Erectile Dysfunction

Treat Erectile Dysfunction Cardiff

Occasional Erectile dysfunction is not an uncommon situation. The impact of stress, anxiety, fatigue and excessive alcohol can temporarily affect your ability to get an erection. More persistent erectile dysfunction however could be a sign of underlying health problems and requires a medical diagnosis. Recurring erectile dysfunction can affect about 10% of the male population in any age group. Its frequency increases with age, even though age is not considered a cause of the condition. In the 50-59 age group the frequency is more than double that of the 18-29 age group.

Erectile Dysfunction Cardiff: Definition of erectile dysfunction

Erectile dysfunction, sometimes referred to as impotence, is defined as the inability to achieve and maintain a firm erection for the duration of the chosen sexual activity. It is commonly associated with problems initiating (or continuing) sexual (or anal) intercourse. Erectile dysfunction can also affect oral sex and masturbation.

Erectile Dysfunction Cardiff: Implications of erectile dysfunction

Sex is an important part of a fulfilling relationship. But when something is hindering your capacity to enjoy your sex life, it can be challenging for both you and your partner. How can it affect you? Erectile dysfunction is a sexual condition that can undermine your self-esteem and self-confidence. How you define your masculinity can be deeply rooted in the ability to sexually satisfy your partner. This expectation can create feelings of failure and embarrassment when you are unable to achieve an erection. It is common to avoid sexual relationships rather than confront your embarrassment during an intimate encounter. You may also feel isolated from your peers because if this issue was to become known, you could then be the focus of social humiliation. In your relationship, how you communicate with your partner can also affect your erectile dysfunction. A lack of open discussion of your condition can cause a misinterpretation of events. When you continuously refuse your partner’s sexual advances, they can easily think that you have rejected them because you no longer find them attractive. The real reason for your refusal however may be based on your own fear of “failure” that you will not be able to satisfy them sexually. This misunderstanding begins to damage their self-esteem, even though attractiveness is not at the heart of the situation. In reality, you are avoiding the potential embarrassment of yet another “let down” and it can cause you to become quite reserved and isolated in your condition.

Erectile Dysfunction Cardiff: What happens during an erection?

Before identifying what is causing your erectile dysfunction, it is important to understand what happens when a normal erection takes place. It’s very easy for this physiological process to breakdown. An erection involves a complex series of functions involving a psychological state of arousal, the nervous system, hormonal and circulatory functions to create localised changes in the penis. Relaxation of the smooth muscle is essential for controlling the flow of blood into the penis. When aroused, the brain sends signals to the nerves of the penis. Blood flow is increased to the erectile tissues. Sexual stimulation (and continued arousal) encourages the release of chemicals that relax this smooth muscle. Sexual stimulation also dramatically increases and maintains blood flow to the erectile tissues of the penis.

Erectile Dysfunction Cardiff: What causes erectile dysfunction?

Erectile dysfunction can happen at any stage of the erection process. There can be various physical and psychological conditions that contribute to your erectile dysfunction. Other than by injury or previous surgery, physical conditions include those which affect:

• The flow of blood to your penis -This is the most common physical cause of erectile dysfunction in men over 40 years old. Arteries carrying blood to the penis can become narrowed which means that there is insufficient blood going into the penis to achieve an erection. Several conditions can increase this circulatory risk of erectile dysfunction. They include hypertension (high blood pressure), smoking, heart conditions, diabetes, obesity, lack of exercise and high cholesterol. • The interference of nerve signals – The sending and receiving of nerve impulses can be interrupted by strokes, multiple sclerosis, diabetes and Parkinson’s disease. Without the essential “message” to open “the blood flood gates” from the brain to the nerves of the penis, they will remain closed. • The presence (or lack) of hormones/chemicals in drugs – Low levels of testosterone, an overactive or underactive thyroid or excessive levels of cortisol (Cushing’s syndrome) can cause your Erectile dysfunction. Drugs contained in prescribed medication can also contribute to your erectile dysfunction and should be discussed with your doctor before you stop taking any medication. Medication for high blood pressure, diuresis (increased urine production) and certain heart conditions are just a few listed medical conditions that could affect you. Recreational drugs including alcohol can also contribute to your erectile dysfunction. • The structure (anatomy) of your penis – Certain medical conditions that affect the structural tissue of the penis such as Peyronie’s disease can cause your erectile dysfunction. With this condition, erections can be painful and can be a source of stress and anxiety. Very rarely there can be a “venous leak” which prevents blood from being retained in the erectile tissues once it has been pumped there. Psychological causes of your erectile dysfunction can develop as a reaction to any of the physical causes listed above. Psychological causes generally inhibit your erection at the stage of arousal. Without arousal the subsequent stages become affected; the nerve signals to the penis, hormonal changes and blood flow. A psychological cause of your erectile dysfunction is more probable if you can achieve an erection in some situations, but have problems achieving it in other situations e.g. when masturbating but not during intercourse. Psychological causes include: • Stress – Stress related to non-sexual issues e.g. coping with work demands, can contribute to your erectile dysfunction. Stress causes the release of adrenaline which narrows the blood vessels, restricting blood flow to the penis. Stress also inhibits nitric oxide from relaxing (expanding) the blood vessels that are associated with the smooth muscle of the penis. Once sex is “perceived” as problematic because of your erectile dysfunction, further stress is created by negative emotions connected with your condition e.g. frustration or disappointment. A negative cycle of anticipatory anxiety, negative experiences and emotions exacerbates the condition, creating more tension and a fear of failure. • Anxiety – As with stress, anxiety about non-sexual issues can also contribute to your erectile dysfunction because the same (stress) chemicals are released with negative emotions. Anxiety specific to sex can be classified as performance anxiety. If you are young, lack any sexual experience or you are starting a new relationship, the pressure of trying to impress your partner can inhibit your ability to relax. When you then add some negative beliefs like perfectionism, fear of embarrassment, fear of failure or social anxiety, it can overwhelm your sexual confidence. With anxiety, you then worry about your erectile dysfunction happening again. You accumulate the “errors” of the previous experiences and transfer the worry into the next situation. Unfortunately, anxiety can direct your mind to the negative symptom (erectile dysfunction) you are trying so hard to avoid! You can also be anxious about a part of your body and this anxiety preoccupies your sexual performance. Low self (body) esteem may have been created by “put downs” from other people. Or it has been perpetuated by your own limiting self-beliefs based on internal insecurities and low self-confidence. Essentially, you believe that what you have or what you do is not good enough. You desperately seek trust, acceptance and confidence from your partner in the initial stages of the relationship because you have been scarred from previous (self or other people’s) criticism. • Depression – Psychological arousal sets up the necessary communication between the brain and your sex organs. Being generally depressed however can negatively alter the brain chemistry necessary to stimulate this pathway. As a result, your depression can cause your erectile dysfunction and ultimately you can have less desire for sex (loss of libido). Any long term condition (such as erectile dysfunction) that is suppressed or that overwhelms an already-stressed disposition can create a reactive depression. It’s yet another problem that exacerbates a feeling of helplessness where too many negative situations further distresses your state of arousal.

