Sexual dysfunction– whether an inability to achieve erection, premature ejaculation, pain or discomfort– afflicts millions of people around the world. Recent data suggests that about 30 million men in the US suffer with erectile dysfunction (ED), for example, and one in four of them are below the age of 40.  While older guys are more likely to have some physical ailment, such as a cardiovascular condition, primarily contribute to the ED, for a large number of men, especially the younger guys, the ED stems primarily from a psychological and emotional issue. In my practice, I mainly see the younger guys struggling with ED, and for them, drugs such as Viagra and Cialis, while a miracle cure for older guys with health issues, do very little to solve their difficulties.

For the purpose of this article, I’m going to focus on ED, although the basic principles would apply for all the other kinds of sexual dysfunctions that people may experience. When we take a closer look at psychological or emotional issues, such obvious ones as anxiety and fear come to mind as likely contributors. Clearly, someone who is anxious about their performance and fearful of a shameful experience if the sex act doesn’t go well, is more likely to struggle with ED symptoms. But I would like to take a closer look at another problematic emotion that often gets overlooked– anger. Folks who regularly read this blog may recall a previous post where I detailed how anger (and its intense cousin, rage) can wreak havoc on the body. In this particular article, I would like the take a look at the ways that anger may particularly play a role in ED.

It may seem counterintuitive, but for folks who have sexual difficulties such as ED, anger is often lurking somewhere deep in the psyche, even if it is submerged underneath the anxiety. In my experience, anger can rear its ugly head in one of two key ways:

1. Anger tenses the body and prevents the relaxation necessary for sexual pleasure, and

2. Anger can be experienced as problematic and frightening, which leads the individual to experience confusion and doubt rather than enjoyment of the sexual experience.

Let’s take a closer look at each of these in turn. In my experience, the kind of anger  that seems to pop up particularly in sexual situations is often linked to negative experiences with the specific gender of the love object. So, for example, a heterosexual man who has ED that is mixed with anger, often may have strong angry feelings towards women as a gender. These feelings of anger may stem from one incident or from one individual from the past, but may then be generalized to all women as a gender. For example, an intrusive or overly-critical mother, an older sister who instigated rough-play, a female cousin who was sexually suggestive but merely teasing, an older babysitter who domineered over the boy, a history of female peers who were rejecting– these are all examples from my professional experience that have created the kind of environment for the boy ripe for a deep and seething anger.

So when a man who is struggling with this kind of internal experience of anger finds himself in a sexual situation, he may find himself unconsciously (or even consciously) experiencing a reactive anger that tenses the body and prevents him from truly relaxing (situation #1 above). In this same scenario, he may find that his anger is protective in that it shields him from allowing himself to be vulnerable, and hence be hurt again by another woman. His subjective experience is often one of anxiety, which defends him from coming into contact with the anger and hostility submerged beneath.

Sometimes, the man may find himself in touch with these angry impulses, but then be so confused and disturbed by them that the relaxation and flow required for sexual pleasure becomes impossible. Guys in this situation may experience what is commonly referred to as the “Madonna/Whore complex”, whereby they cannot possibly do “nasty” and aggressive sexual things to their wife or girlfriend, but would have no trouble at all getting erect with some presumed social castoff (in their minds) such as a prostitute. (Often this complex may also involve sex-negative messaging in childhood, but that’s a subject for another article). These men may have encountered the experience of having intense and pleasurable sex with their partner only when enraged, at which time they may allow themselves sanction to treat their innocent beloved (Madonna) as a broken whore. For these men, they may be in more touch with their anger and it often feels dangerous and problematic– they feel like they cannot just give their impulses free reign and the resulting anxiety and confusion is experienced as a killjoy and erection killer.

I can go on forever. But I’ll just stop there for the moment. The main point is that for many men, getting in touch with their anger holds the key to resolving their ED. By connecting with and accepting the rage, they are then free to either challenge its anxiety provoking effects or use it to positive effect and integrate it in healthy ways into their sexuality.