Context Is Everything For Sex

by Cay Crow, M.A., LPC, AASECT-Certified Sex Therapist

Sexual context


Context is everything. If you want to understand why you are having sexual problems, look at the context in which you are having sex. Women, for the most part, get this inherently because sex for most women is strongly relational and emotional. But too many men expect arousal and erections to occur under any and all conditions. I ask these men jokingly, if you were hanging upside down from a speeding train, do you still expect to get an erection? Most men believe that they could. But what men tend to minimize, if not completely overlook, is the emotional context of a given sexual encounter. Because these clients are male and raised in a culture rife with toxic masculinity, they have absorbed the idea that their erections must occur regardless of the context. However, even if a guy has healthy circulation and the blood flows south as expected, if he is nervous or scared, the smooth muscle tissue that allows the expansion of the erectile chambers will not relax enough for tumescence (getting hard). 

Emotions May Cause Erectile Dysfunction

I had the opportunity to work with a male in his 30s presenting with concerns about his erections. Usually, such clients will use the term “erectile dysfunction” even though they do not fit the criteria for a diagnosis. When I meet with such a client, the first question I ask is about the sexual context. This client had married his high school sweetheart, but she cheated and left him for someone else. He was devastated by this turn of events and still grieving. This client is not someone who has casual sex. He is a one-woman kind of guy. But this client’s sisters decided that he needed a push to start dating again, so they created a profile for him on a dating app. He met women for coffee and, much to his surprise, they wanted to have sex! The client was putting himself in an emotional context where sex was expected but not desired by him. He said that he was not interested in any of the women he met but he felt that he “should” have sex because the women wanted to and isn’t that how people date these days? His disinterest in these partners will impact erectile functioning. Given the emotional context, I reminded him that his penis just might have done him a favor. This is not a guy who can fuck the pain away. He is emotionally vulnerable and wants a connection with a partner (now known as demisexuality). I reminded him that his heart was broken and he needed time to grieve. The client was actually relieved to hear that. He knew that he was not ready to date. All this client needed was to hear that it was OK for him to wait and heal before finding another partner.

Criticism Kills Sex Life

I once worked with a couple who had been married 10 years. The wife was critical and judgmental towards the husband. His response was to shut down. When this occurred, the wife became increasingly disdainful towards the husband. The couple wanted to work on their sex life, but I felt that changing their negative dynamic was much more important. The wife wanted to have sex but expected the husband to initiate and overwhelm her with his desire. The husband was not interested in sex and rightly so! Why would you want to have a fun sexual romp with someone who constantly puts you down?! We did couple work using the Gottman Method, in particular, the Four Horseman of the Apocalypse (characteristics that Gottman proved will end a marriage): criticism, contempt, defensiveness, and stonewalling. Once the couple accepted their individual contributions to their dynamic and worked to change it, they were then ready to address the sexual piece of the relationship.

Keep in mind that no one has sex in a vacuum. Multiple contextual factors can impact a person’s sex life.

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