Common sexual difficulties in men

The two most common sexual difficulties in men which are found in cases of sexual dissatisfaction in marriage are impotence and premature ejaculation. Each of these is generally a product of nervousness rather than of any physical or chemical inadequacy, and no hormonal treatment is likely to help unless there are definite physical indications of a glandular deficiency. Many cases of premature ejaculation gradually develop to normality if they are accepted with patience, but cases of impotence are generally of deeper origin and need some form of psychotherapy if they are to be brought back to normal. Even with this the results are not always good, especially when there is any indication of latent or overt homosexuality. Referral is generally advisable.

It is essential to give some consideration to certain apparently abnormal accompaniments of sexual intercourse, because they may well come up for discussion in counseling. It is generally felt by those who have made a special study of these that considerable latitude is essential in assessing what is permissible, as long as two fairly fundamental principles are safeguarded. The first of these is that any such sexual conduct that is distressing or distasteful to the partner should be regarded as in need of serious reconsideration, and the second is that any sexual conduct that takes the place of proper sexual intercourse is to be regarded as abnormal. If the counselor bases his handling of such situations on these two principles he is not likely to do any harm in this kind of situation. In any doubt a referral to the partners’ own doctor or to a psychiatrist is worth considering.

In any counseling with partners in sexual difficulties the counselor will generally attempt to gain some knowledge of the total background of the situation by getting some idea of the sexual history of the partners. Much of this may come out spontaneously in the stories that each of them give, but the counselor can add to this by some well designed questions when there is an opening for them. He can keep his own mental processes in an orderly sequence by working back from the present to the past. The general history of the present marriage and the sexual attitudes and methods, the number of children and of miscarriages if any, and the feelings of each about them may come first. Then the history of any previous marriages, the conduct of the courtship and engagement period and of any previous love affairs may be discussed, and an opportunity given for an account of anything that may have been a cause of deep regret or disillusionment. Then the attitude of parents and siblings and playmates at school, and the way in which the early introduction to sex was conducted may be reviewed, together with the emotional attitudes of the client to the various manifestations of sex.

The progressively frank discussion of these emotionally charged elements of the situation in the calm accepting atmosphere of counseling will often prove to be an entirely new experience for the client, and it will do much to overcome many of his bewilderments and fears and to bring a growing release from his emotional conflicts and tensions. Even when there are deeply repressed elements, which need psychotherapy if they are to be adequately dealt with, the experience of counseling will provide an important part of the therapy, and may even help the clients to a point at which they can go on developing themselves without specialist help. Much will obviously depend on how naturally and comfortably the counselor is able to handle the sexual aspects of the clients’ narratives, and counsellors need to be at ease in their own personalities in this field if they are to be adequate for the work.

Finally in this discussion of the sexual relationship it might be suggested that at its best human sexual intercourse can be regarded as a complete abandoned self-offering of each to the other as an expression of outgoing unselfish love, a re-enactment together of the partners’ “one-flesh-ness” in the marriage relationship, through which it can be progressively deepened and the partners brought to an ever closer union. If it can be accepted in this way there will be less desire to demand and more willingness to offer. There will also be more regular personal attention to the quality of love which the regular sexual intercourse seeks to express, and in this way the partners will be much more likely to grow together to greater maturity in their total relationship.

Such a “sacramental” view of sexual intercourse should be at least offered to all young people before marriage and fully discussed with them, so that they are clear in their minds about it. The satisfaction of appetite is in no way disregarded, but it is not then the primary motive for this deeply significant action, through which it is hoped to nourish and strengthen the loving bond between husband and wife; so that their union can weather all the storms to which marriage, more than ever in these days, is exposed. While ministers may well delegate the work of explaining the physical aspects of sexual intercourse, and even some of the emotional aspects of it, to doctors, it would seem that the Church has a solemn duty and an equally solemn privilege, to offer this deeper spiritual aspect of it to all candidates for marriage, and to people who may seek the counsel of ministers after marriage for any difficulty in their sexual relationships.

Tags: Counseling