Interview with Mónica Dosil: the psychology of erectile dysfunction

Erectile dysfunction is one of the most common sexual disorders, and the causes of it are not always purely biological. Therefore, it is important to know the psychological factors that promote its appearance and maintain it.

Interview with Mónica Dosil: causes and psychological consequences of erectile dysfunction

On this occasion we spoke with Mónica Dosil, a psychologist residing in Castelldefels with more than two decades of experience working in psychotherapy and sex therapy, to talk to us about the link between erectile dysfunction and what psychological.

To what extent does sexuality shape our identity?

Sexuality defines our life and also our identity. When you describe yourself, you do it based on tastes, hobbies, qualities and interests, but it is your sexuality that gives meaning to everything. Sexuality is a state that encompasses all of our personality traits, an energetic quantum that implicitly and explicitly describes how we behave.

If you are a dedicated person in your personal or work relationships, you also behave in a dedicated way with respect to your sexuality, if you are an introverted person, and you reserve information or emotions, you are also with respect to your sexuality.

We can affirm that sexuality shapes our identity, and this is fundamentally because it originates before the constitution of our way of being, and it is one of the bases on which the personality.

The eroticization that our body lives in its first moments of life when it is caressed and cared for generates the first experiences of pleasure, which will later be the germ of our more or less magnificent sexuality.

Does it also happen in the opposite direction? How does what we believe about ourselves, our self-esteem, affect us in the sexual sphere?

It's fundamental. If you feel good and safe, you act accordingly, feeling free to develop naturally and daringly in the field of sexuality, if you feel insecure in your way of being. That is, if your self-concept is low, you will see it reflected in your sexuality.

Insecure people have difficulties showing their bodies, they make love with the light off, they get uncomfortable depending on which positions related to the sexual act, they do not want to be caressed in some parts of their body... In short, they cannot flow freely and their thought, in some limiting way, affects directly the pleasure they experience, since who try to control all situations and cannot focus on enjoying their body or surrendering to the art of giving pleasure.

Many people believe that erectile dysfunction is a purely medical problem. Is it common for its causes to be basically psychological?

That's how it is. It is true that there is a percentage of cases that have an organic etiology, which is why the urology specialist has to play a priority role in ruling out organic pathology. The second step is to go to a specialist in sexology, who can be a doctor or psychologist in training constitutive, and it will be this professional who assesses the origin of the difficulty and schedules a treatment.

Erectile dysfunction, commonly and inappropriately called impotence, is the inability to get an erection or keep it firm enough for sexual intercourse complete. It is common for it to occur occasionally in men, and this is not a reason to worry.

It is when it begins to occur continuously that action must be taken, since it is then that it is considered a symptom, that is, the body manifests itself and indicates that something is happening. In addition, it is important to intervene in its resolution, since it produces undesirable consequences such as stress, lack of self-confidence and ultimately a persistent decrease in desire sexual.

The psychological causes of erectile dysfunction are varied and sometimes it is a combination of physical and psychological issues. Regarding the psychological causes, it must be taken into account that the brain plays a key role in the activation of the physical events that cause an erection, and that the first necessary factor is arousal sexual.

If, for example, you suffer from depression, the first thing that disappears in that circumstance is sexual desire, and then this will probably affect the ability to have erections.

The most common causes of erectile dysfunction are depression, anxiety, and general mental health disorders. Stress is considered a combined case of physical and psychological origin. On countless occasions, relationship problems due to communication difficulties or any other type of discomfort in the relationship also cause erection problems as a consequence.

In my private practice I observe on multiple occasions that infidelity, in the case of men, results in a high percentage of erectile dysfunction.

Is erectile dysfunction a problem that, when experienced in the first person, is reflected even in social relationships of any kind, albeit subtly? For example, in the tendency to be insecure.

Of course. It is a situation that produces withdrawal of personality.

