Most impotent men have no disease and are not taking any drugs. They fail to obtain or sustain an erection for psychological reasons, which induce the brain to send messages to the spinal cord inhibiting the erection. In many cases, the impotence is due to guilt or anxiety about sex, which may have originated in a sexually repressed childhood, when the boy learnt that sex was to be equated with sin, shame, or lust. In other cases the anxiety may be due to marital disharmony. A destructive marital relationship can cause impotence, and conversely impotence can cause a destructive
relationship. The anxiety can also turn into depression, which in turn can lead to impotence, when the man feels that nothing is worth while. Conversely, depression can be caused by impotence as, in our culture, a man who cannot get an erection loses his self-esteem, and may feel that because of his sexual failure he will lose his sexual partner.
The anxiety which leads to impotence may be due to a set-back in a job. A competitive, ambitious man may become severely insecure and depressed when an anticipated promotion does not occur. Since in American culture ‘making it’ has both occupational and sexual connotations, the man who fails to make it in his job may also fail to make it sexually. He may become impotent.
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