Peter Minich, MD, Ph.D., MAPP, is a surgeon, author, educator, and physician coach. He has co-published Sick Patients Sicker System, How Clinician Leaders Become System Healers with Terrence Deal. Visit www.clinicianleader.com.  Peter’s bio.   Peter writes on the 20th of each quarter, and his past articles are here.

Many of those familiar with the treatment of disease and the world of positive psychology can readily appreciate some of the potential applications. Research continues to legitimize the notion that mind and body are connected. It is easy to speculate how positive interventions might augment traditional therapeutics.  But can positive psychology alone be effective in treating severe maladies such as organ failure? 

That sounds a little far fetched, but consider sexual dysfunction, specifically erectile failure. The male sexual response is a product of penile blood vessels engorging. Diseases that affect the vessels such as diabetes can interfere with this process leading to erectile failure. Drugs such as Viagra target these vessels, helping them dilate. This is classic medicine- define the physical basis of a problem and treat it.

As an urologist, I have treated sexual disorders in this fashion for over a decade. During that time, I have come to appreciate that this is a narrow approach, with limited success. Sexual response- the part that occurs well before penile blood vessels engorge- originates in the neocortical and limbic areas of the brain.  Anxiety, stress, fear, and many other phenomena interfere with sexual response by triggering the release of catecholamines- powerful chemicals that cause blood vessels to constrict. One can see how this might compound the effect of diseases such as diabetes that narrow vessels. This becomes obvious when I see two men with the same amount of penile vascular disease but vastly different erectile function. The difference is the psychological state of the patient.

I believe that that there is a significant potential role for positive psychology in the area of fostering intimacy and ultimately improving sexual health. In my own practice at Cleveland Clinic Canada, we have developed a comprehensive program that integrates both physical and psychological considerations over a 12-week period. Such an integrative approach has proven highly successful in this complex area.

Peter Minich, MD PhD MAPP
Co Director, Urology & Men’s Health
Cleveland Clinic Canada