Interview about Erectile Dysfunction with Matthew Cinnamond

This was a phone interview that was transcribed.


Interview with Fai Kur – SEX THERAPIST

[Matt]  I’m speaking with Fai Kur who has a Master of Health Science in Sexual Health from The University of Sydney and a Bachelor of Arts in Psychology from Edith Cowan University.

 
Fai…

Tell us a little bit about yourself and what it is that you do?

 [Fai] I specialize as a sex therapist.  I run a private counselling clinic here in Perth (Australia) we also offer phone and Skype counselling services. Aside from seeing individuals and couples, I also run workshops for individuals and couples. We personalize all of our services.

 
[Matt]  Why should we be looking to you as a solution to erectile dysfunction?


[Fai] People who have found themselves experiencing an erectile dysfunction often start to withdraw internally, they start to question why, they look at is it themselves is it their bodies, is it the relationship and it really does affect them on many, many levels. So the reason why they would seek someone like me would be to make a change, take an initial step and to create a different pathway for themselves and it will in turn facilitate a shift within themselves, their relationships and their general outlook on life.

 
[Matt]  What happens during a consultation with a sex therapist and you have already said that you do things through Skype so it doesn’t have to be done in person?

[Fai] Because its talk therapy there is no reason why great rapport can’t be developed between practitioner and client. The processes that we go through do not have to happen face to face, over the phone or Skype is an awesome experience regardless.  We are just very lucky that we are living in an age where that is available to all of us. So what happens?  From my perspective I try not to get too much into the story prior to the individual coming to see me as I do feel that once they have engaged in that story they don’t always want to backtrack, so I do like to meet with the individual and go through their sexual history, through their adolescence and we have a discussion as to why it is that they have come in on that particular day, what their concern is. Is it something that has been a problem for them always, is it situational, has it just come up recently, we look at the external factors that might have facilitated this shift within them and based on that initial conversation we then have a dialogue as to how we will proceed and go forward from there. It’s very individual based and that allows the person to have an understanding of why they might have been experiencing their current situation and the belief that change can happen for them.

 
[Matt]  Obviously there are different types of erectile dysfunction, so can you please touch briefly on the different types of erectile dysfunction and the treatments that go hand in hand with those?


[Fai] It’s really important for people to realise, that we use erectile dysfunction in a way as a very blanket term but we do want to divide it up into: does the person have an issue or a concern with getting an erection in the first place, is there a problem with maintaining that erection, is it about the fact that they cum faster than they or their partner would like them to cum or are they taking much longer than they would like to and they are not cuming soon enough.  So it really does get divided into many brackets and the discussion that we would have would very much be focused on what it is that they have presented with.

 
[Matt]  What are the latest treatments/techniques being developed, and who is carrying out trials of these new treatments?


[Fai] I do believe that there are a number of clinical trials occuring and there is a lot of research happening but it depends who you are.  If you are a medical practitioner, you would be focusing on the medications that are available to help in the treatment of erectile dysfunctions and premature ejaculation. At the moment we would be looking at things like the Cialis, Levitra and Viagra for somebody that was more struggling to get an erection and in terms of premature ejaculation if we do go down the medical route they would be looking at something that is an SSRI or an antidepressant based product. More recently a new product has come out so instead of going on it on a daily basis, it’s a little bit more like Viagra in the sense that you would take it on around the time that you are planning on having intercourse and it’s active in your system for a number of hours and that came out in Australia in June so it’s very recent, I personally haven’t had a lot of feedback, however it’s always good to know that some of these products are being developed.

 
[Matt]  While we are on the topic of pills and medication, do you find that there is a significant amount of emphasis placed on selling men a pill, rather than finding the root cause of the problem and offering them a solution?


