Impotence

Impotence in Non-Western Cultures

Less-than-ideal erections have long been seen as a concern worldwide, although different cultures hold different ideals of sexual performance and understand erectile difficulty to be caused and cured by different factors. In China, for instance, traditional medicine has dealt with impotence for over 2,000 years. Chinese traditional medicine understands impotence as a problem resulting from a bodily energy blockage located in the liver or kidney; this condition is treated with herbal medicine and acupuncture. In many cultures, such as that of the Azande of north central Africa, illness is believed to be caused by the intervention of malevolent spirits; the cause of impotence is thought to be witchcraft, and the condition is treated by counteracting the witch. The herbal treatment of impotence, as well as ideas of erectile difficulty caused by spirit intervention, coexist in many areas with the use of pharmaceutical treatments for ED.

Recent History of Impotence in the West

Ideas about the causes and nature of impotence have changed dramatically in western societies over the past century. At the turn of the 19th century, persistent impotence was understood as a medical problem, but one with behavioral roots. Too much sex, masturbation, or “perverse”(other than heterosexual, procreative) sex were thought to physically damage the penis and deplete what was thought to be a limited supply of energy-giving sperm. Impotence was treated with behavioral change, specifically warnings to reduce sexual activity and perform only heterosexual, traditional sexual acts. Behavioral treatment was often accompanied with medical treatment, such as surgical treatment for [Page 889]urethral strictures to address the physical damage that doctors thought was caused by excessive sex.

As psychoanalysis, Sigmund Freud's theory of the unconscious and the treatment of neuroses, became popular in the first half of the 20th century, impotence came to be seen as a symptom of underlying psychological problems. With the popularity of psychoanalysis, sexuality became to be commonly seen as a natural drive, albeit one that could be expressed incorrectly in individuals suffering from childhood trauma. Thus, the treatment for impotence was no longer behavioral change but participation in a psychoanalytic talking cure designed to uncover trauma and set sexual development on a healthy path.

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