• Relationship problems – A new relationship brings a mixture of excitement and anxiety. You feel under pressure to please your partner sexually (performance anxiety), but haven’t established the level of trust required to communicate any of your insecurities. Your inhibitions and worries can also be exaggerated if you have suffered with erectile dysfunction in past relationships or there has been a lack of sexual relationships more recently. Your self-confidence can diminish without having the opportunity to correct the situation “in practise”. Unresolved arguments and disputes in established relationships can also be a cause for impotence. Conflicts from issues away from the bedroom can create tension and resentment inside the bedroom. And when sex can sometimes be a spontaneous tension-release from a partner’s sulking, the timing of your erectile dysfunction may add yet another layer of frustration in your relationship. You are trying to break the hostile atmosphere between you, but struggle to find a solution to create peace. Some erectile dysfunction issues persist because there is poor communication generally or about sex in your relationship. Without discussing these issues, there can be an increased feeling of responsibility if your partner’s sexual needs are high and you are unable to satisfy them. Or the demands may be increased because you are trying to start a family and you are feeling the added pressure of not being able to fulfil your part in conception. In situations where your partner has low self-esteem issues, you may not want to start any intimacy because if you do not achieve an erection, your erectile dysfunction might suggest that they are not attractive enough to arouse you. When relationships are recovering from traumas like known infidelity, the betrayal can be very damaging. A lack of trust (when your partner has been unfaithful) or guilt (when you have had the affair) can be another cause for intimacy problems. Indeed, even when your affair is not known by your partner, your own guilt and distracted commitment can still cause your impotence. • Sexual boredom – Arousal is helped by a feeling of excitement but when sex has become a routine, apathy can take over. Since erectile dysfunction increases with age, it may also coincide with those in long-term relationships where it requires more effort to keep sex exciting with a long-term partner. Inhibited communication can be behind the sexual indifference because you feel embarrassed or ashamed to openly discuss your sexual desires with your partner. Or having communicated your desires, your partner is too embarrassed to participate. • Other issues – Deeper dysfunctional attitudes towards sex can be rooted in traumatic experiences from childhood. They can include sexual abuse or any sexual traumas that cause a stress/anxiety response when you are being intimate. In certain cases, a sexual phobia can develop where any sexual activity can trigger panic attacks. Other negative attitudes towards sex may come from inhibited religious beliefs or sexual orientation problems. Even porn addiction has some suggested connections with erectile dysfunction depending on how it is used. It is not clear if sexual boredom, an absence of sex or a method of stress relief drives the porn addiction. The connection with porn may be different for each person, dependent on their background, their personalities and their relationships. There are some claims that excessive masturbation causes erectile dysfunction, but these claims tend to be anecdotal without an understanding of the nature of sex. They can also be prone to gender bias where the sexually-deprived partner wants to point blame on ‘something’ because their sexual relationship has ‘dried up’.

Erectile Dysfunction Treatment Cardiff: Treating your erectile dysfunction

Medical intervention – A consultation with your doctor or specialist will establish any physiological reason behind your erectile dysfunction e.g. high blood pressure, diabetes or cardio-vascular conditions. Options for treatment relevant to your medical condition will then be identified. In some cases, if your problem is hormonal, your endocrinologist will discuss hormone therapy. If anatomical issues are causing your erectile dysfunction, then surgery could help you. Penile implants (semi-rigid and inflatable) can be inserted, but these are not usually available on the NHS. Medication – Various medication in the form of phosphodiesterase-5 (PDE-5) inhibitors are prescribed to increase blood flow to the penis. Each type is taken within a period of anticipated sexual activity and requires a dosage that fits your sexual lifestyle. Your doctor will establish if there are any contra-indications e.g. angina or previous heart attacks. As with all medication, there can be side effects e.g. headaches or indigestion, but the prescription can be altered to ensure these are minimised. There is usually a cost for this prescription but there are some conditions that are exempt e.g. diabetes. You may be given a free prescription if you have had any relevant medical treatment that could directly cause your erectile dysfunction e.g. kidney transplant. Approaching your doctor is safer than buying on the internet unless you are buying from a reputable supplier. Speak to your doctor about the effective use of natural remedies e.g. vitamins or herbal remedies. There may be a placebo effect with some remedies, but if you believe the product will help you, then (for psychological erectile dysfunction) it can have the desired effect.

Reduce risk factors – There are certain lifestyle conditions that increase the risk of developing erectile dysfunction. These include: • Being overweight, • Drinking alcohol before sex or drinking in excess, • Smoking or taking recreational drugs, • Being physically inactive, • Feeling constantly tired, fatigued and sleep-deprived, • Suffering with stress. These issues are discussed below. Vacuum pumps – A vacuum pump is a plastic tube that is attached to a hand or battery operated pump. The penis is inserted into the tube and the air is then drawn out of the tube by the pump. As the suction continues, the vacuum then causes blood to fill the erectile tissues of your penis. Once erect, a rubber ring can then be placed around the base of the penis. This acts to reduce the venous outflow, helping you to maintain an erection. Like any new device, it takes practise to develop confidence using it. There are contra-indications (anti-coagulant medication) and side effects (possible pain and bruising).

Psychological treatments for erectile dysfunction

If your doctor has dismissed any underlying physiological causes of your ED, then exploring your lifestyle issues and psychological causes can help you treat the underlying reasons for your impotence. Lifestyle issues and erectile dysfunction -

As already mentioned above, there are numerous lifestyle issues that can contribute to your erectile dysfunction. • By stopping smoking, you reduce the risk of damage to arteries throughout the body. Nicotine encourages blood vessels to constrict and as you are aware, blood flow is essential for erections. • By avoiding alcohol, you reduce the short-term impact that it can have on your arousal levels. In excess, alcohol can lower testosterone levels (essential for dilation of blood vessels in the penis). The general advice is to drink in moderation, but get to know your limits and its effect on your arousal levels. • Recreational drugs such as narcotics, stimulants and hallucinogens can also have an impact on sexual functioning. Prescribed drugs can cause your erectile dysfunction but should be continued unless you have consulted with your doctor. Alternative medication may be available. • Reduce your weight if are obese by eating healthily. Obesity can increase your likelihood of atherosclerosis which can reduce blood flow to organs including your penis. Being obese also lowers your levels of testosterone which is essential for sexual function. Testosterone increases the availability of nitric oxide which dilates the blood vessels of the penis. • Take regular moderate exercise. Exercise can help with a number of different health issues. Cardio-vascular exercise can help with more efficient heart and blood vessel functioning to vital organs. It can help to reduce blood pressure (ask your doctor if you have any contraindications to exercise). Muscle tone, general stamina, self-esteem and self-confidence can also be improved. Exercise can help you to lose weight, release your physical tension caused by stress and may help to boost testosterone levels.

Anything in excess can be detrimental to your health, so it is important to establish a moderate exercise routine. Long distance cycling can compress the nerves in the pelvic area which can affect arterial blood flow. Moderate your cycle-training if it affects you in this way. • Ensure you have enough relaxation, rest and sleep to counter tiredness and fatigue. Depleted energy levels can be a mood-dampener for your arousal levels. When you are over-tired from a long day at work, the nerve signals from your brain to your sex organs are temporarily interrupted. After a rest period or by the following morning, the situation can be very different! Persistent tiredness and fatigue may indicate another underlying medical condition worthy of investigation by your doctor. • Manage your stress (see below).

Managing stress and erectile dysfunction

Finding ways to manage your stress can help reduce your erectile dysfunction. You might expect your stress levels to be high during the big life changes that include moving house, being made redundant, changing jobs or being promoted, a change in your relationship (for example a new relationship, separation, divorce, or you are about to become a father). When dealing with these major life events, erectile dysfunction can be fairly common, but your erectile dysfunction should resolve itself as you settle into your life change. You can be more accepting of a temporary situation when you know what is causing your impotence. When you are under continuous stress, the warning signs might not be obvious. They include emotional reactions like irritability or anger. They can also include physical responses like excessive sweating, changes in your bowel movements and disrupted sleeping patterns. Behaviourally, you may find that habits become excessive or that you procrastinate doing trivial tasks. Erectile dysfunction is one indicator that your stress level is high. Managing stress can be achieved in several ways. By implementing some of the lifestyle issues above, you may find that this is sufficient to help you cope with the situation (even though the negative situation still exists). It may also reduce the frequency of your erectile dysfunction. Without pro-actively dealing with your stress, you continue to produce adrenaline and experience the mental and physical effects of this hormone (erectile dysfunction being one of them). Common strategies to manage stress include: • Talking to others about your problem (off-loading), • Delegating some of the tasks, • Problem-solving the situation to eliminate any perceived obstacles, • Altering your own beliefs and expectations about the situation, • Finding way to vent your emotions e.g. exercise, • And learning to relax.

