How Therapy Can Help Men With Porn-Induced Erectile Dysfunction

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By Andrew Irwin-Smiler, Ph.D.

Jim came to me for therapy because he was having a hard time getting it up during sex. I asked him what he thought was causing the problem, and he said it was porn. He told me that he’d been cruising online porn sites for about a year, since his last relationship ended. Jim didn’t think he was looking at that much porn, but he couldn’t figure out what else it might be. He knew it wasn’t alcohol or pot, because he also problems getting hard when he was sober.

Jim could get it up during sex, but it usually took a lot of effort from both him and his partner. He rarely “just got hard” the way he used to. Now, he needed a few minutes of “direct penile stimulation” as it’s called in the jargon. That means his partner would need to play with or suck his cock before he’d get hard. And we’re not talking just a bad night every now and again, but almost every time he had sex. Neither Jim nor his current partner were happy about it. He’d also had problems when he hooked up with strangers.

Jim and I worked through the following three steps. They’re fairly simple, but the first one can be very difficult. This is becoming one of the common treatments for guys who are having difficulty getting an erection because they’re watching too much porn.

Let me be clear about two things before we start. One is that the problem we’re addressing isn’t watching too much porn, the problem is jerking off to porn too frequently. I’m not saying that porn is good or problem free; that’s a different conversation. What we’re going to deal with here is erectile dysfunction due to jerking off to porn too often for too long, say at least five times per week for the last six months. The result is that you’ve (re)trained your system and created a particular set of muscle memory for what causes an erection.  In essence, this is the same training that helps a quarterback throw a perfect spiral every time, allows a carpenter to saw a straight line with regular strokes, and allows a chef to make cut veggies quickly into even slices.

I’m making an assumption that you do not have any health problems that might contribute to an erectile problem. That’s more common than you’d expect for guys at midlife and beyond, but it’s pretty rare among 20- and even 30-somethings. Conditions that contribute to erectile dysfunction include anything that effects blood pressure, like hypertension and heart problems, many disorders that make it hard to breath, like COPD and lung problems (but not most forms of asthma), and obesity. If you suffer from one of these conditions, or even if you haven’t had a physical in years, you  should get checked out by your doctor.

I’m also making an assumption that at some point, your ability to get turned on and get hard used to function properly with another live person, or at least your imagination and your hand. If you’ve been masturbating to porn since the early days of getting a stiffy, you may need more serious treatment with a therapist who specializes in sexual disorders. What I’m recommending here may not work for you because it’s trying to take  you back to a place you’ve never been to.

As with any medical advice you find online, this treatment may not apply to you or be effective for you. For the best possible treatment, you should consult either a sex therapist or another medical professional.

Here’s the plan. It’ll take approximately three months before you (re)gain normal functioning.

Step 1. Stop watching and jerking off to porn. Yes, really. You — your body — needs to unlearn what you’ve been teaching it every day for the last however long its been. And lets face it, you’re not watching porn for the plot, dialog, or cinematography, you’re watching it as a masturbatory aid. Find something else to do with that, what, 20? 30? 60? minutes of your time. The important thing here is that you start to break the connection between seeing all those naked bodies and getting a hard-on.

I also want you not to jerk off for a month. Yes, a month. Really. Again, this is part of breaking the connection and resetting your system.  In essence, you’re giving your sexual arousal system a month off from masturbation. If you’re having sex with someone else, you can keep going, just don’t have sex with yourself.

Step 2. After you’ve gone a month without porn and without jerking off (and especially without pulling your pud to porn), you can start to masturbate again. Don’t do it every day, try to go three or four days between sessions. You need to start slowly, just like an athlete returning from an injury.

Do NOT start watching porn again. Do not pass go, do not collect $200. Instead, use your imagination and play with your whole body, the same way a partner might touch you. After all, getting turned on is about more than your dick. You don’t need to take a hot bath, light a bunch of a candles, and play some Barry White, but if that’s your thing, go for it. This is “me time” after all.

In all seriousness, it’s very important that you don’t jerk off to porn at this point. When you were watching porn, it was all about what you saw on screen and what your hand did in your lap. With a live partner, you may — or may not — keep your eyes open and you’re certainly going to be touched. By closing your eyes and imagining sex, and especially by touching various parts of your body, you can help retrain your body to feel aroused by your sense of touch instead of your sense of sight.

Believe it or not, jerking off this way might be challenging at first. You might discover that you can only do it in certain positions or that only some of your fantasies are arousing. For example, you might find that the easiest — or only — way to get hard is to be in exactly the same place you were in when you were watching porn: seated at a desk or maybe lying on your back on your bed. That’s ok. This is training, after all, and it’s important to get the basics right.

If things are going alright after two weeks of masturbation, change your motion. The build up to orgasm comes from the motion. Jerking off to porn is usually about the motion of your hand, but sex with a partner is usually about the motion of your hips. Instead of moving your hand back and forth around your cock, start using your hips to push your penis into your hand.

Another thing to start trying after two weeks of successful masturbation is to stop part way through.  Get hard, count slowly to 10 with your hand off your cock, then continue. If you stay hard, then count to 15 or even 20 next time. If you lose your hard quickly, then count to 5 next time. This is important because when you’re with a partner, you need to be able to stay hard long enough to put on a condom or change positions.

Step 2 can take as little as three weeks and as long as six weeks. You must spend at least three weeks in step 2; this is training and training takes time. If you’re not having success after 6 weeks, consult a professional. If things are starting to work properly after 6 weeks, move on to the next step.

Step 3. After you’ve been jerking off for two to three times per week for a month, and you’re still not watching porn, it’s time to add some variety. Variety is the spice of life, after all, and it certainly helps make for a more interesting sex life. It’s time to change it up.

If you’ve only been masturbating in one position, try something else. Sit, stand, lie down (back or belly), get on all fours, whatever. Get hard, stop, get a condom and put it on, then continue, just like you would in real life.

Here in month three, your masturbation – or rather, practice – should be more like real sex and less like sitting in front of a screen and petting your snake.

That’s it guys. If this doesn’t work, and if you’ve really worked the program, you need to consider other possibilities. One is that you have a physical condition and need to see a medical doctor. Another possibility is that you need to see an individual therapist to work through some issues regarding sexuality. A third possibility is that you and your partner may need to see a couples therapist because you’re not able to get hard with this partner.

Originally appeared at The Good Men Project

-image adapted from Greg Nehring/flickr under Creative Commons 2.0 license