TR: Do you see many men with this condition?
Dr.Snyder: People with BDD tend to avoid mental health specialists. Which is not surprising, since part of the psychology of BDD is the conviction that one has an actual physical problem. It's much more likely I think that a man with penile BDD will purchase penis enlargement equipment or consult a surgeon than consult someone like me.
TR: Why would a man have "penile dysmorphic disorder," even when he doesn't actually have a small penis?
Dr.Snyder: Good question. The answer, as one of my urology colleagues puts it, has more to do with the "big
brain" in a man's head than with the "little brain" between his legs. There is an extraordinary diversity of human minds.
TR: What kind of a man would be prone to penile BDD?
Dr.Snyder: Some people seem to have an innate tendency for obsessive thinking. Why some of these people develop BDD, and others
OCD or
Anorexia Nervosa is unknown. Many of these obsessive thinkers also have behaviors (such as compulsions and avoidance behaviors) intended to reduce the distress associated with obsessive thinking. Unfortunately, over time these behaviors seem to make obsessive thinking worse.
TR: For example?
Dr.Snyder: A man who begins to obsess about the size of his penis may begin to compulsively and repeatedly measure his erections, and to avoid
dating because he's convinced he'll be humiliated. Then the whole thing can spiral out of control, until ultimately he's online studying penis enlargement techniques.
TR: The penis itself doesn't tolerate all this obsessive self-scrutiny very well, right?
Dr.Snyder: The more obsessively a man worries about his penis, the more likely he'll develop a sexual dysfunction. If a man finds himself obsessing about his penis or any aspect of his sexual function, he should get help before he causes himself psychological or physical harm.
TR: How do partners react when a man gets obsessed about the size of his penis?
Dr.Snyder: When a married man comes to see me worried about his penis or his erections, I usually ask to see his wife too. Often her chief concern is that he's so obsessively preoccupied with his problem that he's become a stranger to her in bed. Women experience such preoccupation as selfish - which in a way it is.
TR: What practical advice would you give to a man who's gotten obsessed about the size of his penis?
Dr.Snyder: Step back and notice your compulsion and avoidance behaviors. Notice how often you compulsively
masturbate in order to reassure yourself you're OK. Or compulsively measure your erection. Or compulsively surf the net for penis enlargement advice. Or avoid dating because of
fear of
humiliation. See if you can drastically reduce compulsive and avoidance behaviors.
TR: And if a man can't manage to do this?
Dr.Snyder: Get professional help. Be forewarned, though. Most mental health professionals don't know much about sexual issues. To find one who does, go online to
www.sstarnet.org or
www.aasect.org. Or if you're in New York, contact me -
www.sexualityresource.com/contact.
