By its emphasis on a parental and environmental understanding of sexuality, psychological theory and practice inadvertantly reinforce the feelings of shame and social non-acceptance even rejection for the sufferer of foreskin conditions.

The science of psychology shoulders great responsibility in the understanding of sexuality and shows great compassion for men`s doubts and worries about their sexual and self images, their castration fears etc., However the actual reality of a non-functional erection and its influences are ignored.

The accepted cliché - that one`s equipment is always "normal" or that the man`s penis size shape or any other difference is irrelevant to his being a man - has significant consequences for individuals with anatomical problems. As every youth understands that penis size and bends etc. should not affect his sexuality, the isolated individual with actual (or imagined) physical problems is under immense social pressure to forget or repress these embarrassing socially unacceptable and even laughable ideas; instead of being able to freely discuss the subject andreceive some specific treatment (or be reassured). His guilt and shame magnify and compound his situation.

Against the background of his many years training, the psychologist at present when confronted with "foreskin problems" will deduce that a psychological disturbance must lie at root, thus causing the anatomical condition to become a problem in the first place. It is necessary to correct this situation.

In contrast to worries about penis size and shape, foreskin conditions are actually and manifestly painful or difficult during sexual activity and this has a significant effect on the sexual possibilities and behavioural development.

Against a background of repressed or accomodated anatomical genital pain or difficulty there will be inevitable psychological repercussions - it would be rather remarkable if this were not the case. And as the painful erection is only one factor supporting and combined with all the other factors in a personality, the consequent behavioural and psychological patterns will inevitably be related to childhood problems. But among these childhood problems it is important to recognise that the anatomical predisposition to pain or difficulty was often present since birth and the influence of an uncomfortable and avoided erection is a fundamental influence in the psycho-sexual development of an individual.

This overlooked phenomenon could excite considerable interest among psychologists.

Therapists should be aware that even if environmental problems appear to predominate, a short conversation to confirm the patient is aware of foreskin retraction will eliminate the possibility of this extra hidden complication.

WABREK - The Therapists Responsibility
Students of sexual psychology are sometimes taught that if a man reports pain during sex then they should send him to a Urologist (93), Wabrek made this mistake before concluding: "During the physical examination, most males don't get an erection, so it is difficult to find out if the foreskin will retract over the erect glans; therefore, this must be elicitated by history."

Wabrek points out the responsibility of the sexual therapist to discuss this uncomfortable subject with the patient and not simply send the patient away to the Urologist. Diagnosis is sometimes only possible during erection OR through dialogue.

Urologists do not give an erection stimulant and then test the free movement of the foreskin - (at speed!) - Urologists diagnose foreskin conditions in the flaccid state. They receive no training on the point which Wabrek establishes "The teaching point is that just because the foreskin slides over the flaccid penis does not mean it is going to slide over the erect penis."

How To Ask
To ascertain if a foreskin condition could be causing problems the therapist may first tentatively ask if the patient is circumcised - this may eliminate the need for further questions or pave the way for more detailed questioning: To ask if retraction take place automatically during erection may be a tactful and informative step; however after this it will be necessary to use the simplest and most accurate method of enquiring directly - if it is enjoyable to move the foreskin, alternately covering and uncovering the glans.

It is not enough to ask if the glans shows during masturbation, men who expose only the tip of the glans will often believe that this is sufficient, others will habitually hold the foreskin retracted to avoid the ring scraping over the glans. If there is a foreskin then this must be able to move freely not being held forward or backward in any way.

To ascertain the exact nature of the problem, a brief discussion about the sexual effects gives a far more accurate diagnosis than flaccid examination.

Please read: Adult Info.

See also The Psychologists Collective Repression