Treating depression and erectile dysfunction

When going through big lifestyle changes, depression can be a common reaction. Sexual arousal is normally lowered by depression. This is because you are not generating enough of the chemicals necessary to stimulate the essential nerve pathways between your brain and your sex organs. Your arousal levels can be low or non-existent depending on the severity of your depression. Those with erectile dysfunction can then develop a further reactive depression (and anxiety) because of the helplessness of your condition Depression is commonly treated with medication and can be helped with therapy. But there are many strategies that can help you lift your mood and sense of optimism. Some of these strategies are listed above (Lifestyle issues and Managing stress) and involve you: • Challenging your negative thoughts to elevate you out of your depression • Setting small achievable goals can give you a feeling of success and help you focus away from your “dark cloud”. • Scheduling goals can help you to re-connect with a moderate level of responsibility where you are in charge. Often depression can be caused by a sense of over-responsibility. • Setting daily goals can also help you to establish a routine. Rumination is common with depression but spending time dwelling on the negatives can pull you down further. Even if you are aiming for a daily 15 minute walk, the exercise can boost your endorphins and help lift your frame of mind.

Treating anxiety and erectile dysfunction

As already mentioned, any negative emotion such as anxiety produces the same stress chemicals that can inhibit your arousal and interfere with nerve signals from the brain to the sexual organs. Your anxiety can be related to non-sexual issues; external events that are dulling your arousal levels e.g. worrying about redundancy. The anxiety can affect many aspects of your life with your erectile dysfunction is one symptom. Medication or therapy is commonly used to treat anxiety, but there are many techniques that can help you cope with your anxiety.

Some of these strategies are listed above (Lifestyle issues, Managing stress and Treating depression). Other techniques include: • Learning relaxation techniques that involve slow, deep abdominal breathing that can help you to ease your physical tension. • Relaxation techniques can be used with visualisation, where you imagine yourself confidently coping with the situations that are causing you to feel anxious. • Using this process will help you recognise your anxious negative “self talk”. You can then learn to transform it into believable positive self talk e.g. change “I won’t get this job” into “I have the skills to succeed in this interview”. Your anxiety can be specific to sexual issues creating a form of sexual performance anxiety. High expectations about your sexual performance can come from a variety of sources. Media portrayal of masculinity can filter down into male youth culture setting up an unrealistic sexual role that you are expected to fulfil. These expectations can be brought into your first sexual encounter as a goal-driven, highly-charged experience (even though you may not really know the ropes yet!) And when it doesn’t go to plan, your perfectionism stores the negative event only to throw up the negative emotion (anxiety) in your future sexual experiences. If your sexual performance isn’t working for you, consider changing the nature of your performance. Some the strategies above (Lifestyle issues, Managing stress and Treating depression) can help you learn how to relax and approach sex in a different way. The breathing techniques and visualisation of arousal are essential to access a more relaxed state so that your arousal can encourage communication between your brain and sexual organs. In your mind anything that you want to imagine yourself doing will help you. It can also help to review your underlying beliefs which are making your sexual performance such a pressured experience. Fear of failure, fear of embarrassment and distrust only serve to exaggerate your performance anxiety. Consider what will help you adjust your perspective: • Does sex have to be perfect every time? • Is it such a failing if it doesn’t happen this time? • With erectile dysfunction being so common, is it that embarrassing if it happens today? • Can I talk to my partner about my worries? • Can you build up your intimacy in stages? By considering some of these questions, you begin to challenge your negative habitual thinking. They can help you apply more confident solutions to your anxiety.

Other Self help techniques for erectile dysfunction

Kegel exercises – These exercises are used to strengthen the pelvic floor muscles (also known as the PC muscle). These muscles are activated when you stop urinating mid flow. You can practise tensing these muscles anywhere (but don’t actually practise whilst urinating) e.g. whilst sitting in a chair or standing in a queue, tense three times for ten seconds each; rest for ten seconds in between each one. Practise these exercises up to three times per day. It is believed that by having strong pelvic floor muscles, it can increase the blood supply to the sex organs and create a stronger orgasm.

Masturbation

Masturbation is a natural function that can be used to practise your “peak” aroused state. When used in combination with relaxed breathing techniques and visualisation, it can treat your erectile dysfunction. When masturbating, visualise what epitomises arousal for you – in whatever situation, with whom and doing whatever arouses you – remember that this is a practise of exciting what is in your mind, even if it doesn’t happen in reality. If an image is a turn-off for you, reject it until you have found your personal peak aroused state. Renew the image often. Whether you tell your partner about this image is completely your choice. The principle is to individually re-programme arousal in your mind so that the nerve pathways between your brain and sex organs can communicate. It is a form of self-hypnosis. When you have mastered your visualisation on your own, you can then consider introducing your visualisation with your partner (see below).

Practical methods with your partner

When erectile dysfunction has clouded the intimacy with your partner, it’s time to get back to the basics and progressively build it up from there. After discussing this issue, agree that this is the way forward. With you having practised relaxed breathing and visualisation with masturbation, you can take your self-hypnosis into this next transitional stage of recovery. Sensate focus is the term used to emphasise exploratory pleasurable touch with your partner. In the early stages, it is often (but not always) without touching the sexual organs. It helps to take the pressure off the erection and intercourse thereby removing any performance anxiety. It also helps to re-build the arousal response from the brain to the sexual organs over a period of time; a form of re-sensitisation into enjoyable sexual intercourse. Both partners can benefit when they can admit that the previous system needs to be rejuvenated. The process requires both partners to be open and communicative about what you enjoyed when “exploring” each other and would like to be repeated in the next session. Explore different areas of the body by varying touch (massage can be a useful way of appreciating therapeutic touch), “mouth work” or using any physical aids e.g. vibrators. You move through each stage say every two weeks, but this can vary. Both of you being ready to progress is more important. In the first stage concentrate on the whole body but not the sexual organs. Then, in the second stage add some sexual organ stimulation in addition to what you want to keep from the first stage. Orgasm is not the emphasis but may happen incidentally. If the programme is moving successfully, begin some form of penetration in the third stage but without orgasm being the emphasis. Consider different styles of motion, varying of pace, intensity and style of movement. Be prepared to be open about trying positions, using any research material to build your knowledge. Be sensitive to what the other partner is enjoying, without being overly critical if something is not pleasurable.

Relationship therapy

Stress and anxiety from unresolved tensions in your relationship can seep into your intimacy. When you are preoccupied with the issues of a major row, your partner may be ready to let go, but until you are ready, these conflicts can block the arousal centre in your mind. Your erectile dysfunction then becomes a new symptom that blocks your sex life. When your erectile dysfunction has become a worry for you, it’s important to admit this to your partner. You may want to hide the issue because of the embarrassment and fear of failure. But the relationship will not be able to focus on repairing the problem until it’s out in the open. When the hidden issue persists for too long, it can become be too sensitive to discuss openly. And men generally tend to run away from sensitive issues until the issues have reached catastrophic levels. This is where outside help in the form of relationship therapy can objectively deal with “what is not being communicated” and find practical steps to deal with suppressed issues. Often with erectile dysfunction caused by sexual performance anxiety, the hidden issue is that you are trying so hard to please your partner, that it stops you from being able to relax and enjoy sex. When erectile dysfunction is generally misunderstood by your partner, it can cause a series of new problems. If your partner has low self-esteem issues, then they may misinterpret erectile dysfunction as a loss of attractiveness; they think that you cannot achieve an erection because you no longer find them desirable. They can become angry and resentful. They can even become suspicious that you are having an affair. In reality, what they believe is so far away from what is happening on your side, that these sensitivities create crossed lines of communication. It adds more pressure on you to “do your part” in bed just so that they can feel desired and “good enough”. Ultimately, when they are suspicious and have jealousy issues, it can help them to believe that you are remaining faithful.