[Fai] Absolutely, I think in regards to what you have acknowledged there, it is really important.  I think that one of the bonuses in terms of products like Viagra coming out isn’t just the fact that a product came onto the market, but it’s the fact that people started talking about their erectile functioning and about their concerns and their dysfunction that they might be experiencing. With that, the hope would be that they were given permission to go to their GP or go to a sex therapist and seek out a conversation and a solution with somebody who personally works in that area and will allow them to personalise the treatment. As opposed to going to a company who is more about marketing and less about individual services. It’s important to find out what the active ingredients are in a particular treatment, and when we find out what the active ingredient is, then we can do our own research and find out whether or not that delivery system will help with what our problem is. One of the issues, as you mentioned is that we sometimes hear of stories where somebody with premature ejaculation has been given the medication that is really not made for that and it’s really more about helping their erections.  So it doesn’t solve their premature ejaculation problem. In some cases it might help, so it’s not to say that every case needs to rule that out, but they’re not given the right product for the right concern.  It causes a lot of trauma because they have finally gone to seek help and if that doesn’t work for them and it if it’s been expensive then they are unlikely to go to the next person.

 
[Matt]  There are companies that require you to pay for a minimum of one year of medication when you use their treatment.  This makes the treatment very expensive.  Do you feel that this is always necessary or could it possibly be taking advantage of men who are willing to try or pay anything to solve their problem?


[Fai] Absolutely, I am having an emotional reaction to that interestingly.  It does not have to be expensive.  Absolutely you find yourself paying for the fact that you are seeing somebody who specializes in the problem area that you have, if you had an issue with your heart or if you had an issue with diabetes then you would go to the right specialist. We don’t need to find ourselves signing up to a year program, what we need to do is sign up to start a program, we sign up and decide that we are going to talk to somebody, that we are going to start a process. Anything that requires you to sign up for a year my question is what does that mean?  Are they saying that you will not have a solution in the next two months, are they saying that you will be healed in a year, it actually doesn’t make any sense to me to have a time limit on it so don’t do it as its absolutely not necessary no.

 

[Matt]  Often, people look to alternatives to medication because they are concerned about side effects.  Are there known side effects of your treatments that people should be concerned about or is it possibly only other benefits on top of the help with the erectile dysfunction that they were originally seeking help for?

 
[Fai]  I really do believe that when we look at something that is as primal and as necessary to our self-esteem, to our identity as our erectile functioning, then as we go through the process of facilitating change for them and healing for them that it would heal other elements of their life, their self-esteem, their identity. We want to give them resources and a new way of viewing themselves, we want to give them tools to either overcome moments in time where they get a bit anxious and are worried and they can use those resources and those tools and change their thinking their limiting belief that they may have developed and apply it to all facets of their life. In terms of will they have any negative response to it; the scenario is that, depending on how they present and what it is that they have shared with us we can’t always say that there will be a change in their erectile functioning based on what they have shared with us.  For example if they have had a radical prostatectomy and if there has been nerve damage, I’m not able to tell this individual that I am going to shift their capacity to have an erection. What I can do is educate and share with them how to oxygenate the penis post operation to maximise the potential of getting their erection back but also we can look at, how else can they interact with their partner, how else can they facilitate pleasure and intimacy and connectedness. We view sex very much as being penis into body, whereas if that part of our anatomy doesn’t function as well as we want it to we start withdrawing from our partner, and then potentially our libido can go down and how we view ourselves shifts and what we want to do is we want to give them that back. We want them to reconnect and we want them to feel as awesome as they can based on the truth and reality of their situation and to me that can be life altering so that is a gift.

 
[Matt]  What is the success rate of your treatment?

 
[Fai]  I believe that if somebody has come to you and they have said this has always been a problem for me.  I remember being 15, I remember being 19, I remember being 22 and this was their concern and it’s the concern when they are alone during masturbation and with a partner then to me that is harder to treat.  Unless there was a reason that something happened during early childhood or if that’s just how their body responds we can often find ourselves not able to shift them as much as they would like.  In those cases potentially we may look at medication or injection therapy. In regards to somebody where it has been situational or it has come up in a circumstance it has come up because they were stressed at work or stressed in the relationship, when something of that nature creeps up on someone later in life then the potential for change and coming back to where they were, I won’t give it a number but it is very high. They are two very different groups and the one group is much easier to facilitate shift and change.

 
[Matt]  Are your treatments considered to be a relatively new solution to the problem or is there a long history of evidence to support your treatments?

