Although the figures vary between various clinical studies, estimates are that some 60% of cases of erectile dysfunction are due to organic causes. Atherosclerosis, hardening of the arteries that restricts blood flow, nerve damage from diabetes, Parkinson's and other diseases are frequent culprits. As such, drugs or surgery are treatments that are more common. Nevertheless, it remains true that, even apart from the occasional impotence that affects virtually all post-pubescent males, long lasting erectile dysfunction often has psychological causes.
Anxiety, depression, stress and other mainly psychological conditions can produce chronic impotence. The qualifier 'mainly' is used since the mind and body are intricately related. Even these mental conditions are often influenced or essentially caused by hormonal or other physiological factors. That being the case, erectile dysfunction counseling plays an important role in the treatment of a large number of ED cases. Counseling is not just a bull session and patients who participate in it are not just passive recipients of wisdom from a trained professional.
Counseling is an active process, guided by a professional, who is often a licensed psychotherapist, but one in which the patient is primarily responsible for his own progress. Unlike purely medical issues, no therapist can cure an ED sufferer against his will, or without the patient's active efforts.
During erectile dysfunction counseling sessions, the therapist will ask the client to explore feelings of anxiety, depression and others at the root of the ED after ruling out physical causes, of course. Like the popular image of therapy, clients may be asked to discuss dreams, childhood experiences and other issues.
Nevertheless, the chief focus will remain on what is happening now. This may include present work circumstances, marriage or relationship conflicts, and a wide variety of other issues, any of which can lead to chronic anger or depression.
Counseling is much more than simply 'talking about your problems' in the belief that they will dissipate spontaneously like smoke when a window is opened. Clients have to make actual changes in their beliefs, their choices and their actions in order to influence circumstances and their outlook. They have to alter both the inside and the outside in order to change the underlying reality that is causing erectile dysfunction.
That requirement is very difficult for most sufferers of ED, as it is for all other counseling clients. In some ways, the cliche that 'change is difficult' is a saying that is silly. Some kinds of change are the easiest thing in the world. One simply decides to purchase this brand of car rather than the one that had been the usual choice. But changing one's approach to sex, to relating, altering a view of one's self can, in reality, be very difficult.
However, in every case, just as with 'purely' physical issues, something causes depression, anxiety, chronic anger and the other psychological factors that may result in erectile dysfunction. Removing them, therefore, requires the client to make changes that will alter those underlying causes.
The process of discovering what they are and devising techniques for changing them is what erectile dysfunction counseling is all about.