Helping your partner with erectile dysfunction

Supporting your partner with erectile dysfunction is essential for his recovery. Talk to him about the condition, his feelings and concerns. He is likely to feel embarrassed about the condition and he will hope that it will right itself. Often it does once it is out in the open. If the erectile dysfunction does not change, encourage him to have the condition diagnosed by a doctor and explore treatment options. Erectile dysfunction is common and by making healthy changes in his lifestyle as a start, it may cure it. If there is a psychological cause then there are still many treatment options available. As a partner, his erectile dysfunction will be affecting you too. If your attempt to discuss the issue causes further conflicts, it may be better being handled externally by a therapist. Sometimes a condition like this exposes many suppressed issues in both partners of the relationship.

Erectile Dysfunction Treatment Cardiff: Treating your erectile dysfunction with Hypnotherapy

When your erectile dysfunction is stress or anxiety-related, hypnotherapy can be an efficient way to treat your condition. Different hypnotherapy techniques can be employed to improve your practise methods and treat underlying psychological causes. What can hypnotherapy do for you? Identify and treat the cause of your erectile dysfunction – The arrival of negative situations like erectile dysfunction can produce feelings of inadequacy; you get trapped in your erectile dysfunction symptoms and you are unable to separate the emotion from your condition. The negative emotion is stored in your mind from past traumatic events. They act as the cause of your erectile dysfunction. The emotion surges up into your consciousness to warn you about the danger of another “distressing” performance when you are next being intimate. Hypnotherapy can identify your past causes and release the emotion from these traumatic events so that you can freely embrace new positive learning states. Help to reduce stress and anxiety – Whether your stress and anxiety is external or is now part of your erectile dysfunction, hypnotherapy can lower your stress and anxiety responses. By introducing deep relaxation and breathing techniques into your coping skills, you can break the cycle of worry and ease the pressure that is affecting your sexual performance. Lift your depression – You can feel helpless when a condition like erectile dysfunction interrupts your intimacy. A reactive depression is only natural when you are fearful of starting a new relationship or struggle to maintain the current relationship. Hypnotherapy can stimulate your “sexual arousal” in your mind helping you to re-connect the necessary communication between your brain and sexual organs. Motivate you to change your lifestyle – Hypnotherapy is renowned for treating habits. If your erectile dysfunction is a symptom of poor lifestyle habits, then hypnotherapy can help you to improve your sleep habits, lose weight, stop smoking, reduce your alcohol, and start exercising. Treat negative beliefs that are intensifying your erectile dysfunction – Your sexual confidence can be overwhelmed by obsessive negative beliefs. A one-off loss of erection can turn into persistent erectile dysfunction when you interpret the event with perfectionism, fear of failure, fear of embarrassment or social anxiety. Hypnotherapy can help you dissociate these negative beliefs that have merged into your sexual performance. Visualisation of your arousal – The images and emotions of your arousal can become contaminated with persistent erectile dysfunction; what used to be a natural experience gets blocked by a concrete wall. With fewer positive experiences, it’s natural to avoid the pressure of yet another let down. As you acquire the essential visualisation techniques to practise with, you can boost the confidence back into your sexual relationship. Build low self-esteem and low self confidence – Any long term condition such as erectile dysfunction can damage your self-esteem and your self-confidence. Avoidance of your intimacy would be an understandable method of coping but this would severely limit the enjoyment of your relationship. In a deeply relaxed state, hypnotherapy can help your unconscious mind accept suggestions that will raise your self-esteem and self-confidence. Hypnotherapy techniques can be employed to anchor your past confident triggers with your intimacy so that you have a stronger belief in you and your abilities.

Stimulate effective communication with your partner – You and your partner are the best people to resolve your erectile dysfunction. But your communication can become strained when you are playing into each other’s sensitivities and you are trying so hard to please the other partner. In your relationship, you are learning about the values that you both bring into the bedroom; it’s easy to misinterpret your responses and make the situation worse with feelings of responsibility. When these issues are dealt with objectively by a professional therapist, it can help you focus on more open and decisive communication that will resolve some of the underlying obstacles.

Erectile Dysfunction Cardiff: For further information on treatment, contact Richard J D’Souza Hypnotherapy Cardiff

Premature Ejaculation

Premature Ejaculation Treatment in Cardiff

Premature ejaculation is a common sexual problem amongst men under 40, with 30% - 70% of males being affected. The actual figures may be higher because premature ejaculation is viewed as a taboo subject in male youth culture. Men with premature ejaculation may not admit that they have the condition until it is acute.  

Premature Ejaculation Cardiff: Definition of premature ejaculation

Premature ejaculation is can be simply defined as ejaculating earlier than you (or your partner) would like. Premature ejaculation usually happens before or shortly after penetration with minimal stimulation. It is an unsatisfying experience for both partners. Premature ejaculation is very subjective in nature. What can be “normal” for one male (and their partner) may be premature (or delayed) compared to the expectations of another relationship. The average time for male ejaculation during intercourse is somewhere between 4 - 8 minutes. Premature ejaculation can be a “lifelong” condition that has existed during puberty or “acquired”, which develops later in life. Both can have biological and psychological causes.  

Premature Ejaculation Cardiff: Implications of premature ejaculation

Sex is an important part of a healthy relationship. When something is inhibiting your ability to enjoy a satisfying sex life, it can be distressing for you and your partner. Premature ejaculation is one of several sexual conditions that can inhibit the enjoyment of your intimacy, putting a strain on your relationship. As a short-term problem, premature ejaculation can be an annoyance for both partners. Quite often, the condition can just disappear naturally. But as a long term condition, it can impact on your self-esteem and self-confidence. Some men will avoid new relationships rather than face the frustration and embarrassment of their premature ejaculation. Partners of those with premature ejaculation can also suffer distress. If there are communication problems, saying that there they are dissatisfied might put too much pressure on the man with premature ejaculation, making the condition worse. If your premature ejaculation happens before penetration, there could also be problems with conception.  

Premature Ejaculation Cardiff: What causes premature ejaculation?

Your premature ejaculation may have a biological background and thus it is important to have any biological issues diagnosed by your doctor before exploring a psychological connection. For example hyper-sensitivity of the penis can cause premature ejaculation and this would be identified in your pubescent years during masturbation. Or a medical change could have contributed to your premature ejaculation. Your doctor would test for medical conditions like diabetes, high blood pressure, hormone levels or prostate problems before considering other possibilities. In some cases, drug use or alcohol can cause your premature ejaculation, so your doctor will want to discuss any relevant lifestyle issues. Early background experiences can form negative “hurried” and anxious attitudes towards sex. Fear of being caught masturbating can condition the pubescent child to ejaculate quickly. Traumatic experiences can also be a cause for ejaculatory dysfunction. For example, being caught masturbating (and then being punished for it) or being sexually abused can similarly influence your anxious, guilty or shameful attitude to sex. The effects of these experiences may not become conscious until you enter into a sexual and emotional relationship. In addition to early sexual conditioning being the psychological cause of premature ejaculation, there are other psychological and emotional issues that can cause your ejaculatory dysfunction. Physical tension (held in the pelvic and abdominal muscles) can provoke the ejaculatory reflex and low moods from stress and depression are two major influences. The emotions themselves can act as triggers for your premature ejaculation, so that when you feel stressed or depressed, your premature ejaculation is worse. Other common negative emotions include anxiety, embarrassment, frustration, shame, despair, disappointment, guilt and anger. Other personality traits such as perfectionism can increase anxiety about your sexual performance. You place excessive pressure on yourself to please your partner causing a state of tense hyper-arousal. Being self-critical can also cause you to focus on what has “gone wrong” and project the worry of this “mistake” into the next sexual experience. The negative response to your “mistake” can also be intensified if you have social anxiety. You are more prone to feeling embarrassed about your premature ejaculation, escalating your anxious expectations into the next situation. Sexual performance anxiety is common with sexual inexperience and lack of self-confidence, with the tendency to be over-excited. It can also be evident in new relationships where you may want to impress your partner with your sexual prowess. Any situation in which you place a high level of importance will increase your stress levels and likelihood of premature ejaculation. In new relationships, it may feel like it is too early to communicate and discuss your control and intimacy issues. As the anxious male, you are then unable to establish a level of trust. This can be magnified if you have had premature ejaculation in previous new relationships. The likelihood of premature ejaculation is also increased where there has been absence of intimate relationships for long periods. Your anxiety and hyper-sensitivity can increase without having the opportunity to practise acquired control techniques. But even unresolved problems in established relationships can create ejaculatory dysfunction. Emotional conflicts “outside of the bedroom” can leak into the bedroom, causing tension during your intimacy. This can then create a negative cycle of stress, particularly if the partner is unsupportive of your condition, creating even more performance anxiety. Some premature ejaculation issues are specific to the bedroom and become established because of a lack of communication. For example, there can be increases in your partner’s sexual needs leading to hidden anxiety about pleasing your partner. This high expectation on your performance exacerbates your premature ejaculation, overwhelming your ability to satisfy your partner’s needs.  

