What you need to know about erotophobia

After examining Joyce and Mark, I concluded that there was nothing physically and physiologically abnormal with them.

"I always knew there was nothing medically wrong," Joyce said, "I know my husband does not believe in witchcraft but those evil powers exist and cause problems like what we are facing."

Mark frowned. He shook his head and ignoring her, asked what my next course of action was going to be given the findings.

The couple was in their mid-thirties. They had been married for seven years and had two children. Mark was a doctor running a private practice while Joyce was a fashion designer. It had been eight months since the time they attempted sex and failed.

Mark asked Joyce to leave the consultation room briefly. He wanted to talk to me privately. Joyce obliged.

"So there is a secret I did not tell you," he stated, "I had sex with my secretary and from then on my erection failed and I developed this fear of sex!" he divulged.

A religious person with strong values on sex, it happens that Mark could not come to terms with his action. The next time he tried to be intimate with his wife he was flat. There was no erection. Then fear gripped him; he was traumatised. Any time he attempted he would become apprehensive, his heart would beat fast, he would sweat and his sexual organs would shrink, giving him a feeling that they were being swallowed into his abdomen.

"I have no morning erections, I dread having my wife near me and I have been creating situations to stay away from the bed, pretending to work late into the wee hours of the morning."

I concluded that Mark had erotophobia, the fear of a sexual situation. It was brought about by an extramarital sexual experience that went against his values. He was unable to reconcile his actions and his values.

Erotophobia is quite common and has many causes. Other than extramarital affairs in people with strong values around monogamy, previous sexual assault, painful sex, body shame or dysmorphia, relationship problems, or any sexual dysfunction can lead to anxiety, apprehension, and fear. Treatment of the condition aims to tackle the root cause.

"So in my case what do we do?" Mark asked impatiently, he was visibly distressed by this stressful condition. I booked him for therapy to manage the psychological issues.

In the first therapy session, we explored his experience of the extramarital sex and what it meant for his values. It was important for Mark to identify and take responsibility for his action, and realize that it caused conflict within him. He needed a plan to reconcile with his subconscious to have internal peace. He also needed a plan to prevent similar occurrences. He needed to take charge of the situation to free his psyche from further trauma.

Beyond that, I trained Mark to identify negative thoughts. It is important to realise that negative thoughts are not necessarily factual, sometimes they are exaggerated. If you do not identify and analyse them they immediately influence your feelings and you get traumatised. When you can identify them you can pack them in a place in your mind and take time to critically analyse them and use them to make factual decisions. This is a big step in taking charge of a difficult psychological situation.

But sometimes it is not the thoughts that influence your feelings and actions. A bad feeling can just crop up without any prior negative thoughts and if you do not manage such feelings they begin to influence your actions. You should take it that feelings are meant to inform you that something is amiss. Take time to find out why the feeling could have come. Once you identify the cause of the feeling develop a plan to deal with it.

Meanwhile, learn to be in the moment when with your spouse. Do not shift your mind to the past or the future. Avoid ruminating over the past while you're with your partner; you are likely to lose the present. That only leads to sexual failure, anxiety, and frustration.