Psychogenic ED Therapy: Overcoming Psychological Erectile Dysfunction
Specialized Behavioral Support for Men in Oregon
Erectile dysfunction is often categorized as a "medical" issue, but for many men, the root cause isn't physical—it's neurological and psychological. If medical exams have ruled out underlying conditions, or if your symptoms seem to fluctuate based on the situation, you are likely experiencing Psychogenic ED.
I provide a confidential, science-based approach to help men move out of their heads and back into their bodies.
What is Psychogenic ED?
Psychogenic ED occurs when the brain’s "stress response" overrides the "arousal response." While physical ED (organic) is typically caused by blood flow or hormonal issues, psychogenic ED is a communication error between the mind and the nervous system.
Coordinated Care with Oregon Urologists
I often work as a "second-line" specialist. If a Urologist has told you "everything looks normal," I am the specialist who helps you address the psychological side of the equation. I provide in-person sessions in Lake Oswego and secure Telehealth sessions for men across the state of Oregon. View Information for Referral Providers.
Common Indicators of Psychological ED:
Contextual Success: You experience firm erections during self-stimulation or upon waking (morning wood), but struggle during partnered intimacy.
Sudden Onset: The issue appeared suddenly, often following a stressful life event or one "failed" encounter.
Spectatoring: You find yourself "watching" the encounter like a critic rather than feeling it as a participant.
Performance Anxiety: You feel a sense of dread or "pressure to perform" before intimacy even begins.
The "Adrenaline Block": Why "Trying Harder" Doesn't Work
The primary culprit in psychogenic ED is adrenaline. When you feel anxious, your body enters "Fight or Flight" mode. Adrenaline acts as a vasoconstrictor, pulling blood away from the extremities to protect your vital organs.
In this state, the body is biologically incapable of maintaining an erection. No amount of "willpower" can override this survival reflex. Therapy focuses on lowering the "threat level" in the brain so the body can respond naturally.
It’s Rarely Just About the Bedroom For many men, performance anxiety is an extension of a larger pattern of high-functioning stress or social pressure. Understanding how your nervous system handles daily stress is key to lasting recovery. Explore My Approach to Men's Anxiety & Stress Management.
My Treatment Approach
We treat Psychogenic ED as a performance block that can be unlearned. Our work focuses on:
Desensitizing the "Failure" Loop: Breaking the cycle where one difficult experience leads to the fear of the next.
Mindfulness & Somatic Grounding: Techniques to keep your awareness on physical sensations rather than anxious thoughts.
The Dual Control Model: Identifying your unique "Sexual Brakes" (stress, shame, fatigue) and learning how to lift them.
Partner Communication: Tools to lower the pressure within the relationship, turning intimacy back into a shared experience rather than a solo performance.
Frequently Asked Questions
How do I know if my ED is psychological?
While only a medical professional can rule out physical causes, psychogenic ED is often identified by the presence of erections in non-stressful situations (like waking up or during self-stimulation) but a loss of erection during partnered intimacy.
Can I still use medication like Viagra or Cialis while in therapy?
Yes. These medications can often act as a "training wheels" to help rebuild confidence while we work on the underlying psychological triggers. I am happy to coordinate with your prescribing doctor regarding this.
Is this covered by insurance?
Many Oregon insurance plans cover therapy for anxiety and stress-related conditions. I can provide a superbill or discuss my current insurance affiliations during our consultation.
Take the Next Step
Psychogenic ED is a common and highly treatable condition. You don’t have to "white-knuckle" your way through performance anxiety alone. I offer secure Telehealth sessions for men across the state of Oregon.