Erectile difficulties are one of the specialist areas I work with
People sometimes assume that because erectile dysfunction or erection difficulties are not prominently listed on a general therapy website, they are not something the therapist works with. In my case, they are.
I work with men where psychological factors may be contributing to erection difficulties, particularly where there is performance anxiety, self-monitoring, loss of confidence, fear of another disappointing experience or a pattern that varies between situations.
The language can feel awkward. You can use whatever words feel easiest — erectile dysfunction, erection difficulties, performance problems, losing an erection, difficulty getting an erection, or simply “something isn't working the way I want it to.”
Common reasons people contact me
- Erectile difficulties where psychological factors may be contributing
- Sexual performance anxiety
- Getting an erection but losing it when pressure increases
- Monitoring your erection instead of being present during sex
- Fear that a previous difficulty will happen again
- Loss of sexual confidence after an unwanted experience
- Avoiding sex or intimacy because of fear of failure or embarrassment
- Anxiety with a new partner or after a period without sex
- Difficulty relaxing into intimacy
- Relationship or communication factors contributing to sexual pressure
- Unhelpful expectations about what sex, arousal or performance 'should' be like
- Other sexual-confidence or intimacy concerns that may have a psychological component
How the pressure cycle can develop
One difficult experience can be enough to change what happens next time. Instead of attention being on touch, pleasure, connection or desire, part of your mind begins checking: Is it happening? Am I hard enough? What if I lose it? What does my partner think?
That monitoring can create more pressure, and the pressure itself may interfere with the response you are trying to protect. The next experience then seems to confirm the fear, making the cycle easier to trigger again.
How we may work
Depending on your situation, the work may draw on psychotherapy, behavioural strategies, anxiety-focused work, clinical hypnotherapy or BWRT®. We may look at anticipation, attention, beliefs about performance, previous experiences, relationship context and the habits of checking or control that have developed around sex.
The aim is not to demand a particular physical response from your body. It is to reduce unnecessary psychological pressure and help create conditions in which sex can become less like a test and more like an experience again.
Other sexual or intimacy concerns
Erection difficulties are not the only reason somebody may seek help. I can also discuss sexual confidence, anxiety around intimacy, avoidance, shame, relationship pressure and other psychologically influenced concerns. If you are unsure whether your particular issue fits, ask rather than assuming that it does not.
A private self-guided resource
I also run The Quiet Problem →, a separate discreet website focused specifically on psychological aspects of erection difficulties and sexual performance pressure. You can explore that privately without making an enquiry.