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The Cirque du Soleil of Marriage presents "The Mask of Viagra"

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Erectile dysfunction is a common and disabling condition in men. It has been known to cause extensive psychological distress and many relationships have ended due to the resulting inability to have sex. In men over forty years old, this is a very common condition. As a result, Viagra has brought significant happiness back into marriages and relationships in which other dimensions of the relationship are great except for the sex. Recently however, I have noticed in my long-term therapy practice and in several consultations, that many people who use Viagra in their marriages do not use it for their affairs. In fact, in their affairs, they do not need it at all. Why is this? And what does this mean?

The initial spark that leads to sex in many relationships often dissipates with time. This occurs in part due to familiarity, boredom, moving onto more spiritually evolved tasks and because the desire to procreate diminishes with age. When Viagra is used to reinstate erectile function, it helps to consummate the desire that both partners have to please each other. However, it may also create the illusion that one partner is more "desirable" than they actually are, or that their desirability is sexual, when in fact, it may be otherwise. While it is still possible to love someone romantically and not be able to perform sexually, it is also possible that this love is blocked due to fears of having sex. For the man who needs Viagra for his marriage but not his affair, what does this mean?

It may mean that he is avoiding relevant problems with intimacy with his wife, and that this should be addressed in order to further the primary relationship. Also, it may mean that his marriage is not as stimulating, not due to any "fault" of his of his partner, but due to the factors mentioned above. Furthermore, erections can be stimulated not just by sexual attraction but by novelty, fear, secrecy and excitement and these factors may not be present in his primary relationship. But should they be?

A long-term relationship cannot, for example be "novel"; nor should it be. Also, the sex is not usually "secretive" and there is not usually "fear" associated with the sex. Again, why should there be? Is Viagra an adequate or more appropriate substitution for these elements?

I believe that Viagra may mask possible problems in a relationship. In effect, it covers up potential problems that exist and makes the relationship less likely to advance. Many couples don't care about this. They simply want the erection back, and this is one solution. But, given the fact that other contexts for novelty, fear, excitement and secrecy (such as affairs) may be sought out, this also puts the relationship at risk and compromises what may be an otherwise great relationship. What then can be done in the case where Viagra is being used as a mask for problems in a relationship? Below are some things to consider:

(1) Instead of seeking out these factors elsewhere, couples may create "novelty" by not scheduling their sex times, or they may add different dimensions such as sex toys or different sexual positions to their experiences. Other forms of novelty such as "soft" S&M games, playing dress-up, fantasy games and having an attitude of playfulness may also add some spice to sex lives. This may be why threesomes or switching partners also work for some people, although I would argue that it is difficult to substantiate this as being better than Viagra.

(2) Couples may also not avoid the need to deepen intimacy. After committing to each other, dealing with children or family, couples often forget to focus on deepening the relationship. Some couples are even afraid of this and will do everything to avoid it. One of the most destructive things that some long-term couples use to continue a "non-familiar" sex life is that they never actually get to know each other. As a result, they have great sex, but the "unpredictability" factor robs them of the benefits of trust and deeper intimacy. When you are always on edge with a partner, or not completely revealing, the distance may help sex at the detriment of other elements of intimacy. Couples would do well to address some of this in the relationship. How do you deepen intimacy? You talk. You do things together. You identify combined goals. You make commitments to these goals and reach them together. You fight. You face the boredom. One of the most important things though is that couples need to remember that they can't be intimate with each other if they are not pleased with their own lives. People who feel enlivened about their own paths are often in a much better position to be intimate without strain or boredom.

(3) I would suggest that while "secrecy" is not helpful in long-term relationships, "alone-time" is. This gives both people time to re-charge and bring something fresh into the relationship. This often causes anxiety due to separation, but growing trust and commitment can help solve this.

(4) I do not believe that fear or sensationalism form an adequate basis for an intimate sexual relationship. They may, through play, help lighten things up for a little bit, but when they become fetishes, the depth of the connection is often lost. While this is easier, it is a heavy price to pay. Balancing play with the real challenges of self-connection and freedom is important when one is facing having to enliven a sexual relationship. In a sexual relationship, this can be achieved in numerous ways such as facing the fears that have stopped the development of intimacy.

Thus, while organic causes of erectile dysfunction may be valid indications for Viagra, couples may need to join forces on other real issues that compromise long-term relationships. Viagra may be a mask, and a marriage may be made into a circus if the deeper issues are not dealt with. Affairs may help or hurt a relationship. Either way, looking behind the mask of Viagra may reveal an important face of that relationship that could benefit both partners as they get to know each other more intimately.

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