While common, erectile dysfunction can have a number of causes, not all of which are physiological. Below, Dr. Dan Watter shares a story that he hears all too often in his practice: a couple that is healthy and “has never been happier” encounters issues with male performance in the bedroom.
Lisa and Brian have always had a satisfying sex life, ever since they began dating two years ago. “We’ve never had a problem before,” Brian told me during their first appointment. But now he was experiencing erectile difficulty—he could attain an erection easily enough, but would lose it not long after he and Lisa started having intercourse.
“It just doesn’t make sense,” added Lisa. “We’ve never been happier outside the bedroom. In fact, we just got engaged!”
Lisa and Brian’s story is one I hear frequently from the couples I work with as a clinical psychologist specializing in sex and relationship issues at the Morris Psychological Group in New Jersey. The details can vary: Perhaps the male partner has begun experiencing premature ejaculation, delayed ejaculation, erectile dysfunction, or another sexual concern. He and his partner usually come to therapy after his doctor has ruled out any physical causes of the problem. But when I start asking questions about the couple’s life together, one underlying theme almost always emerges: Sexual dysfunction aside, they say, their relationship has “never been better.”
In Brian’s case, he had finally proposed to Lisa after years of failed previous relationships. They seemed genuinely happy, and he was looking forward to their future together. Other couples describe similar positive changes—what I term “relationship-deepening moments”—such as moving in together or getting married. Until now, their sex lives have been overwhelmingly satisfying for both partners. This new dysfunction appears to have come out of nowhere and, at first glance, seems completely baffling.
A Deeper Dysfunction
The surprising truth, however, is that this sexual dysfunction isn’t occurring in spite of these relationship-deepening events—it is occurring because of them. Couples are typically shocked when I explain this phenomenon. How could such a happy time present in such a frustrating problem? Understandably, the female half of the couple has her own worries: Has her partner lost interest in her? What has she done wrong? But this type of sexual dysfunction rarely has anything to do with the woman herself. Instead, its roots lie deep within her partner’s subconscious, tied to his own personal history.
In speaking with Brian, I began asking questions about both his childhood and adulthood, peeling back the layers of his life before he had even met Lisa. As we delved deeper into his past, I learned that Lisa was a bright spot in a life that had seen its share of heartache. Brian’s parents had divorced when he was quite young, and he only saw his father a few times a year. His mother had passed away when he was in his twenties, and previous romantic relationships had usually ended when they got too serious. Lisa was different, he insisted, and he knew he wanted to marry her.
Brian wasn’t lying. He was deeply in love with his fiancée—so why was his penis suddenly not cooperating? In my experience, this type of sexual dysfunction tends to occur when men begin to suffer existential anxiety in response to major positive relationship changes.
In other words, all of their unspoken fears of abandonment, loss, and rejection culminate in panic that presents itself as a sexual problem.
Brian really did want to marry Lisa, but the prospect of serious commitment was bringing all of the angst associated with his past experiences to the surface—even if he didn’t realize it. Not every man in this situation is subconsciously reacting to abandonment issues. Others may be unknowingly panicking about what they perceive as a loss of freedom and autonomy, a response I often see in men whose parents or previous partners were extremely controlling.
It’s important to realize that this form of sexual dysfunction is very common and, as I assured Brian and Lisa, it can be treated. Often, just providing the couple with a narrative that explains the cause of the dysfunction can be enormously helpful, as it relieves much of the fear that the problem is the relationship or the partner.
Most couples in this situation are baffled and afraid of what this unexpected sexual dysfunction means. For many men, this may not be the first time this has occurred. Taking a good history often uncovers that this has been the man’s pattern in other relationships that may have become more serious and committed. Because these couples always have a strong sexual foundation, partner and individual therapy that focuses on resolving past trauma and loss can help get them back on track to achieving happily ever after—inside the bedroom as well as out.
[related_article id=”9651″ float=”right” size=”full” target=”_blank”]
