Factors in Male Sexual Inadequacy

1) A representative selection of the enormous literature on factors generally held to be causally important in male potency disorders is reviewed. Although some degree of overlap may exist, for simplicity, the subject is considered under the three main “etiologically presumed” subgroups: “organic,” “constitutional,” and “psychogenic.” The pathognomonic features of each are briefly outlined. 2) Since most authorities state that “psychogenic factors” are dominant in male potency disorders, the review concentrates on a sample of this literature; contributions from a) psychoanalytical, psychoanalytically-oriented, b) eclecticist, and c) behaviorist sources are evaluated. The most frequently asserted “psychogenic causes” of male potency disorders encountered are a) anxiety or fear, b) hostility and resentment, c) disgust, d) inversion of the sex drive, e) inhibition, f) personality factors, g) ignorance and misinformation, and h) the functional psychoses. It is concluded that, with the possible exceptions of the functional psychoses and inverted sex drive, where there is a strong clinical likelihood, if not as yet a proven statistical association, no definite statement regarding the etiological importance of the other “psychogenic factors” can be made using the presently available material. In most cases, etiological generalizations have been made on inadequate nonspecific data, often derived from single or a few case studies. Another serious criticism relates to interpretation of observations; for example, that anxiety, hostility, disgust, and other such factors or a functional psychosis might coexist with a potency disorder is incontestable, but to assume causality may only rarely be admissible; more often these may be its consequence or a mere coincidence. 3) Some suggestions for improving the methodology of psychological research on etiological factors in male potency disorders are offered and may include a) greater empiricism, b) more stringent criteria for inclusion in any study which should be explicit, prospective, controlled, modest, and replicable by others, c) the use of standard objective validated measuring instruments, and d) the application of appropriate statistical methods. 4) Despite the consensus view widely expressed in the literature that potency disorders are psychosomatie, few, if any, workers have attempted specifically to measure simultaneously and to correlate physiological and psychological responses in these or related conditions. 5) It is suggested that, in the future, a multidisciplinary and simultaneous approach, involving psychiatric, psychological, and physiological parameters will provide better and more valid methods of studying the etiological interrelationships between various “psychological factors” and disordered potency.