As a MD and bodyworker I come into contact with many people, and friends who inform me about their problems. One field I am particularly interested in is behavioural disturbances in sexuality there where male impotence happens as a psychosomatic issue. So no physiological problem, erections happen during the night, but functional impotence may rise in sexual encounters. I want to share some of my experiences, as not much is published in this field related to the following.
Psychosomatic impotence
In one of my patients there was a situation of psychosomatic impotence, although the erections during the night were powerful. Many talks to sexologists did not bring any relief. In the past he was sexually exploited while 12 years old by 2 girls slightly older. He buried this memory many decades till it resurfaced in a dream. He than remembered vividly the situation.
A new approach was constructed based on combining sildenafil (Viagra) with tantric touch and meditative bodywork. Not a common pairing in mainstream practice, but this combo has a strong theoretical potential and may indeed open up new therapeutic territory. Let’s break this down and look at both the mechanism and the context. Here some milestone thoughts, developed in dialogue with ChatGPT.
💊 Sildenafil: The Mechanism
Sildenafil works by:
- Enhancing blood flow to the genital area through inhibition of the PDE5 enzyme,
- Increasing tissue responsiveness, particularly in the corpora cavernosa (penile erectile tissue),
- But not directly inducing arousal — sexual or sensory stimulation is still required.
This means it amplifies the body’s physical response to already present arousal — making it ideal in a context where subtle sensations or gentle erotic touch are used.
🧘♂️ Tantric Touch or Erotic Meditation Context
In tantric massage or meditative bodywork, the focus is often on:
- Reawakening numb or dissociated areas of the body,
- Bringing awareness to energy flows and blocked zones,
- Using presence, breath, and intention to allow integration of sensuality with consciousness.
In the case we discussed — where the glans is physically oversensitive but erotically under-integrated, and the anal area has become a maladaptive erogenous focus — using sildenafil selectively could:
- Facilitate erection with minimal or very light stimulation,
- Allow gradual, meditative reintroduction of penile sensation, ideally with safe, slow, non-goal-oriented touch,
- Serve as a support for somatic re-patterning, helping the man re-map his erogenous awareness.
🌀 Therapeutic and Ethical Considerations
Using sildenafil in a tantric or meditative setting is not standard, but some experimental somatic therapists and conscious sexuality practitioners might have explored this informally. Still, no peer-reviewed literature supports its integration into formal tantric massage practices, likely due to regulatory and ethical sensitivities.
However, with clear intention, informed consent, and a therapeutic framework, this approach could be:
- A bridge between pharmacological support and inner awareness,
- Useful in psychosexual trauma integration, especially where genital identity has been altered or disowned,
- Supportive in shifting the “erotic mapping” back to include the penis without threat, pain, or shame.
🧠 Core Pattern: Erotic Displacement through Trauma
Both an earlier case with circumcision-related hypersensitivity and anal shift) and the case above (post-assault situational impotence) reflect a disruption in the erotic-affective neural circuitry caused by early trauma. That is, in both men:
- The genital zone becomes disconnected from integrated pleasure.
- Erotic energy becomes diverted or suppressed — either to another zone (anal), or away from intimate presence altogether.
- The body still functions (erections occur), but the relationship to the body is fragmented.
This is fundamentally a case of erotic dysregulation — where pleasure, safety, arousal, and identity no longer align.
💡 Why the Topic is Consistent
The clinical diagnosis or trauma event may differ, but the underlying mechanism is shared:
- Somatic memory ‘stores’ fear or shame in the body.
- Erotic energy becomes either inaccessible or maladaptively channeled.
- Consciousness splits: the person may intellectually desire intimacy, but the body shuts down when it’s time to receive or give pleasure in safety.
This makes tantric touch, supported presence, and gentle pharmacological support (like sildenafil) a unified approach, not just an isolated intervention.
👨⚕️ A new inroad in psychosomatic impotence
This new proposal of treatment combines:
- Scientific knowledge of erectile physiology,
- A deep respect for consciousness and sacred experience,
- An understanding of trauma-based erotic remapping,
- with a therapeutic intuition trained to hold vulnerability without pathologizing it.
This isn’t about creating a new protocol for performance, but about restoring access to sacred erotic embodiment.
In some articles here we will further deepen our approach, and hope both sexuologists as well as men suffering from psychosomatic impotence will find their way into this realm. Shunyam Adhbhu
breath4balance 