Counseling, More Than Just Talking
Estimates vary, but many studies conclude that approximately 60% of cases of erectile dysfunction are due to organic causes. Atherosclerosis, hardening of the arteries that restricts blood flow, nerve damage from diabetes, Parkinson's and other diseases are common culprits. As such, drugs or surgery are more common treatments.
But it remains true that, even apart from the occasional impotence that affects virtually all post-pubescent males, long-lasting ED often has psychological causes. Stress, depression, anxiety and other chiefly psychological conditions can produce chronic impotence. The qualifier 'chiefly' is used since the mind and body are intricately related. Even these mental conditions are often influenced or essentially caused by hormonal or other physiological factors.
That being the case, counseling plays an important role in the treatment of a large number of ED cases. Counseling is not just a bull session. Patients who partake in it are not just passive recipients of wisdom from a trained professional.
Counseling is an active process, guided by a professional (often a licensed psychotherapist), but one in which the patient is primarily responsible for his own progress. Unlike purely medical issues, no therapist can cure an ED sufferer against his will, or without the patient's active efforts.
During counseling sessions the therapist will ask the client to explore feelings of anxiety, depression and others at the root of the erectile dysfunction after ruling out physical causes, of course. Like the popular image of therapy, clients may be asked to discuss dreams, childhood experiences and other issues.
But the chief focus will remain on what is happening now. 'Now' may include present work circumstances, marriage or relationship conflicts, and a wide variety of other issues. Any of these can lead to chronic anger or depression.
Counseling is much more than simply 'talking about your problems' in the belief that they will dissipate spontaneously like smoke when a window is opened. Clients have to make actual changes in their beliefs, their choices and their actions in order to influence circumstances and their outlook. They have to alter both the inside and the outside in order to change the underlying reality that is causing erectile dysfunction.
That requirement is very difficult for most sufferers of ED, as it is for all other counseling clients. It's a cliché that 'change is difficult'. In one way, the sentence is silly. Some kinds of change are the easiest thing in the world. One simply decides to purchase this brand of car rather than the one that had been the usual choice. But changing one's approach to sex, to relating, altering a view of one's self can, indeed, be very difficult.
But in every case, just as with 'purely' physical issues, something causes depression, anxiety, chronic anger and the other psychological factors that may result in ED. Removing them, therefore, requires the client to make changes that will alter those underlying causes.
The process of discovering what they are and devising techniques for changing them is what counseling is all about.