PSYCHOLOGICAL ASPECTS

When a patient decides to obtain infromation about penile enlargement, many psychological aspects have to be taken into consideration: reasons for their request, motivating factors, and expectations are of extreme importance for the management of each case.


PSYCHOLOGICAL ASPECTS

In each treatment, psycological factors play an important role during the consultation, treatment development and evaluation, and post treatment evaluation.


THE PHYSICIAN:
The expectations of the patient seeking information on penile enlargement should be determined. The patient is expecting to find a doctor who can explain the process in full detail in a professional and confidential fashion.


THE PATIENT:
By listening to the patient carefully, the physician can appreciate his goals and expectations. One should not generalize with different patients, since there are different reasons and personality traits involved in the patient's objectives for using the Andro-Penis. One would want to carefully evaluate those personality traits which involve insecurity, role improvement, and relationship improvement.

As long as we identify the patients objectives and remind him of his goals, the physician will help mantain the patient's interest, achieving more effective compliance during the treatment period.


PATIENT CLASSIFICATION ACCORDING TO MOTIVATING FACTORS:

TYPE I:
Spoken Objectives: Dimension.
Latent objectives: To obtain better security in sexual relationships, to achieve increased desirablility, to avoid rejection and solitude, to be part of the winners circle, and to improve pleasure given to their sexual partner.

A prototype patient is a 40 years old individual that for the first time in his life presents with erectile dysfunction, one who perceives decreased length of his penis or with diminished virility. In this case, by explaining that tissue growth and neo-vascularization caused by the treatment improves not only the quality of erections but also the length of the penis and a sense of virility, the patient's objective(s) will be achieved.

Important emotional changes which effect the patient are readily observable. Sometimes, however, there may be a change in the partner's attitude, which may present a entirely new set of issues for the patient. Attempts to help the patient identify these can be helpful, especially if rejection is an issue.This patient is likely to avoid intimacy , and has an absence of emotional or sexual relationships. They may constantly seek superficial interactions, in some degree, to compensate for personal frustrations which may have originated in their youth (L. Festiger 1975)

We need to transmit confidence to the patient, with the reassurance that his penis will grow and that the quality of his erection will also improve. When they perceive a penis of a larger dimension, the patient's self esteem should also improve. The patient will think of himself as a better lover and feel more proud of his sexual attributes. As a response to the phalic falacy, he will likely see an increased sexual desire in his partner, which can enhance foreplay and improve positive expectations from intercourse.

All this information will be received by the patient in the way of Feed Back . Increased confidence and self esteem will make his sexual approach calm and relaxed, thus automatically helping to activate the parasympatic nervous system - a key factor in erection.
These achievements by the patient, over time, will improve his confidence in the emotional and sexual aspects of his relationships As a consequence, he will see improvement in other aspects of his life such as social skills, goal achievement, work, etc.


TYPE II :
Primary Objective: Obtain a penis of normal or average dimensions.
Secondary Objective: Eliminate insecurity complexes, solitude and rejection.

We are talking about a patient with a smaller than average penis, or a small penis that creates an inferiority complex for the patient. Some of these individuals avoid situations in which their nudity will be exposed (dressing rooms, beaches, sexual encounters,etc.) They present obsessive thoughts about their nudity that are focused on the size of their penis. Such individuals, during their consultation, express their feelings of being observed and perhaps made fun of due to the small size of their penis.

This individual want to make sure that the growth will be both in erection ( to satisfy their own needs as well as those of their partners) and in flaccidity (since they feel observed and criticized by others).

At the begining, these patients are reluctant to expect results from the treatment. Due to their high personal motivation and after being provided with the proper scientific information, they usually decide to begin the treatment. They have the highest treatment compliance index and tend to use the device for more than 9 hours a day.

Even though they are very enthusiastic with the treatment, if they do not see results on a short term (1-2 months), they question the treatments efficacy. In such instances, it is recommended to instruct the patient that the first month is an adaptation period and to continue the treatment 11 hrs a day for the first month and a half to accelerate growth.

It is very important to support and to educate the patient during the first months of treatment to alleviate pessimistic feelings. They need to know that in this period there is an increase in penile girth and an improvement in erections. This should be proof that the treatment is working as expected.

During treatment, these individuals require a parental-like guidance and a continued support from the physician.

At the complition of the treatment, patients usually express feelings of satisfaction and an improvement in their quality of life, not just on their sexual one.


TYPE III:
Primary Objective: Obtain a penis of large dimensions
Secondary objective: They usually posses narcissistic traits with the goals being to elicit sexual desire from their partners and admiration by others. They believe that with a larger penis, they will belong to an elite group, that of the winners.

Some of the patients, have difficulty in establishing significant personal relationships and base their communication on sexual assets, those that make them feel comfortable and more secure.

We are discussing a very heterogenous group, so will we analyze the different attitudes and motivations of the members in 4 categories.

A.- Male in a stable relationship: those who want to obtain a larger penis to improve on his relationship and to introduce new forms of play that will gratify both individuals. They seek a change in their routine. They tend to have financial means to seek treatment.

B.- Male without a stable relationship: those who have multiple sexual partners. They find gratification in such relationships. They are very proud of his physique, of their appearance, and of their large penis .( "Teoría Psicoanalítica de las neurosis", Fenichel, O - 1987) .

C.- Sportsman: those who invest a lot of time and money in their physique and traits and who are narcissistic. They frequent places where they can exhibit themselves (Nudist beaches, swimming pools, dressing rooms, etc....) since they feel very comfortable and know how to elicit admiration by others. These patients are very hedonistic; if they feel discomfort during the treatment, they will usually stop.

D.- Homosexual or Gay: these men often place a lot of importance on their penis size. There is generally less of a need to be convinced about the efficacy of the treatment, but when these patients obtain 1 or 2 cm of growth , they often abandon the program prematurely. Compliance is encouraged.