then to treat this issue?

Step 1: some basic mind-body education (debunking the light switch theory)

1. Erections come and go. It's completely normal during sex for the erection to vary. Sometimes it's harder, sometimes it isn't.
2. Erections are not under your control. You cannot will one to happen. The more you try, the less likely you are to succeed.
3. Sex is not only about penetration. When all the focus is on 'the act', the sheer terror of repeated perceived failure is going to make your member shrivel up and run for cover.
4. You have to stop beating yourself up. Like right now! Just as you wouldn't criticise yourself for throwing up (sounds daft as it's a physical act not in your control yeah?), losing an erection is just as normal and out with your control. Sometimes the body just does what it wants and that's totally ok. Don't sweat it.

Step 2: treatment package

This is a good one and it's pretty easy.

Just stop having sex.

Yep. You are on a sex ban for a couple of weeks. 14 days without penetration. No masturbation. No oral. No just giving it a wee, sneaky try to see if it works again.

Now if your partner wants to do her (or his) thing, so be it. But you my friend, you are learning how to get in touch with your arousal again. We want all thoughts of the 'big crescendo' off the table. This is all about increasing your confidence, getting to understand that 'hey I lost an erection and hey it came back again. And wow, the sky didn't fall down!!!'

You are going to stop having sex, so you can stop having the 'oh my God what if it happens again???!!!!????' thought. Or the 'maybe I'm getting old and this is what happens?' or 'Oh shit, maybe she'll leave me because I can't perform anymore' or 'maybe I'm no longer a man'. `[Please complete as appropriate for your own special brand of self-flagellation].

Basically, what we are aiming for is for you to get a holiday from whatever torturous thoughts you are having about your sexuality - no need to have these thoughts, if you aren't going to be expected to 'do-the-do' - and put the full focus back on play, pleasure, and connection (with yourself and with your partner).

And for those that doubt that something so simple could work for something so painful and anxiety-provoking, I'm happy to report that my client has recently informed me that he is following the protocol (3 days) with impressive results and that both he and his partner doubt they'll be able to last the full 14 days abstinent.....

PS I have to advise that it's also a good idea to speak to your doctor and check there is nothing physical going on. But generally, as a rule of thumb, if you are getting an erection in the morning, can still masturbate, then it's likely to be psychologically caused. And there's never any harm in giving the above a try. If you find that you come back stronger and harder, well lads you've got your answer - you were just a bitty upset and anxious and that's ok.

(I'd also add that in 30 years of Psychology I've never once heard a woman discuss her rating system for erection hardness, so remember, boys if you are aiming for full toro-like, tumescence every time, that particular paranoia is coming from you)