Getting expectations clear and discussing them in detail with the therapist and your partner is an essential part of sex therapy. If you can get erections in some situations but not others, it’s realistic to explore what is happening in the situations when you don’t become erect. For example, a man who feels he “should” have sex whenever his partner is willing may discover that just removing that requirement solves the problem. If you have a physical illness which plays a role in your potency, your expectations of what constitutes success must, of course, be defined with those facts in mind. A sex therapist will probe and help you define what constitutes success for you. It’s important to get this clear before you embark on a program of therapy, so everyone knows the goals and objectives of the program.
Sometimes a couple comes in for one problem, and in the process of defining the man and woman’s expectations, different concerns emerge. Harry’s announced reason for wanting sex therapy was his inability to consistently maintain an erection. This 57-year-old man suffered from high blood pressure and had to take medication for this condition. He also had been diagnosed recently as diabetic, a fact he found very difficult to accept.
Harry’s first marriage had ended in divorce. In discussions with the therapist it became clear that Harry blamed his erection problem for the breakup of this relationship. He was convinced that the same thing might happen again with his second wife, Shirley, a vivacious 54-year-old who also had been married before. For the most part, Harry and Shirley considered themselves a happy couple. But increasingly, Harry was fixated on his “sexual failures.” He was convinced that Shirley would reject him just as his first wife had—and that his erectile problems were to blame.
Harry felt an erect penis was necessary to satisfy a woman, and he was quite surprised when the therapist explained in detail that this was not true. He was even more surprised when Shirley, encouraged by the therapist, explained that she was not overly concerned with Harry’s erection problem.
When Harry lost potency, Shirley’s usual comment was, “Don’t worry about it.” Harry interpreted this remark as a well-intended solace for his failure. But Shirley meant her words, and more. Her first husband had been, she explained, a “slam-bam thank you ma’am” kind of guy, and Shirley was quite happy to be cuddled, kissed and caressed. She wanted to be physically close to Harry, but she did not feel especially deprived by Harry’s loss of potency. What she did want was physical affection. Harry’s preoccupation with intercourse as the only “real” sex was troubling her.
What Harry and Shirley learned in sex therapy helped their fundamentally sound relationship. They learned to communicate more clearly and directly. Each learned to say what was wanted without confusing the other. Relieved of the self-induced pressure to always produce an erection, Harry relaxed and found his erections improved. He also began taking better care of himself, because he could accept more easily the changes his diabetes required in his life.
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