Premature Ejaculation Cardiff: Treating your Premature Ejaculation

Medical intervention – After a thorough examination by your doctor, they will diagnose what is causing your premature ejaculation and then explore options for treatment. Oral medication in the form of anti-depressants is commonly prescribed. You may not be depressed, but SSRI’s have the useful side effect of delaying ejaculation. As with any medication there can be negative side effects too. For some people, the stigma of taking an anti-depressant influences them to pursue other treatment methods. Topical applications/condoms – The use of anaesthetic sprays and creams can reduce sensitivity, helping to delay ejaculation. Side effects include reactions to the chemicals used and a reported temporary loss of sensation for the partner. Condoms containing these chemicals can be used to reduce sensitivity. Even without the chemicals, a standard condom can be used to reduce sensitivity during sex and help delay ejaculation. Additional lubrication can have the same benefit.

Self-help methods

When things are persistently going wrong on the “playing field”, it’s time to identify what is causing this and apply the solutions into the training sessions. If you don’t have a partner right now or communication isn’t at its best, this means masturbating on your own and (re) learning to control your arousal as a practise for your next intimate opportunity. Without your partner present, you remove any pressure to perform (performance anxiety) and remove the fear of failure. This helps you develop self-confidence in stages and explore various levels of controlled arousal, rather than “all or nothing” responses. Practical methods include “stop-start” techniques that help you learn to control your ejaculatory response. When masturbating, vary the level of stimulation up to the pre-orgasm stage and then reduce the stimulation so that your arousal fades back down to a moderate level. Continue staying in this “zone” over a number of times during the session until you are ready to climax. The “squeeze” method – This method (by Masters and Johnson) involves first stimulating to erection and then squeezing behind the head of the penis (frenulum) for about 10 seconds to slightly reduce arousal. Continue stimulation to the pre-orgasm stage and then squeeze again until the arousal has reduced. Continue this process of “stimulation and squeeze” until you are ready to climax. Kegel exercises – These exercises involve contracting the PC muscle to control ejaculation. The PC muscle can be identified by stopping the flow if urine when you next go to the toilet. If you can stop urinating and start again, you have engaged the correct muscle. It is this specific pelvic floor muscle that also controls ejaculation. Tension in the abdominals, gluteals or thighs can provoke the ejaculatory response, so these muscles need to be kept relaxed. This is also a useful exercise in muscle tension awareness. Practise tightening the PC muscle three times for ten second intervals; rest for ten seconds in between each one. Then, during masturbation, practise tensing the PC muscle prior to orgasm. This helps to delay ejaculation whilst maintaining a level of stimulation.

Relaxed breathing – Learning how to take deeper breaths can diminish the ejaculatory reflex. Breathing techniques are commonly used in self-hypnosis, meditation and yoga to relieve stress and muscular tension. By practising slow, deep abdominal breaths when not involved in any sexual activity, you can become aware of which muscles are tense and which ones are relaxed. When you have this internal awareness, you can control and release tension using breathing techniques. As mentioned above, tension in the abdomen, thighs and buttocks can trigger the ejaculatory reflex. Controlled tension in the PC muscle can lower the ejaculatory reflex. Master deep breathing techniques and then integrate this muscular tension/relaxation control into your masturbation. Visualisation – What you visualise in your mind is another way of controlling unconscious bodily functions including your premature ejaculation. These images aren’t just on autopilot. Top professional athletes use positive visualisation to get in “the zone” to enhance their peak performance in sport. They also use it to release the affect of traumatic experiences. What you visualise can also affect what happens during sex. Think of something stressful and your heart will beat faster, your breathing will become shallow and your body will create muscular tension. These conditions are more likely to trigger you premature ejaculation. But if you visualise a calmer state of arousal, then it can help lower your ejaculatory reflex. To begin with, practise visualising “control”, confidence, calmness and deep breathing during sex. Then integrate these images into your masturbation. Avoid visualising “negatives”, because your imagination will take you to the place you don’t want to go! For example, “don’t think of an orange” and you know what happens! “Don’t think of ejaculating quickly...” and you’ll create the tension in your body that does just what you don’t want to happen. With practise, your visualisation can create a range of arousal levels to match the stage of your intimacy e.g. “low” during foreplay and “high” during climax. At advanced levels, this mind control can help you become a master of sexual arousal. Refractory period – The refractory period is the period of “down” time (or recovery) between each ejaculation. It varies greatly between men, ranging from minutes to hours and even days. After the first ejaculation, some men experience less sensitivity during the second erection. This reduced arousal can be used to your advantage by learning about the average time of your refractory period. If the period is quick, you can then masturbate before sex (or early in your foreplay) to release your first hyper-aroused premature ejaculation. This ensures that your second erection will have longer intercourse. Learn about the length of your refractory period during your masturbation.

Practical methods involving partners

Having practised these techniques on your own with masturbation, you can then apply these self-help methods during sex with your partner. When you introduce a new technique into an activity, expect some level of distraction as the new technique falls into place. The important thing is to be patient. There are numerous other methods that can help your premature ejaculation. Vary the length of your foreplay by trying longer (or shorter) periods of time. Change the focus of your foreplay with less (or more) time stimulating the penis. Massage can be a good way of facilitating relaxation in overly tense muscles and naturally reduce the stress levels in the recipient. Having trained yourself to be more aware of your arousal levels, you can also aim to penetrate with lower levels of arousal at the start of intercourse. Maintaining this moderate arousal during sex can be achieved using the following techniques: • Practise slower motions at the start of intercourse and increase speed of rhythm when you want to ejaculate. • Withdraw at intervals to ease the sensation, re-penetrating to increase arousal. • Use circular motions to reduce stimulation rather than deep thrusting motions. • Vary your position. The missionary position (man on top) requires the most muscular tension particularly around the core muscles (abdomen) because you are supporting your whole body weight. This can increase your premature ejaculation. Positions with less postural tension include ‘side-to-side’ and ‘doggy-style’. • You can also have sex with your partner on top of you to reduce your muscular tension. Plus, if you are unable to embrace any of these techniques and your partner is sensitive to your arousal levels, they can also vary the pace and rhythm to help control your premature ejaculation.

