Between the Pages: A Guide to Sexuality and the ‘Existential Penis’

Using an existential psychotherapy approach, therapist Daniel N. Watter, Ed.D., discusses a new model for understanding and addressing male sexual dysfunction in his book, "The Existential Importance of the Penis: A Guide to Understanding Male Sexuality."

In the first book of its kind, Watter argues that the penis is a conduit for male emotion and, therefore, regulates a man's ability to form and experience intimate relationships.

Watter is a practicing clinical and forensic psychologist and a certified sex therapist in Parsippany, New Jersey. He is the author of more than 30 articles and book chapters on sexuality topics and formerly served as president of the Society for Sex Therapy & Research (SSTAR).

In this exclusive interview with Giddy, Watter spoke on how existential psychotherapy can help men with erectile dysfunction (ED), intimacy issues, hypersexuality and more.

Editor's note: This interview has been edited for length and clarity.

What is existential psychotherapy?

Watter: Existential therapy is a little difficult to define because it's not really just one thing. It's based on existential philosophy, which has a long history from the existentialists. It started to be applied to psychotherapy by [psychiatrist] Viktor Frankl, who was probably one of the first and most influential to do it. Then Irvin Yalom, a psychiatrist I write a lot about, coalesced everything and made it jell. It's his particular version of existential therapy that I practice.

In a very basic sense, existential therapy looks at what you might call a threat to existence. In other words, problems that would typically bring people into therapy are ones that threaten their existence as they know it. For example, mortality is probably the biggest threat to existence we could think about. But [there are] other things, such as isolation from others, relational difficulties, responsibilities that come with freedom and, of course, a life that feels like it has no meaning. All of these things threaten our sense of well-being and our ability to live lives that are meaningful and worthwhile.

You write that the thesis of the book is 'the penis is the conduit of male emotion and regulates the closeness/distance that men will allow themselves to experience in intimate relationships.' What do you mean by that?

I've been working a lot with men for over 40 years and I've found that men are much more emotional and emotionally reactive than they're often given credit for. [Actor and comedian] Billy Crystal made the joke, "Women need a reason to have sex. Men just need a place." It's funny, but it makes the assumption that men are like machines when it comes to sex. There's no emotional piece to it. And that's so not true, at least in the men who are going to present for sex therapy. Obviously, they are coming in because they're having some emotional conflict. That emotional conflict is often represented or spoken through the penis.

Men are not always as good at articulating their feelings or even identifying their emotions. A lot of them get depressed. When you repress emotion, it's going to come out some other way. You can't just sit on emotion and expect things to disappear. If it doesn't get acknowledged and articulated directly, it's going to come out in some other way, oftentimes through the body.

A lot of times when men are having erectile difficulties, it's because their penis is trying to send them a message that's being generated in their unconscious. If a man is feeling unsafe or conflicted in the relationship or is afraid of intimacy or rejection based on past trauma in their life, often, their unconscious mind sends a message to the penis in a self-protective way to shut it down. In other words, "This is a dangerous place to be."

A lot of times, I'll see men come in with erectile difficulties after having a good history of sexual functioning with a partner that they're now having problems with. The question then becomes, "If sex has been good for a long time, why is it problematic now?"

Often, the sexual difficulties began following what I refer to as a "relationship-deepening event." You'll often hear things like, "Sex was great. And then we moved in together and I couldn't get an erection." Or "Sex was great. And then we got engaged." When that happens, and that's a very frequent pattern, it suggests to me that now that the relationship has deepened, my risk and my vulnerability have increased. So if this partner now abandons me or cheats on me, then that can do me real harm, whereas before, the relationship was more casual. Of course, this is all happening at an unconscious level. When this happens, you often do find men who have had some past experiences with loss or abandonment or some type of early childhood trauma.

The penis is giving you a warning, saying, "I'm not comfortable with this. Something here is bothering me." The primary task of sex therapy from the existential perspective is to try and help the man figure out what his penis is trying to tell him. What is being communicated by this erectile shutdown?

The book describes an interesting case of a man who was approaching the age at which his father died and then suddenly started exhibiting hypersexual behavior.

Yes, that's a very common presentation in those cases, which are sometimes referred to as sexual addiction or hypersexuality. Confrontations with mortality can often spur an uncharacteristic explosive expression of sexual behaviors. The reason from an existential perspective is that the antidote to death is a life force, which is reproductive. So the penis actually becomes a conduit for the search for a life force because it is capable of producing life.

One of the ways people often will look for an antidote to fears of death is to turn to sex, and the sex becomes compulsive and excessive, and it's uncharacteristic. Something that's often overlooked in traditional sex addiction treatments is when did this begin? Almost all people who come in complaining of sexual addiction weren't always like this. Their sexual behavior was not always out of control. But something happened. Something got triggered.

We will see men whose fathers died young and they live with this cloud over them, this fear that they're not going to live past a certain age, and as they approach that age, they sometimes find themselves behaving sexually in some very uncharacteristic ways. You see traditionally monogamous men having affairs. You see people whose sexual behaviors were always well controlled regardless of their level of desire and, all of a sudden, they can't stop themselves. It's rooted in this overpowering existential fear of death.

How can men do a better job of listening to their penis?

First, recognizing the problem that's occurring is very likely the penis trying to send a message. A lot of times, men don't realize that. The typical explanation for sexual dysfunction in sex therapy has always been performance anxiety. I take real issue with that. Why would someone who's got a good history with somebody develop performance anxiety? It just doesn't make sense to me why that would be so much of an interruption to sexual function.

My thinking is that what often gets triggered is some type of repressed, early childhood trauma. That's the message the penis is oftentimes sending. There's something here that represents some threat to our existence. Once men recognize their penis is speaking to them, the therapist then tries to find out what's been repressed in their consciousness. Once something becomes conscious, you can deal with it.

If your fears are of loss or abandonment or mortality, whatever they may be, if you can identify them, then the body doesn't need to represent them anymore. It's kind of like traditional trauma work. In therapy, you work through those [fears], and your penis doesn't need to do these things. Once you get out of your penis's way, it works fine.