Author: Josif Fidanovski

Although there are many various types of sexual dysfunctions, one of them is considered especially significant: erectile dysfunction, caused by an inhibition in the sexual excitement phase during the male’s sexual response. It is defined as a permanent, occasional or recurring inability to develop or maintain an erection required for one to successfully engage in sexual activities and complete sexual intercourse.

Apart from the first instance of the 85-year-old man who abstained from sex for 3 years following his wife’s death, I once had another client with erectile problems. He came to see me some time after his divorce, which was caused, among other things, by his passive role in marriage and pathological jealousy. His then-wife ended up cheating on him (a self-fulfilling prophecy), which he had a hard time getting over. Despite feeling angry and bitter, he would not accept a more rational understanding of love and sex. He remained a victim of his immature thinking, which manifested itself sexually. After divorce, he tried to have sex with younger women, but he failed—except with the drug Cialis, although even with it, the sex wasn’t that great.

His poor sexual functioning was not caused merely by his “scar” of being cheated on and divorced; in the sense of distrust towards women, but also by his wrong expectations. Even though we worked on his problems for several sessions, he failed to accept the responsibility for his own sexual exchange. Being desired by young girls flattered him; he stopped having panic attacks, took some anxiolytics, antidepressants, and felt confident in verbal communication. However, sex was still an issue. I suggested that he try to find a more serious woman, who would understand his condition and be tolerant of his current erectile dysfunction. However, I could not “cure” his ego, which caused him to keep spiraling down. In the end, he fell in love with his friend’s daughter, telling me that the two of them had a close encounter without sexual intercourse, so he required that I give him an instant solution for sex. Seeing that psychosexual therapy does not offer that kind of help, I told him that only an injection may stiffen his penis, and sent him to a urologist. He later informed me that the urologist didn’t give him the injection, but only Cialis and some anxiolytic powder, and admitted that it was not the right way, but also that he could not “let that girl go”—because she was too good looking.

All of these indicate that erectile problems are not that trivial and it often turns out that many men do not wish to engage in proper relations with their partners, where they will show their true face, but instead they build false, shallow relations, full of lies and deceit, only to fulfill some societal ideals and satisfy their egos. They may believe that women appreciate and respect those men more, but that is no excuse. Those same women will sooner be disappointed and leave them when they realize that these men are not how they have presented themselves. This is why I advise men to take a risk and be more honest when meeting women, because in the end they always get more out of it. Maybe they won’t have as many sexual partners, but what they do get will undoubtedly be more meaningful and fulfilling.

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Although there are many various types of sexual dysfunctions, one of them is considered especially significant: erectile dysfunction, caused by an inhibition in the sexual excitement phase during the male’s sexual response. It is defined as a permanent, occasional or recurring inability to develop or maintain an erection required for one to successfully engage in sexual activities and complete sexual intercourse.

Freud classified impotence as a type of neurosis, and only with the arrival of Masters and Johnson, as well as Kaplan, did impotence receive a nicer name, free of pejorative meaning and negative self-evaluation, which is erectile dysfunction. Another discovery then was that not every man with sexual problems is necessarily neurotic, suffering from a personality disorder or another psychopathological disorder. One can be completely “normal” and be unable to develop or maintain an erection, without it meaning anything other than (most commonly) an inability to initiate or maintain sexual excitement during one of the phases of the sexual response cycle. Therefore, a satisfying erection cannot be achieved without positive sexual excitement, although, in rare cases, certain fears may lead to an erection (e.g. when men were forced to rape women at gunpoint during the war). Generally speaking, fears have an adverse effect on sexual functionality, although uncommon fears such as the fear of being discovered by others (e.g. while engaging in sensual contact in the bathroom at a friend’s party) may increase excitement.

The first research of all types of impotence was conducted by Kinsey et al. in 1948, when they established that there was a relatively high percentage of “total impotence”, both psychogenic and organic in origin, on a sample of over 6,000 men. They determined the percentage to be 2–4% at the age of 35 and 77% at the age of 80. More methodologically valid tests were subsequently conducted, indicating a percentage of 7‒10% (Hawton, 1985). In 1993, the National Institutes of Health found that there was a high prevalence of erectile dysfunction in the United States and that between 10 and 20 million men over the age of 18 suffered from this disorder.

The article proposes to discuss two examples of such:

An 85-year-old man, after abstaining from sex for 3 years following his wife’s death, experienced several failures with a woman who accepted to have sex with him (mostly due to financial aid on his part), and approached us, demanding that we enable him to have a hard penis when he takes off his clothes so that she could see that he is “ready to go” and a “real” man. He would not accept my suggestions that things did not work like that even in much younger men, but he still, somewhat foolishly, hoped that there was a drug that would “raise him from the dead”. Prejudices of this type are not uncommon in men, who often expect that their penis should function regardless of their psychophysical condition, and the pharmaceutical industry relies precisely on these myths when it produces drugs for potency. This perspective disregards any ideas about necessary conditions, good relations with the partner, erotic surroundings, etc., as unimportant.

Your partner may be Monica Bellucci or Claudia Schiffer, but if you are not “there”, are absent-minded, have not provided your necessary conditions, do not have a positive sexual excitement, are not in good relations with your partner, you will not have a satisfying erection. No drug can give you that.

Therefore, an erection only means that your penis is hard. Whether you really want sex, whether you are indeed a real man, whether you find your partner attractive, etc., depends mostly on your assessment, your feelings and current circumstances. It would certainly not be a good idea to want to act upon your erection caused by looking at your best friend’s daughter

(to be continued …)

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