Volonté is excited to feature the writings of several sex and relationship experts from Dr. Ian Kerner’s project, Good in Bed. This week we welcome Dr. Kelly Wise, a therapist for individuals and couples.
Dr. Wise specializes in sexual and intimacy issues. He uses an eclectic approach of therapeutic models, including, but not limited to, cognitive behavioral therapy, solution focused therapy, psychodynamic therapy, and narrative therapy. He is also the founder of Wiser Sex Therapy Associates, a collaborative group of therapists promoting social justice, LGBTQ rights, feminism and sex positivity in our personal and work environments.
Erectile unpredictability (EU)—a less pathologizing term that has emerged recently to describe what is more commonly known as erectile dysfunction—can be infuriating, especially when medical professionals tell you that the problem is all in your head. Those who struggle with EU want to know it’s fixable. And in many cases they’re more than happy to rely on a pill such as Viagra, which seemingly makes the problem disappear.
But when you simply take a pill rather than putting in the work of actively managing something like EU, you’re not solving your underlying problem. Instead, you’re just masking it by treating the symptom versus the cause.
Why Mindfulness Is the Key to Managing Erectile Unpredictability
People today—in our culture of non-stop busyness—tend not to be very present in their bodies. We’re attached to our phones. We’re addicted to being productive. When given the opportunity to sit still, we feel compelled to check email or Twitter or Facebook or make a phone call or read a book… anything that distracts us from the present, seemingly empty moment. These days, with our minds bouncing all over the place, it can be uncomfortable to just be in our bodies.
If we can just sit still and breathe, however, and observe what’s happening in our bodies, things begin to change. We begin to detach who we are as people from the thoughts that are so often racing through our heads.
This is why I recommend mindfulness as a solution for many of my sex therapy clients. As you come to master (or at least practice) mindfulness, you can eventually bring these powers of mindfulness and focus into the bedroom. And when you do, you can focus more on pleasure and on sensations than on performance.
Why is this important? Those struggling with EU tend to be fixated on their performance in the bedroom. And when you worry about your performance during sex, you take yourself out of what should be more of a flow state. Flow is a term used in positive psychology that refers to the mental state you’re in when you’re fully immersed in an activity. And when you’re fully immersed in the experience of sex, you’re not worrying about what might or might not happen. Instead, you’re experiencing—and hopefully enjoying—all of the various sensations that come with sex. You’re trusting your body to do what it needs to do.
To bring the lessons of mindfulness and flow into the bedroom is to focus on the things that turn you on and, in turn, to allow yourself to feel pleasure. I’m not saying you should be selfish. But I see a lopsidedness with men who struggle with erectile unpredictability. With these sexual difficulties come low self-esteem and the mindset that, if you’re going to be sexual with someone, you must have other ways of making them feel good because you’re not good in this one way. But when you think this way, you place too much of your focus on performance. What’s really effective is to focus on your own pleasure so your body can begin to feel all of the related sensations and, as a result, respond.
How Can You Start Practicing Mindfulness?
People who have struggled with erectile unpredictability don’t trust themselves because… well… they’ve had unpredictability during sex. So when I start to work on mindfulness with clients, I first put them in situations not related to sex where they can work on improving their confidence.
For example, I have them think about an activity during which they feel like their best selves… one in which they get so lost, they don’t even question their performance.
I have them think about a part of their day during which they see themselves shine. I have them question what they’re feeling in the moment. This is the state we are trying to mirror in the bedroom during sex. If they can observe this state of being and bring it to other parts of their lives, and also build body awareness, things can start to change for them in the bedroom, too.
Doing a body scan meditation is also a good means of building both mindfulness and body awareness. I have my clients close their eyes, take some breaths, and start by focusing on their toes. What do their toes feel like? Is there tension? Energy? Stiffness? What does the whole foot feel like? Are they clenching their foot? Can they relax it? We then travel up through the entire body in this way.
Once clients feel comfortable practicing this on their own, I have them do it before a date or other intimate encounter, just so they can let go of some of their anxiety or, at the very least, notice and observe it.
Later on, this ability to objectively observe sensations and emotions allows clients to stay focused on their own pleasure, rather than being carried away by their anxious thoughts.
When it comes down to it, the secret to managing EU is in bringing your best self into the bedroom. Focus on what makes you feel confident, relaxed, and in that optimal flow state. Teach your body to know and recognize that state. Once you have a handle on that, you can bring that body awareness to sex. It takes practice, visualization, and a sense of equanimity, but the more time you spend “in” the body and out of your head, the more seamless this will become.