Do drugs produce impotence?
Anti anxiety drugs like librium, valium and mepfobamate taken for a prolonged period depress sexuality and occasionally cause disturbance of orgasm.
Phenothiazines like largactil, eskazine frequently cause dry ejaculation due to non closure of internal vesical sphincter just prior to ejaculation resulting in discharge in urinary bladder. Oestrogen and cortisone produce impotence and lack of desire.

Can vasectomy operation lead to impotencv?

No. Such operation has no side effects, in fact many people report that after operation they have devloped erection. Erection depends on testosterone, a male hormone which is released into the blood stream. Testes also contribute very small quality of the ejaculated fluid so quantity will also not diminish substantially. Actually neurotic, psychotic or impotent male should not under go sterilisation.
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There are two basic kinds of narcissistic relationships. One, designated a twinship transference by Heinz Kohut, a psychoanalytic specialist in narcissistic disorders, is an alliance of two grandiose individuals who mutually support each other’s proud and inflated self-perceptions while remaining blind to each other’s delusions. They typically view themselves as a pair of pearls among swine—or (perhaps a bit more graciously) among synthetic pearls. The other kind of narcissistic relationship is called an idealizing transference. Here, a narcissist who feels inferior and needs to idealize somebody attaches himself or herself to a narcissist who feels superior and needs to be idealized. The former hopes that, by coupling with the latter, some of the “superiority” of the idealized object will rub off. The latter hopes to bolster his or her esteem by being the object of idealization.

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“Sexual Battle,” as with all other games described so far, will be successful to the degree that a couple can play it with sincerity. This goes without saying about any endeavor—you cannot cook a good meal without sincerity. However, when one is dealing with sex, people’s resistances multiply, and there is a natural tendency to be critical and perhaps derisive. Depressed people may want to negate this game (and all other games in this book), finding them silly or too complicated or too simple. I have found that I have had to give my own clients lengthy pep talks to properly orient them to the games. Because these are not miracle-workers, but only devices to help couples get closer, they are only as effective as the couples who play them allow them to be.

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Aim: Jolt each other out of their passive and aggressive defensive postures by mimicking each another.

Game Plan: Husband and wife lie virtually naked in bed. The husband wears an article of the wife’s clothing—could be a hat, a blouse, panties, or shoes. The wife wears an article of the husband’s clothing—hat, pipe, jockey shorts, T-shirt. They play out their continuing sexual conflict, but each impersonates the other, deliberately aping and exaggerating the other’s behavior.

If the couple were my aggressive female patient and passive husband, about whom I wrote in the beginning of this chapter, the wife might sit up in bed with her eyes closed and pretend to meditate. The husband might hit her (lightly) with his fists and complain that she is such a nerd. The dialogue might go something like this:

“Can’t you see I’m meditating?” (Wife impersonating the husband.)

“Oh, you’re such a nerd.” (Husband impersonating the wife.)

“Leave me alone. I’m meditating.”

“I don’t know why I married such a nerd. Why couldn’t I have married a real man?”

“Quiet! I’m trying to achieve cosmic consciousness! Stop trying to do dirty, earthly things to my body while I’m looking at universal harmony.”

“When I think about the kind of man I always dreamed of marrying and the one I ended up with, I want to puke!”

“Oh, God, save me from this witch!”

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“Shhhhh!” He holds a finger to his lips. “Sit down.” She sits. “Good,” he says. He then places an imitation (but attractive) crown on her head. “I hereby crown you queen for a night.”

“This is silly,” she may say; or, “I’m too tired for games”; or, “What are you up to?”

“Shhhhh!” Would my lady care for a glass of champagne now, or after her bath?”

“My bath?”

“Yes, your bath.”

If she is a difficult case, she will attempt to get out of this in some way: “This is all very nice, but I’m not in the mood,” or, “You look silly in that tuxedo.” She may even become obnoxious and insulting. The husband must persevere and not take anything she says personally. And he may cleverly (for once) use his knowledge of her to persuade her.

“Here—let me massage your temples,” he may say (or, “Let me massage your shoulders”). He can try a trade-off: “Humor me tonight and I’ll do something for you some other night.” If all else fails, he can explain that he is playing a therapeutic game recommended by a psychotherapist, and that if she wants to improve their marriage it would be beneficial for her to play along—at least for one night. Eventually, if the husband perseveres, he will wear down her stubbornness, and she will give in. Then he can proceed.

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Indeed, sex therapists across the country report that the most common complaint among couples today is lack of interest. Many men and women are having shallow, infrequent, or no sex whatsoever, simply because they do not care to. They truly live lives of quiet desperation, and often their underlying mood is apathy. Because of the hazards of sex and their own internal resistances to it, they have given up on it. Their sexuality remains only in the fantasy sphere.

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