Relationship therapy

Stress and anxiety from unresolved conflicts in your relationship can leak into activities in the bedroom. It can affect both partners in different ways, but your premature ejaculation could be a symptom of problems in your relationship. How well are you communicating in general? Can you talk about your sexual needs in a non-judgemental way? It wouldn’t be surprising to learn that when there are problems with your intimacy, it is reflected in the relationship (and vice versa). When left open-ended for too long, the subject-matter can become too delicate to discuss. Men are generally less talkative about these issues, not wanting to admit that there is a problem until it is at catastrophic levels. This is where outside help in the form of relationship therapy can resolve “what isn’t being communicated” and find resolutions that can put you both back on track. The relationship therapy can deal with issues both inside and outside of your intimacy. Sometimes, because of the lack of communication between partners, your premature ejaculation can be attributed to assumptions about the needs of your partner. For example, you may be trying so hard to please your partner in bed, that your “pressure to please” is creating your stress. But maybe your partner is already content and would prefer you to relax more during sex, but his hasn’t been communicated effectively. Or maybe your partner’s slight disappointment with the premature ejaculation is being viewed as a complete failure on your part, making the situation more anxious for you. Actually, in their disappointment, they are reflecting what you are feeling. They are genuinely very keen to help you and are willing to try any methods to put it right.  

Premature Ejaculation Cardiff: Treating your premature ejaculation with hypnotherapy

When your premature ejaculation is anxiety or stress-related, hypnotherapy can be an effective way to treat your condition. Various hypnotherapy techniques can be used to enhance your practise methods and treat the underlying causes. This can ensure a more rapid change than if you were dealing with these techniques on your own. How can hypnotherapy help you? Identify and treat the cause of your premature ejaculation – When negative habits are ruling your life, it can seem like there is no alternative but to continue on your negative path. Your mind stores the emotion from negative past events to warn you about the “danger” of it happening again. But the stress of that past trauma is creating excessive tension and self-limiting beliefs. These past traumas are destroying your confidence. Hypnotherapy can help you identify the causal event and release the emotion, allowing you to access new positive learning states. Break the cycle of expectation – Expectation has a habit of creating your reality. You fear having premature ejaculation and the anticipation builds the anxiety into the condition. Hypnotherapy can serve as a useful method to break these disruptive negative thoughts and replace them with more positive constructive thinking patterns. Relax your ejaculatory response – When you have premature ejaculation, the communication between your unconscious mind and your sexual organs has become “over-excited” with the slightest arousal. In hypnosis, suggestions can be used to calm the ejaculatory response, diminishing the rapid nerve impulses that are provoking your premature ejaculation. Reduce physical tension – Physical tension is a key feature of our premature ejaculation. If you are having problems benefitting from the breathing techniques, hypnotherapy can boost your relaxation response. Relaxation training can then be given in hypnosis to enhance your learning experience.

Visualise a controlled arousal – Having an intense visualisation of the experience you want during your intimacy will focus your mind and body towards this reality. In a relaxed hypnotic state, conscious interference will be minimised so that you can embrace the imagery as a “real” experience of controlled arousal. Using self-hypnosis, you can then integrate this template into your intimacy. Build your self-confidence and self-esteem – Long term premature ejaculation can damage your self-confidence and your self-esteem. It can cause you to avoid intimate relationships for fear of the issue happening again. In a deeply relaxed state, your unconscious mind will readily accept suggestions to boost your self-confidence and self-esteem. Your past confident triggers can also be anchored with your intimacy helping you to develop a stronger belief in your ability. Encourage effective communication in your relationship – The best people to deal with your premature ejaculation is you and your partner. But there can be many reasons that your communication is inhibited. When these inhibitions are identified and treated, it can help you (and your partner) deals with the relevant issues more confidently.  

For further information on treating your premature ejaculation in Cardiff, contact Richard J D’Souza Hypnotherapy Cardiff

Treat Your Flying Phobia

If you are seeking ways to treat your flying phobia, it will require a complete reassessment of some essential issues: how you perceive flying in a plane, the management of your own anxiety and the underlying beliefs that are influencing your reaction. Having a ‘fear of flying’ recognises that when you fly, you suffer with high anxiety. The phobic flyer however avoids flying completely and is extremely distressed when they go anywhere near a plane. They may even suffer anxiety when friend or family member takes a flight. This is the major distinguishing factor between a fear and a phobia: when you have a fear, you somehow manage to get through, whereas when you have a phobia, you keep away!

Since you have a flying phobia, let’s consider that for some time, you have abandoned the idea of flying in a plane. You are a master of avoidance strategies, but you are desperate to change this situation and treat your flying phobia. What are the first few steps that will initiate a change? Here are six stages that will help you face your flying phobia so that you can view it as a more manageable task. Be prepared for some deep self-analysis and a strong determination to acquire your coping skills. It may even require some outside help, but we’ll come onto that later. These ‘treat your flying phobia tips’ draw from my years of experience as a clinical hypnotherapist helping patients overcome their flying phobias in Cardiff with hypnotherapy.  

Treat your flying phobia Cardiff #1: Identify your primary belief

Very few flying phobias begin as flying phobias. Flying just happened to fall into the progressive development of an unresolved external fear e.g. a fear of confined spaces. Over time more anxious situations are engulfed by the original fear until any situation can unpredictably set off your panic attack. In your heightened state of alertness, you ultimately ‘panic about panic’, responding to your own internal danger ‘signs’, until no situation appears safe. When you can identify your primary belief however, you are in a better position to confront what is driving your flying phobia. You can then focus on dealing with the primary issue and ignore the minor ones that are fooling your heightened state of alertness. Identifying your primary belief can be achieved with self-hypnosis. Take your time with this visualisation: Imagine a time-line of all your past experiences and as a viewer looking in from the outside, consider all the situations when you first panicked. You may not have realised at the time that it was a panic attack, because you were trying desperately to cope with the situation. You were probably young and felt very distressed. Your mind will have “sited” the situation although you may not have become conscious of it. But it will be there waiting to be identified. Then consider any situations in your past that you made an effort to avoid. With avoidance tendencies, you recognise that there is something uneasy about going into this situation; you just haven’t identified the primary issue behind it. Identifying your primary belief can take you one step closer to being able to treat your flying phobia. If you are struggling with his visualisation, learn some breathing techniques to help you relax and help you use more of your imagination. You can also use this list of fears associated with a fear of flying to help you analyse what lies behind your flying phobia.  

Treat your flying phobia Cardiff #2: Manage your anticipatory anxiety

Dealing with the anxious event whilst it is happening is one thing. Coping with what is ‘churning’ in your mind before the event takes place is the focus of this ‘treat your flying phobia’ tip.

