Have Mental Health Questions? Ask a Psychiatrist Online
Welcome, I am a professional counselor, Behavioral-Consultant and relationship expert. Would you like me to answer your question?
Hi again. When you say E.D. do you mean erectile dysfunction?
I am a healthy 23 year old and from speaking and seeing urologist they believe its psychological
Well one of the best forms of psychologically based treatment for erectile dysfunction is cognitive behavioral therapy or CBT. They way CBT works is it looks at thoughts feeling and behavior that interfere with sexual responding and erection. A CBT psychologist will usually have you keep a CBT journal where you record your thoughts and feelings that take place in close association with problem in time....
Usually during the act where things are starting to heat up kissing, etc I do not think of anything. I am focused on the act.
I have been dealing with this for awhile and I have had many times to look back on it
For example may men get anxious with E.D. So a common CBT therapy goal will be to teach the relaxation response. The client the learns to self-invoke relaxation when he would otherwise feel anxious.
What lead the urologist to suggest psychological issues?
well he said that in a 23 year old its cannot be a lot of things..he gave me viagra which makes me erect but it doesn't last more then 5-6 minutes.
So he said almost 100% of the time its psychological
When the time comes to have sex I find myself not being excited mentally because I know I cannot get erect
Sorry I just had a power failure here but the power is back on now.
I was briefly disconnected.
My next questions would be the same as if I were working with you face to face in counseling. What gets in the way? Are there specific thoughts or anxiety?
I see you're offline right now. I'll check back a bit later for your response. Again sorry for that last delay in my response, due to the brief power failure.
Thought I'd check back in.
Checking back again....
Sorry Doctor I was out with the family. To answer your question, the rush, the excitement, everything leading up to it just is dull for me. Kind of like a guy jumping out of a plane. First few times he does it, its surreal, but eventually it gets dull. My last girlfriend was a real beauty, killer body and all. Any guy would be immediately turned on at her touch, but same thing with her. We would kiss things get intimate and I just was not erect. What I was thinking? Anxiety maybe because I know I won't get erect. As I am kissing her my mind is blank I am just in the moment type of feeling not thinking about anything. It seems her touch or any girls touch just does not excite me. Am I gay? Hell no. I just cannot explain why I do not react like a normal guy.
When I am out with my friends they could dance and grind with a girl and would be turned on so easily. I just do not know why I do not get effected the same way.
I will check back tomorrow. I do appreciate your time and concern. Talking to you will hopefully put my mind closer to the write track.
Best thing for us to do here, especially over the weekend is leave messages back and forth....
You've provided some very detailed information. You've clarified your situation but I still need to understand your question. Any chance you could refine it a bit?
Yes, My question is with a help of a psychologist how would I begin to fix this
I know online it is tough to give me a step by step "cure" but what would be some techniques or things I could try to do
You're right, this is a simple 1 question, 1 answer service. The answer to your presenting question is that a psychologist can help you with your erectile dysfunction, by helping you identify and change thoughts, feelings and behaviors that may be getting in the way of sexual functioning, for psychological reasons....
Two of the most important areas targeted in cognitive behavioral therapy around sexual dysfunction generally, are 1) thought restructuring; and, 2) relaxation training. So for example, if it was determined through face to face clinical interviewing and through the use of the CBT journal that specific thoughts and ways of thinking were getting in the way of sexual performance, then those thoughts would be "thought stopped" and replaced with thoughts more facilitative of the sexual response....
Relaxation training is used by psychologists in CBT to help client's because high anxiety often gets in the way of sexual functioning. So, in the same way that negative thoughts or stopped and replaced, anxiety is replaced with the relaxation response. If anxiety is getting in the way then learning how to quickly self-invoking the relaxation response (becoming deeply relaxed) can make a real positive difference. Anxiety is replaced with relaxation in the same way that negative or sex-interfering thoughts are replaced with sex-facilitative thoughts.
The positive thought change makes relaxation easier and relaxation makes positive thought change easier.This synergistic clinical change process then facilitates sexual responding. In more complex cases, a cognitive behavioral psychologist may refer to a clinical sexologist or sex therapist, who has much more specialized training in cases that do not respond to more basic CBT interventions.
I recommend learning more about CBT, maybe starting your own CBT journal to really find out what's getting in the way. Here's what I mean by CBT:
I strongly recommend learning the relaxation response. Not can it help with sexual dysfunction, but it has incredible benefits in many other areas of life as well. People who practice relaxation every day for 20 minutes for a month or 2 can learn to totally relax themselves in just seconds. This can be really helpful in all kinds of situations involving high stress...
This is not a really flashy site, but it's one of the best I've found to really help teach you the relaxation response basics:
You may also find it helpful to learn more about who clinical sexologists are and what they do:
Well, hope my answer was helpful to you. Please don't forget to press the green "Accept" button.
I'm pretty sure I've covered all the basics here. If I've missed something or you feel I haven't answered your question, please let me know and I'll do what I can to include any missing information.