 
[Fai]  I believe that it’s not necessarily a new treatment as such.  I believe that to help an individual, we need to find a holistic way of helping them.  So we use other methods for someone like me, I would use NLP neuro-linguistic programming, ways of helping an individual, use timelines, you can use hypnosis, so within the process of having a conversation we would use methods that do have a long history and statistical data that indicates that there is evidence of shift and change in those therapeutic models. And we take elements from all of these therapeutic models and we use them within an individual within our sessions.  So when something comes up and you feel that they may need to release some hurts from the past that they need to view the situation in a different way that their belief system, their values, their history, all of those things are impacting on them right now we would want to shift that using the methods and to me those are not new but because they are not new, we know that they can work.

 
[Matt]  Obviously every case is different, but is it possible to overcome Erectile Dysfunction quickly or is it always a slow and expensive process?


[Fai]  It can be very quick; the person can walk out of a session with a new belief, a new understanding. If for example, a situation happened and after that their functioning changed, in that session they can see why their body maybe chose to protect them and why they no longer need to hold onto that. They can absolutely make a change in how they feel about themselves, at the time right while they are sitting with you.  There’s no reason why that can’t happen absolutely.

 
[Matt]  The conversation we are having then is very valuable information to someone that is just new to this, because there is obviously a big fear that oh my god, am I going to have this forever?... So I am sure men will be very glad to hear that it is possible to overcome this quickly.


Does Erectile Dysfunction begin to have effects on sufferers in other areas of their health and lifestyles? Can your physical health deteriorate from this?

[Fai] Whenever we experience something that brings us down, that creates stress or distress I do believe that that can have an effect on the body and your body can respond to it.  People can find themselves feeling helpless and hopeless and leading more into a flat depressive type state. I do believe that the body can suffer when you’ve got these problems. If we look at it from a different angle what we need to see more of are GP’s asking individuals about their erectile functioning when they come in to have a conversation with the GP. We are very happy to discuss poo’s and stools but your erectile functioning, and we are not talking about a scenario where you have had a number of months off stress or something is happening but if you have found that you are not able to get an erection, or get a hard, solid erection the way that you used to then we really need to start looking at your cardiovascular health because it can be an indicator that there might be a concern there and your body might be letting you know that you may have diabetes or you might be having problems with your blood sugar.  Your erectile functioning can actually tell you a lot about your physical health and so I think it works in both ways in truth.

 
[Matt]  How much of this problem can be psychological, and what implications does this have on the necessity of medication?


[Fai] In many cases it’s not necessary to take medication we certainly wouldn’t be looking at it as something that we need to use immediately. The pharmaceutical companies have got funds and the funds allow them to market and the funds allow them to come up very high in searches (Google etc.) at the end of the day. Individuals and individual services would find themselves coming in behind those sorts of marketing opportunities and people do want a quick fix. People don’t want to see themselves as having a problem; they don’t want to see themselves as having to go through a process of change. One of the things that I find people coming in for, one of the scenarios is that they come in seeking information but they’re not necessarily that willing to participate in a process that will allow them to heal and to change and for this to become the new person that they are. If you don’t tell them that yes this will change overnight they can feel that you haven’t treated them or you haven’t helped them. But we can only be honest with what they present with, and they do want a quick fix and that’s just how it is.

 
[Matt]  In your opinion, what is the best way for men with Erectile Dysfunction to overcome their fears and embarrassment of involving their partner in this, especially if they are entering a new relationship because at some point the issue will have to be raised?


[Fai] I think if they are already in a relationship their erectile functioning is probably known to their partner.  One of the things that happens if they struggle a little bit with their erectile functioning or not being able to maintain their erection for very long one of the things they end up doing is maybe trying to have sex much faster than they normally would and that can now lead to premature ejaculation, then we’re looking at a very different issue. At the end of the day, those experiences are had with their partner so if they have a relationship that is going well where communication flows, I believe that talking to their partner about wanting to get help for this, wanting to have a conversation about this will be positively received by their partner because they want their husband or boyfriend to feel better about themselves. When it comes to being concerned about this and looking towards a new relationship that does make it a little trickier, but I also tell people that if they have the belief that things will be okay and that they are overcoming their concern then their belief will be the reality of their situation.  And if they find themselves with a new person who is not nice about it, who makes them feel bad about it, to me this indicates more about the person that they have met, about who they are going to be as a partner and potentially looking at that response and questioning whether or not that is going to be the right person for them.  A lot of the time when you are the person with the issue, you take responsibility for the response that you are about to get when you are talking to somebody or when you are trying to attract somebody and I like to turn it around and go, what responsibility does that person have?  Who do they need to be to you for them to be good enough or for them to be the right person to start a relationship with? So it’s not easy but if you frame it in the right way, it becomes much easier to see it from different angles and to facilitate that conversation.
 