Anticipatory anxiety is the worrying that precedes your exposure to a future fearful event. It could be fear of a panic attack or an imagined “catastrophe” when flying. It is ‘real’ anxiety that exists in your mind because common sense tells you that “the flight is not happening right now”, but your emotional history is creating symptoms as if you were experiencing it right now! In an attempt to warn you of this danger, your “fight or flight” stress response ‘kicks in’ and generates more anxiety symptoms. Unfortunately, this extra alertness is adding to your distress because these are the symptoms you are desperately trying to avoid. Externally, nothing is happening yet, but you are causing your own false alarm! Your mind is locked in a circle of “what if’s” that could go wrong in the forthcoming flight (but rarely ever does go wrong in that situation). The continuous red alert created by anticipatory anxiety can disrupt your life in many ways including your concentration, your moods and your sleeping patterns. Hyperventilation, palpitations and IBS are commonly experienced on a daily basis. Even when you are doing something routine, the fearful outcome rises up into your awareness and prepares you for the imminent danger, even though it could actually be weeks away. The irony with anticipatory anxiety is that your worry works against you. Your mind is waking you to the place that it is desperately trying to avoid (usually having a panic attack). Don’t think of an orange, and what happens? You think of an orange! If you associate anxiety with an orange, thinking of an orange will generate your anxiety symptoms. If what you historically associate with flying are imagined catastrophic events and/or panic attacks, then when you think about flying, up surges your anxiety symptoms as a warning of these past/future threats. Anticipatory anxiety plays its part in almost all anxiety-related conditions and situations. When you can recognise anticipatory anxiety’s deceptive nature of avoidance, you are in a better position to release your ‘false alarms’ and deal with the situation in hand (i.e. control your emotions when flying). Here are some ways to manage your anticipatory anxiety when you want to treat your flying phobia: • Separate the present from the past/future Anticipatory anxiety “locks” you into perceiving the build up to the anxious event and the actual fearful situation as one traumatic process. It’s as if you are on a conveyor belt about to be tipped into the fire and the only way to survive it is to avoid it completely. Using this analogy, step off the conveyor belt and break free from the build up (the anticipatory phase). Only then can you consider what you are actually required to do to cope with the situation when it happens. In many cases, you are required to do very little in your phobic situation, as is the case when you fly in a plane. Control your stress symptoms and let the journey take care of itself. • Recognise that being anxious now doesn’t mean it’s going to get worse It’s easy to think that if you are suffering anxiety now and the flight is a month away, your anxiety will only get worse as the flight draws nearer! But this is anticipatory anxiety fooling your mind again. The majority of anxiety is created leading up to and immediately before the phobic situation. In the phobic situation a very different set of resources are required. Consider the situation where your primary fear is of confined spaces. You will have high anticipatory anxiety just before boarding the plane and prior to take-off. But once the plane has taken off, the anticipatory phase has passed. You are now coping with your confined space and can benefit from the exposure to it. If you fear turbulence, you may run a series of anxiety attacks throughout the flight. This is because you will panic when you experience turbulence. You then switch back to anticipatory anxiety, placing yourself on standby waiting for the next sudden movement of the plane. When you focus your coping skills on dealing with turbulence alone, only then can you become more proficient at overcoming it. • Anticipatory anxiety “feelings” can overshadow a successful outcome You already know that previous traumas can keep you on the high alert when facing similar situations again in the future. But what do you take away from the event when the outcome has ended favourably? When the plane has successfully landed at its destination (or you removed the spider from the bathroom), does it mean that you no longer have a phobia? This “light bulb” moment of change can instantly happen in some situations and with some people. This is because the success of the event has altered your deeper beliefs and emotions related to your phobia. But when the success (or the absence of the imagined catastrophe) fails to register with you, it can be because you are measuring the success using your anxiety feelings. It’s as if “you felt anxious at some point, so it must have gone wrong. Better stay on the alert next time just in case!” Inevitably, you stay locked in the anxiety cycle the next time you challenge your phobic situation. Part of the positive re-learning process is to have some anxious feelings, but this doesn’t mean it has failed. Even positive change can create “butterflies”, so expect a degree of anxiety. When you can focus on the success of the outcome, the anticipatory anxiety will no longer keep you locked in anxiety. • Anticipatory anxiety is such a waste of your precious energy You can now identify that anticipatory anxiety is creating a false alarm and fooling you into believing that the worst possible outcome is going to materialise. But the number of times that the imagined catastrophe has actually happened is probably rare (compared to the times that the imagined catastrophe didn’t happen). Until you can appreciate that all of this emotional preparation is unproductive and is a waste of your effort and energy, you’ll continue to stay on the alert, waiting for your past history to repeat itself. What can you do about this? It takes courage to stare anxiety in the face and ignore your anticipatory anxiety warning signals that just serve to distress you. Only then can you focus your effort on how to cope in the situation that is triggering your anxiety when it actually happens. That’s where the positive emotional benefits will be returned to you. Is keeping busy going to help to you manage the anticipatory anxiety? It can, but you have probably found that when you are doing something routine, the anxiety pops up into your awareness. So it’s not the total solution. It’s ironic that in many cases, you are required to do very little in that situation that is triggering your anxiety. When you are sat on the plane, you can use some techniques to control your anxiety and find some activities that help pass the time; and that’s just about it! For those who rely heavily on distraction as a solution, this is where your mind is compromised. Yes, it helps when you can actively engage in activities, but when they are ‘low intensity’ activities, anxiety will worm its way into your consciousness and overwhelm you. So ‘meet’ with your anticipatory anxiety and let it pass through your mind, right out of the other side! You don’t have to battle with it; your energy is too precious!  

Treat your flying phobia Cardiff # 3: Commit to desensitising your phobia

This ‘treat your flying phobia tip’ assumes that you have identified your primary belief related to your flying phobia. Let’s say that your flying phobia has grown out of a fear of confined spaces. You can now begin to approach moderately anxious situations that are confined but without the same intensity as flying (e.g. lifts or other modes of public transport) and re-learn how to desensitise your response. This is classic systematic desensitisation, and provided you are committed to the re-learning process, you can gradually re-build your confidence in progressive stages. Methods of desensitisation involve creating an anxiety scale from one to ten. Ten on the scale would be a highly anxious situation (flying); one would be a calm situation. On the scale involving confined spaces, identify all of the dynamics that increase the anxiety rating. This can include, the level of commitment, size of the confined space, number of people present (social anxiety), the relationship of the people present (are you more confident when you know them?) etc. The aim is to start low, engaging in various situations and progressively moving up the scale as you relax or get used to these situations. Then challenge the next situation further up on your anxiety scale, until you are ready to cope with flying.

The process also involves setting up an internal anxiety scale. Ten on the scale is feeling panicky; one is feeling relaxed. When you enter a chosen situation, assess your anxiety level e.g. going into a confined space triggers your anxiety at feeling level of six. Aim to stay in the situation until your anxiety level goes down even slightly so that you feel more relaxed than when you arrived. As long as the situation doesn’t change (i.e. there are no new perceived threats), your anxiety will peak, stabilise and then decrease. The act of staying in the situation until your anxiety level lowers helps you to benefit from exposure to your perceived threat. By repeating this process, you will overcome your fear of the situation over time. However, leaving the situation at the height of your panic state increases your phobic response. A “quick getaway” reinforces your mistaken “claustrophobic solution”; that the quicker you can run away, the calmer you will feel. So wait for the anxiety to diminish and learn some relaxation techniques to facilitate this change. So with your commitment to overcoming progressively anxious situations, the top of the anxiety scale (flying) won’t seem like a huge mountain to climb in one go. You will develop confidence and self-belief en route. The emphasis on “commitment” is also an important requisite. This is because when you commit to a realistic goal, it helps your mind to decisively focus on the method required to achieve the goal. This is in contrast to the effect of anticipatory anxiety (see above) that causes your mind to hesitate and avoid confronting the situation. You’ll keep dithering until you can’t run away any longer, which will generate more anticipatory anxiety. Committing to a realistic goal has with it some notable amounts of stress, but the commitment helps you to step away from the procrastination stage and move into the “how to do it” stage. This is helpful in the process of change and for the beneficial exposure to your fear when you want to treat you flying phobia.  

