Sexual and Couples Therapy

In many cases, the trigger for sexual impotence is the psychogenic component, making assessment, guidance, and psychological treatment essential.

At AndrologíaBarcelona, we also have a team of sexologists specialized in erectile dysfunction to address all types of cases.

Psychogenic erectile dysfunction often coexists with other sexual disorders such as hypoactive desire or premature ejaculation, and can be both a cause and a consequence.

The proper management of erectile dysfunction usually requires, as we carry out in our Barcelona center, a multidisciplinary approach shared and coordinated with various professionals.

What causes psychogenic erectile dysfunction?

In patients with erectile dysfunction, there is a pressure to achieve and maintain an erection or penetration during every sexual encounter. This demand for “performance” prevents them from enjoying the sexual act, which creates a state of alertness that makes the patient focus more on obtaining and maintaining an erection rather than relaxing and giving or receiving pleasure.

As a consequence of this excessive concern about sexual performance, even the slightest difficulty triggers anxiety and fear of not being able to meet expectations. This fear is known as “anticipatory anxiety,” which occurs when a person increases their level of alertness in anticipation of a future situation, thinking that this will help them maintain control in the face of uncertainty. This anxiety involves the interaction of cognitive, emotional, behavioral, and physiological responses before, during, and after a sexual situation.

This leads to feelings of insecurity, anxiety, dissatisfaction, guilt, and frustration both in the individual and in their interaction with their partner.

Factors affecting this type of erectile dysfunction

These patients have a fear that previous experiences will repeat (the first “failure”), and therefore present with worry about criticism, feelings of shame, unrealistic expectations to satisfy their partner, fear of rejection, breakup, or abandonment.

In most cases, the quality of communication with the partner is unsatisfactory or insufficient, both at a sexual and general level (lack of assertiveness, openness, or empathy).

Certain triggers such as a new sexual partner, one-night stands, stress, work conflicts, grieving a breakup, family problems, and issues of all kinds can be factors in the onset or maintenance of the dysfunction.

The best professionals in erectile dysfunction in Barcelona

Sexual and couples therapy is, in these cases, the best treatment option for erectile dysfunction. Our team of experts can provide you with an assessment and offer help.

What is sexual therapy?

Sexual therapy is a type of psychotherapy aimed at helping to externalize a sexual problem and begin managing it to enjoy a satisfying sex life again. It consists of various stages or exercises carried out in the patient’s privacy and intimacy, either individually or as a couple.

The initial goal is to express, detect, and modify the causes in order to reduce the level of anticipatory anxiety (fear of failure) and decrease the pressure to “perform on demand.”

Using cognitive-behavioral techniques, specific objectives are proposed.

Identify and combat anticipatory thoughts related to sexual relations, replacing them with more adaptive ones.
Reduce cognitive distortions related to performance pressure, perfectionism, guilt, and fear of abandonment.
Soften and control physiological responses.
Lower tension levels associated with sexual activity and carry out successful gradual approaches.

Intervention Program for Erectile Dysfunction

Sexual psychoeducation, providing the patient with sexual information and addressing sexual myths and taboos.
Promote a healthy lifestyle, encouraging the patient to take care of themselves.
Relaxation, mindfulness, and techniques to shift attention: focusing on the here and now.
Diaphragmatic breathing. Part of the physiological process of erection involves the proper functioning of the parasympathetic nervous system (PNS), and deep breathing activates the PNS.
Dysfunctional beliefs. Improve introspection and restructure automatic and anticipatory thoughts.
Encourage erotic games and avoid focusing sexual relations solely on penetration.
Personalized systematic desensitization (in imagination and in vivo) through gradual exercises.
Personalized self-stimulation program and sexual therapy adapted to each patient and process.
EMDR therapy.

Sexual therapy focused on the couple

When a patient attending the clinic has a partner, couples sexual therapy is aimed at the cooperation and involvement of both parties, who take responsibility and share the approach simultaneously.

At both the individual and couple levels, social skills training (assertiveness) and communication quality improvement are often established. Sessions last 1 hour and occur on a weekly or biweekly basis, alternating between individual and couple visits. Additionally, the professional assigns tasks for the patient to complete between sessions.

Sometimes, this type of therapy is combined with psychiatric or pharmacological treatment (PDE5 inhibitors), known as combined therapy.

Would you like more information about sexual and couples therapy?

At AndrologíaBarcelona, we have specialized urologists and sexologists.