Not hard due to psychological pressure

Erectile dysfunction caused by psychological stress (also often referred to as "not hard") is essentially a temporary disorder of body function caused by emotional stress. More than 90% do not have organic damage. According to the 2023 clinical survey data of the Chinese Sexology Society, 73% of these people do not need to take drugs. They can fully return to normal levels through cognitive adjustment and behavioral intervention alone, and there will be no sequelae.

Don’t believe it, I just received a consultation last month from a 28-year-old department manager of an Internet company. He had just been promoted for three months and was focused on projects until two o’clock in the morning every day. The KPIs were so overwhelming that he was not even answering work messages while eating. The first time the problem occurred was on my girlfriend's anniversary. I was scolded by my boss that afternoon and was still 30% short of the quarterly target. The hotel and atmosphere were all in place, but nothing worked. I was so embarrassed that I wanted to find a crack in the ground and crawl into it. After that, I became obsessed. Every time I stayed with my girlfriend, I would subconsciously wonder, "Is it going to work out again this time?" The more I thought about it, the more problems came up. After two months, the two of them were about to break up.

Regarding the causes of this problem, researchers from different directions have quite different opinions. Consultants who follow the psychoanalytic school will feel that many times it is not that you "can't", but that you subconsciously "dare not" - you are afraid that you will not be able to meet your partner's expectations, and that this failure will confirm the label of "you are not good". In order to help you avoid this kind of frustration, your subconscious mind will simply let your body "go on strike" first, which is essentially a kind of self-protection. Scholars from the cognitive behavioral school put it more bluntly. This is a typical "functional inhibition caused by misaligned attention." It is the same reason that playing games with you feels hot, but when the leader stands behind you, you immediately transform. The instinctive reaction that should have been led by the parasympathetic nerve is suddenly cut off by your head full of anxiety about "can it work, is it enough?" It's strange that it works well.

Even when it comes to solutions, practitioners in different fields differ. Many urological doctors tend to "build confidence first and then talk" and prescribe one or two PDE5 inhibitors for you to ensure one or two successful experiences first, directly breaking the vicious cycle of "fear of failure - real failure - more anxiety". For people who have been unable to perform normally for three or four months in a row, this method is particularly effective. However, many sexual psychology counselors do not agree with this approach. They feel that it is easy to leave people with the psychological hint of "I must rely on medicine", which in turn prolongs the self-healing cycle. In fact, there is nothing wrong with both ideas. They are just suitable for different people. If you are really anxious to the point where you can't sleep well, it is not a shame to take medicine to bring you back to your state. If the situation has just happened once or twice, there is no need to rush to take medicine.

I have met too many people who resorted to medical treatment as soon as they encountered this problem. They ate more wolfberry, lamb loin, and oysters than they had eaten. Some people just stayed in the gym and lifted irons for two hours a day, making themselves so tired that they could not even walk. In the end, it was of no use. Instead, because they spent so much money and put in so much effort, they still didn't get better, and they became even more anxious. To put it bluntly, your steering wheel is broken, it’s not that the fuel tank is out of fuel, so what’s the use of keeping on refueling?

Let’s talk about the 28-year-old guy before. I didn’t prescribe him any medicine at the time, so I asked him to do two things: first, honestly talk to his girlfriend about the situation. The two of them agreed not to engage in any intimate activities at all for half a month. On dates, they would eat his favorite Chongqing hot pot and play the live-action scripted movies he loved to play when he was in school. He could relax as much as he wanted. No one was allowed to mention that.； The second is to arrive in front of your home after get off work every day. First, sit in the car for 10 minutes, switch the work group directly to the background without interruption, and watch cat videos, or just stare at the street lights in a daze, throw the identity of "department head who has to shoulder KPIs" in the car, and then open the door and pretend to be your boyfriend. On the 12th day, he sent me a message, saying that the two of us were sitting on the sofa watching old cartoons, hugging and hugging each other, and it just happened naturally. There was no tension in the mind like before.

Oh, by the way, don't think that all similar situations are psychological problems. If you still don't get better after a month or two of adjustment, and even the morning erections have completely disappeared, then it is best to go to the hospital to check your hormones and blood flow, and rule out organic problems. Don't hold on to it and delay things.

After all, your body is much more honest than you. It knows better than you whether you are stressed or anxious. Just like you will feel sleepy when you are tired, you will be unsteady when you drink too much, and you will not be able to erect when you are under great pressure. This is nothing more than a signal it sends to you: "You are too tight, it's time to loosen it up." There's really no need to take this as something that the sky is falling from. The less you take it seriously, the faster it will get better.