Treat your flying phobia Cardiff #4: Manage your panic response

This “treat your flying phobia tip” considers your reaction only. What do all phobias have in common? Regardless of whether your phobia is related to an object, situation or internal fear, you will panic or fear that you will panic. Your panic has become your conditioned response. You believe that by confronting your situation (and/or panicking), it will traumatise you further. When left on autopilot, a panic attack will “lock” onto whatever you believe to be the cause. If you can’t identify the cause then, over time and left untreated, it is likely to generate a social phobia and agoraphobia, spontaneously erupting at random. With a flying phobia, you associate your panic with flying. But the plane, the crew, the journey (or any other part) is not “causing” your panic. It is caused by a series of internal negative programmes now conditioned to keep you on the alert until you can change it. Objects and situations outside of you are harder to “control”. Some situations like flying require you to be a “passive passenger”, allowing what’s around you to take place as a series of compulsory events. You can’t just tell the pilot to pull over for five minutes to give you a break! So part of your reprogramming is about turning this focus away from what’s going on “on the outside”, and giving attention to what’s happening “on the inside!” When you can switch this focus of attention, you will be devoting so much more of your energy and resources onto internal events i.e. the source of your panic. Not an easy task, but is essential to fully take control of what is yours. The control-centre for changing your panic is in your mind, not the object or situation. Trust that the external situation will take care of itself. You may not consider this next activity to be helpful, but persist with it. Momentarily close your eyes as if to meditate so that you can remove some of the visual cues likely to distract you from focusing on the inside. This places your mind into the arena where to can manage your panic. Now imagine closing your eyes on a journey in which you would feel moderately anxious. Does it cause you to feel tense? If it does, then consider practising this in situations in which you consider them to be moderately anxious e.g. when travelling on a bus. It will be a useful resource in your preparation for flying because you are learning to access your internal solutions, rather than being distracted by external false triggers. So having switched your attention to the “inside”, what does your panic present to you? Fearful beliefs can vary from thinking that you are going to die, to being embarrassed in front of your peer group, or thinking that you are losing control that will eventually cause you to breakdown. This is part of your anticipatory anxiety (see treat your flying phobia tip #2). You continue to escalate your response by triggering more fearful beliefs, hyperventilating in your attempt to cope, but this makes your condition worse. The tension in the abdomen or chest is a common feature of panic attacks. By learning how to breathe to reduce your panic, you can alter the course of your physical symptoms. Do use the link to master your breathing techniques because when you are breathing slowly, deeply and abdominally, your physical tension can be lowered. With less physical tension, it diminishes your internal red alert (see treat your flying phobia tip #3) and the conviction of your fearful beliefs.  

Treat your flying phobia Cardiff # 5: Visualise the experience that you WANT

This treat you flying phobia tip focuses on mental rehearsal. Strong visualisations can serve as mental preparation for your desired future experiences. In other words, when you practise imagining a calm flight, your mind will construct a template of you being on a plane, feeling relaxed. Over time, your repetitive positive visualisation can transform your images into your actual experience. So, work on visualising the experience that you WANT. But I can appreciate that when your default position has a flying phobia in the background, the negative impact of your phobia will initially block your attempts to visualise the ‘other side’. Having a flying phobia means that without actively trying to imagine a relaxed flight, there’s ‘the projection room is empty!’ This will need some serious reprogramming! So how do you learn to visualise? The breathing techniques help you to bring your mind down into a relaxed state where you can access chosen thoughts and images. When you are relaxed, it’s easier to be the “director” in your mind, rather than being directed by past traumas. After your breathing techniques, develop a script of your imagined positive experience during your flight. If this seems difficult to create right now, borrow a “script” from a different relaxing experience and transfer the detail into the flying situation. Next, “colour” the script with your relaxed feelings and emotions, making the details as vivid as possible. You could even use somebody else’s experience for your own script if it is easier to construct. Use whatever can be translated easily into your own positive flight scenario. Once the script is written, begin imagining this scene as a situation that has already happened, as this acts to consolidate the belief about your future reality (I know that it literally sounds back to front, but this is the whole idea – in your mind you want to visualise that you’ve already done it!) Re-draught the script as you become more experienced, intensifying the emotions with each practise. It is a gradual process however, so don’t lose faith if the feelings and images don’t seem real enough at this stage. You are learning to create this state of mind; it won’t be mastered in one attempt. Is it easy to get distracted when visualising? Yes, it’s easy for the mind to wander with all the obligations and responsibilities in your life. This is quite normal, but is common when novices also learn to meditate. Being aware that you have gone off your positive flight path is the trigger to placing your mind back onto it again. Keep practising. How long should visualisation take? After the breathing techniques, the positive visualisation can take about ten minutes a day. Expect a more believable visualisation after a few weeks of daily practise. As an actor would learn their script, the frequency helps the process become automatic. Repetition is important with this ‘treat your flying phobia tip’. What is crucial through this process is recognising that your script is helping you access what you “want”, rather than what you “don’t want”. Imagined experiences of you relaxed, coping with your flying experience is the experience you desire. Ask someone to check your script for positivity if it helps you progress with this.  

Treat your flying phobia Cardiff # 6: Be prepared to avoid avoidance

Most people can relate to this ‘treat your flying phobia tip’ only too well. When a situation triggers your anxiety, the common reaction is to avoid the situation again to stop you feeling more anxiety. This is the natural stress response that protects you from a perceived threat. Over time, if you are required to deal with that situation, your confidence is diminished and you doubt your ability to cope. Anticipatory anxiety (see treat your flying phobia tip #2) rules your mind and “offers” you short-term, secure alternatives to your anxious feeling. It convinces you into believing that if you can avoid that situation now, then you will feel better. Avoidance becomes a tempting safe option. But anticipatory anxiety doesn’t help you to see the long-term implications; it just deals with what is immediately up ahead. With you having a flying phobia, you will know only too well how destructive avoidance can be. It is has been a major contributor to the development of your flying phobia. You are aware that by foolishly “dodging it” over time, you will become reliant on that option as a way of coping. Avoidance stifles your progress and it becomes part of a vicious cycle of anxiety; you take short term fixes to feel better now. But it also creates long term problems that take more effort to undo. So what can you do about this once a conditioned response (your flying phobia) has set in? The answer is to label this anxiety cycle for what it is and begin challenging your thinking and your behaviour. Firstly, recognise and admit how avoidance has fooled your mind into the creation of a condition that has rarely actually “done” this to you, but continues to put you on a huge standby, exhausting you with excessive anticipatory anxiety when you so much as think about that situation. Secondly, find a positive anchor in your memories when you overcame adversity. Have you ever been afraid of something and avoided it only to respond with a hardened determination to keep going until you overcame it? If you’re struggling to find something within your memories, then do you know someone else who has done this? Borrow their example and use it as an anchor and building block for change.

Thirdly, be honest about your personal avoidance behaviour. What do you keep doing that is safe to justify “not” dealing with your goal? Do you procrastinate by watching television or making a snack? “It’s time to tidy the sock drawer again!” is a good example when avoidance is controlling your mind. Help yourself by listing those trivial tasks that interfere with your goal so that you can “catch” yourself running away from it. With busy lives, the mind can easily prioritise according to what feels the nicest first, sometimes referred to as the path of least resistance. When this procrastinating “strategy” is employed to lead your life, those anxious yet important tasks are going to mount up! Fourthly, plan a realistic goal that relates to your flying phobia (see treat your flying phobia tip #1 and #3) that has only moderate anxiety e.g. aim to overcome confined spaces, until you can relax when using lifts. Be sure to expect some anxiety through this process of change. But this is part of the natural “undoing” development. Exposure to that situation helps you to learn how to manage your anxiety. Once there is momentum, your confidence and skill-resources will grow because you are now “dealing” with anxiety rather than “worrying” about it. In addition to this, the exposure will help you eventually get used to your anxiety, rather than being fearful of it. Your anxiety is something to overcome, rather than run away from. It takes courage to want to challenge something that is a deep-rooted part of human nature. So with the confined spaces scenario, grade your experiences (see treat your flying phobia tip #3) and commit to gradually challenge your confined spaces scale on a weekly basis. Use the breathing techniques to manage your anxiety.  

Treat your flying phobia Cardiff: Summary

So these are the early developmental strategies that can help you treat your flying phobia. It can seem a long road back when a response has become conditioned, but with persistence and determination, you can make a u-turn and steadily work towards your flight goal. Of course, if you are struggling with any of these stages when attempting to treat your flying phobia, then hypnotherapy can offer you that booster with any part of your programme.

For further information on how to treat your flying phobia in Cardiff, contact Richard J D’Souza Hypnotherapy Cardiff