[Matt]  Have you dealt with any extreme cases and were they successfully overcome?


[Fai] Some of them have been and some of them haven’t. The ones that haven’t, most of the time they have stopped coming to therapy and I am unaware of what ended up happening with them. One of my extreme cases was premature ejaculation with about three or four strokes internally he would cum but he wouldn’t orgasm.  So we were trying to increase orgasmic sensation and we were trying to increase the amount of time that he went for. The interesting thing was that he had been married for a number of years, and it wasn’t until that particular year where his wife turns to him and said do you even enjoy sex? And he finally confessed. My scenario in that situation was that he stopped his treatment and we were unable to look at increasing his pleasure and increasing his presence and so from my perspective sometimes unsuccessful equals just not turning up.  I no longer see cases as being extreme, because there are just so many of them. Some of the cases are a guy is with a girl and they discuss whether or not they are going to use condoms or not and one day he chooses not to, he enters her, they are going and she yells out something like, don’t cum in me I’m not on the pill and he just freezes.  Then for the next two or three days he cannot ejaculate, he starts feeling pain he struggles so for the next few times he’s with her he just can’t ejaculate, he cannot bring himself to that point. To me those are extreme cases because they need to be dealt with then and there, because if the person can’t ejaculate and they’re feeling pain that’s where I feel the word extreme comes.  Then we do need to look at what we can do to relieve that, why their body responded to it, what do they need to do to change it and that usually can be shifted in the next few days. Other issues can stem from Porn Addiction, but that's a whole other conversation.

 
[Matt]  For the guys out there that are feeling like they are alone, that is obviously not the case, this must be more common than people are lead to believe – is that correct?


[Fai] Absolutely, we couldn’t even put a finger on how many.  There are just so many men walking around with these concerns unnecessarily, if this is causing you any emotional problems or any problem whatsoever, there is no reason why they can’t have a conversation with somebody about it. They don’t need to wait, when it comes to somebody like me who calls themselves a sex therapist, this is what I do, you don’t need to be embarrassed when you walk through the door I am waiting for you to discuss your sexual concern.  We don’t have 10 sessions before we bring it up, it gets raised in the first 3 minutes, and that’s what I am there for. We need to lose embarrassment, and we need to go, this is a part of your body that isn’t functioning to its capacity. If it was any other part of their body, they would be at the GP immediately. And so that’s the comfort to which they need to view this, many many men are struggling and many men have struggled for years and years and cannot believe that they didn’t come to see somebody sooner.

 
[Matt]  If you knew that the information you have shared with me today was the first point of contact with someone who had just started researching a solution to their Erectile Dysfunction, what would you advise that they do from here?


[Fai] I think that they need to acknowledge that there is lots and lots of information on the web, that they may not know the source from where that information is coming from.  They need to seek out specialists in the field and they need to have an initial conversation because that conversation will allow us as the therapist to understand their situation exactly, based on their path and based on their current experiences.  What has worked for them, what hasn’t worked for them, why, what are the hurdles, what are the obstacles do they need to overcome what are the barriers.  This is their whole body, we need to look at how this has affected them in other ways and we need to work on all of those areas so that change can shift, but to answer your question I think that they have to talk to a specialist.  They need to make that appointment because otherwise they are looking at a generalised answer that may or may not apply to them.

 
[Matt]  I have no doubt that there are men who are going to want to know more, so what is the best way for them to get in contact with you?


[Fai] The website is www.sexualfocus.com.au, I offer Skype, phone, and face to face counselling.  I do have overseas clients, I have clients around Australia, I do have clients in Europe and in the US, I have learnt to stay up and have those conversations with people so time zones, locations, should never be a barrier to seeking out the best information that you can get so for me it would be about looking up the website and filling out the contact form and getting the process started.

 
[Matt]  Thank you so much for your time Fai and for offering us a solution.

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