It is common in social groups to find references to the sexual potency of men, in all kinds of more or less casual conversations. Being a man is related in the biology of the species as well as in our society with sexual potency. In the case of being affected by said dysfunction, the affectation on self-esteem is total.

Every time the life expectancy increases in the human being, and other relevant circumstances such as physical decline fruit of the years lived give as a consequence, in man, a decrease in his ability to maintain the erection.

It is important not to reinforce this situation with excessive concern about the experience, since the good news is that there is always a solution.

In our society, sexual conversations happen regularly, the man who suffers from these difficulties is ashamed and tries to hide said situation, hiding it and pretending normal.

Flaws then begin to appear in his personality, which in principle were not happening, such as disabling stress caused by the problem situation.

Does this problem also affect the way in which this sexual dysfunction is perceived? For example, if it affects self-esteem, the person may believe that it is something that has no solution and that it is part of his body.

That's how it is. It is true that in many cases men have erection difficulties since their adolescence and, as this person has always experienced that reality, he ends up thinking that he is like that and that what happens to him is normal, so he does not expect any improvement and does not request aid. It is then that resignation to the problem appears.

In the man who begins to suffer this situation later, the fear that it is irreversible appears and he begins a process of resignation.

This type of sexual difficulties is consulted to us, the sexuality professionals, after a long time of evolution, this is what makes recovery difficult, since the nervous system gets used to the previous situation and usual.

In the end, shame is what makes the person unconsciously choose to resign instead of discuss it with his trusted doctor or any other person who can encourage him to find a solution.

How can psychologists intervene to treat erectile dysfunction?

Psychological treatment has shown high efficacy for this type of cases. First of all, the personality profiles that tend to be affected by impotence are especially perfectionists. These people are so busy doing things so well that they become disconnected from their own desire, they are even too aware of the pleasure of their sexual partner.

Obviously, this does not happen to all perfectionists, it only happens to those who have great difficulties in managing their anxiety. Depression and anxiety are the major causes of impotence, when you suffer from these symptoms is when the time has come to intervene from psychotherapy.

Sometimes, people present depressive symptoms and are not even aware of it. Realize that not all depression happens because you cannot get out of bed, there are many people who suffer from subclinical depressive symptoms, which go unnoticed, because they do not show their faces.

The psychologist offers specific exercises and tools such as relaxation exercises, cognitive restructuring and others, always with the aim of eliminating the irrational thoughts that limit the man who suffers from the disorder. The treatment is definitely effective, and it must be kept in mind that it requires powerful personal work and daily effort. It's like going to the gym, it requires dedication and exercise routines.

On too many occasions, people expect the changes to be made by the sexology professional, but it is the person who comes to consult the one who has to start training his mind daily to achieve notable changes and profitable.

If the man with erection difficulties sets himself the goal of achieving it and puts all his effort into it and provides himself with good guidance, rest assured that he will achieve it.

As a result of the work, the person will obtain longer lasting erections, prevention of incontinence, more pleasurable ejaculation, and the ability to delay ejaculation. All are obvious improvements as a result of the effort in recovering from erectile dysfunction.

How does recovery occur? Does it take to get an improvement?

Recovery occurs gradually, and you always have to focus on improving cardiovascular flow. A clean diet of inappropriate fats and an exercise routine of approximately 30 minutes a day will be essential.

The exercises must be oriented towards cardiovascular activity, thus improving the circulatory flow, in addition to incorporating Kegel exercises into your day-to-day, which are an exercise routine for the floor pelvic. They are exercises for the Pubococcygeal muscle (PB) that is located between the anus and the testicles. When the PB is exercised, better blood circulation is achieved in the entire area that covers the pelvis.

As stress and complex emotional processes affect the erection, psychology works to manage the levels of emotional pressure to which it affects. person submits to himself.

Managing anxiety and stress with competence is possible, and produces excellent effects in improving this difficulty. The more you train the sooner you improve!