Karen Aram Psychosexual Therapist

North London T: 07909 910 624 E: karen@karenaramtherapy.co.uk

Particularly Men....

Why are so many men coming forward for therapy? What are the issues that are bringing men into my clinic and what are the outcomes for them?

Problems for men

The issues that men bring fall roughly into 2 groups: those that feel most of their problems are physical or mechanical, involving problems around erections, ejaculatory control and/or sexual performance: and those believing their issues to be emotionally driven such as loss of desire, intimacy struggles and relationship problems.

What appears to be almost universal is the (natural) expression of anxiety around these issues. Often the anxiety bubbles up in the mind, seemingly prompted at the first thought of sex. However as you struggle to exert control over of your thoughts, there is often a dive of self-confidence and a feeling of shame that can contribute to a 'catastrophising' of what will happen in your mind.

A deeper understanding of how you've come to think and behave will enable us to re-establish new and productive ways of approaching these concerns. Of course there are many overlaps between our minds and bodies; we are all one being after all. However, learning to move your attention from your mind into your body and learning to simply be present to what your body is feeling and experiencing will help change your pathway through sex.

What matters here is how comfortable you are in your ability to express and understand your masculinity and sexuality. I am ever moved by the efforts men make to communicate in a more emotional and meaningful way. The men I see do not match those represented in our culture and society as 'typically male'.

Men and Porn

Recognizing that you are watching 'too much' porn is an awareness that's important. Porn affects individuals differently; it isn't inherently 'good' or 'bad' but affects some negatively.

Porn does not describe nor illustrate intimacy, sensuality, creativity nor sexual mishaps. It excludes smell, taste, touch and the normal and natural body. It can often stifle arousal in the viewer as one becomes unable to self-generate feelings of desire through fantasy and verbal connection to the other, becoming ever more dependent on porn for stimulus. Essentially the end result of watching a lot of porn is in direct contradiction to one of its apparent reasons for existence; used in excess it does not arouse nor excite, it squashes and extinguishes sexual desire. We become observers of ourselves rather than being able to immerse ourselves in the physical nature of sex. We can start to feel inadequate in terms of what we've seen in porn and compare 'real life' normality to onscreen fantasy, finding real life somehow lacking.

Anxiety and doubt can then culminate in disappointment with what we're doing, sometimes leading to erectile issues such as difficulties in getting or maintaining erections. It is only too easy to compare the everyday 'normal body' (your own and others) with to those you've seen onscreen, unable to celebrate nor see the beauty in both you and your partners imperfections.

Of course there are men who may recognise they have erectile dysfunction or have issues of rapid or delayed ejaculation, with little or no porn involved in the problem. Many men recognise they've had these issues from early adolescence, but for different reasons haven't come forward for help. Most men will be motivated to take action when relationships are threatened or are being avoided because of these difficulties.

The Way Forward

All aspects of change demand a degree of trust both in our working relationship and with yourself, in terms of your willingness to embrace and think about new ideas.
I can work effectively with men choosing to come for therapy alone, but depending on the nature of the problem, certain issues maybe more effectively treated with the partner involved as well. This is so because, although it may seem that the issues are all or mostly yours, this difficulty will now sit centrally as a problem in and for your relationship. Both of you may view the problem and its impact differently, but your couple relationship will only benefit and strengthen from both of you going through therapy, gathering the awareness and skills needed to experience a more satisfying sex life.

We can change our behaviors and our thinking. Some believe thinking differently leads to new behaviors, whereas others feel the opposite; it is only by behaving differently and repeating those changed behaviors that our thinking patterns eventually catch up. Lets discuss!

CBT (Cognitive Behavioural Therapy) and understanding what it means to be a man are our corner stones toward helping you create a more authentic and true sense of yourself. Erectile and ejaculatory problems can be worked with effectively using different homework exercises and re-framing some of your thinking. 
I work with current research, clinically successful ideas and an emphasis on communication and feedback. What matters is understanding and working towards what you want for yourself, your relationship and your life.
I witness men from their early 20's to much later in life, making extraordinary changes for themselves. I don't think it's ever too early or too late to re-write your own story and improve the quality of your life.

North London

T: 07909 910 624

E: karen@karenaramtherapy.co.uk

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