Nothing to Fear Except Fear Itself: Erectile Dysfunction

Nothing to Fear Except Fear Itself: Erectile Dysfunction
Andrew J. Rynne Surgeon Clane, Co. Kildare, Ireland

Dr. Andrew Rynne is a general medical practitioner practicing in Clane, Co. Kildare, Ireland. Dr. Rynne specializes in vasectomy, Testosterone Replacement Therapy and fixing sexual dysfunctions in men and women. He also provides an Online Medical Consultation Service at where you can consult... more

Performance anxiety is the big killer.

Performance anxiety is the commonest cause of erectile dysfunction in young men. It is also the most difficult diagnosis to sell. Men generally do not want to know about it. They want a more complicated explanation. They think that performance anxiety is their own fault or that it is a sign of weakness. It is neither, in fact.

It was Franklin D. Roosevelt who first uttered these immortal words: "Nothing to fear but fear itself" during his inauguration speech in 1933 in the midst of the Great Depression. As it turned out, Roosevelt did nothing at all to alleviate that depression. Indeed he introduced a series of measures that served only to keep America locked in depression for a further ten years. That not withstanding, this famous passage from his speech lives on to this day.

Can I help you with anything?

Masters and Johnson, those fearless pioneers who researched human sexual response and sexual malfunctions in the sixties, borrowed Roosevelt's famous phase when attempting to give better understanding into whats happening when young men fall victim of performance anxiety erectile dysfunction. It may be small consolation to a man with this condition to say that he has nothing to fear except fear itself. However, Franklin's observation is uniquely applicable to this dysfunction. For it is the fear itself that causes this humiliating problem. Nothing else, just the fear itself. Get rid of the fear and you get rid of the problem.

Here is what's going on (and Masters and Johnson spotted this with laser-like accuracy).

When a man's desires are provoked by stimulating sexual activity, his subconscious mind tries to send a message to his penis to get ready for some fun, to get erect and to stay that way. In the meantime, however, that same man's conscious mind starts to play tricks on him and allows fear to creep in. So here we have the situation where, on the one hand this man's subconscious mind is doing the right thing in trying to arrange an erection to happen, while on the other hand, the same man in his conscious mind is blocking the subconscious messages with fear.

Result? No proper erection or no lasting erection.

Now here is the trick, and again, Masters and Johnson were very quick to spot this.

What do you do when consulted by a man suffering from performance anxiety erectile dysfunction? Do you tell him to just go home and stop worrying? You can, but that's not going to work. Fear will continue to block his erections. Do you quote him Roosevelt and tell him that he has nothing to fear except fear itself? You can. However, to do so is to invite looks of incredulity and no understanding. No. The therapist attempting to help the young man whose fear is blocking his erections has something far more potent to offer that mere cliche and cant. The therapist can remove the fear altogether. No fear; no failure.

You remove the fear by removing the challenge. Take intercourse off the menu altogether. When there is no challenge to perform, there can be no performance anxiety and no dysfunction. Look after your partner's sexual needs in whatever way she finds enjoyable, but make it clear to her that you are off duty and will not be "performing". After some time, like a few weeks, a man in this situation will in fact get a good erection with which he does nothing. She, on the other hand, may like to use it. That's fine; so long as the man can just lie there passively, she can do whatever she likes with his erection.

This is how you permanently cure performance anxiety erectile dysfunction. Remove the fear and it goes away. How elegantly simple is that?

And no need for any blue tablets either.