Ed when not having fantasies

Hi
I am a carer, i have several chronic illnesses which could prevent erectile function and suffer from fatigue.I am also in my late 50's, taking 10mg of tadalafil daily, I always liked sex and needed sex a stress relief, but now I can not get an erection unless I have sexual fantasies about my wife having sex with another man.We used to be swingers and sleep with other people, but I always liked seeing my wife with another man having sex. She now has physical and mental health problems due to a trauma we suffered in 2012 and swinging is out of the question now.
But I need sex and she is happy to have sex, but I need a solution to my problem, as just thoughts do not always work, but it is all that helps or talk sexy which my wife is not willing to do. Counselling only would work if it is free and online as i live in extremely rural Scotland.
Thanks

Do your medical conditions preclude the use of a little chemical help like those little blue pills, for example.

It's rough to fall into the trap of needing certain thoughts or stimulation, or letting anxiety about the whole issue getting away with a person and making it worse. I blame some of my performance anxiety on things like that, in my case I'm bisexual so I let it get in my head that what I have isn't going to arouse me and of course that becomes self-fulfilling. It's hard to get out of your head to enjoy what is happening, sometimes. I have wondered before if ED pills would help with that kind of thing or not, just a little extra push, so to speak. That's something I'd talk to my doctor about, if I were in your situation and wanted to continue a sex life with my wife.

Hi
I am taking the equivalent of the blue pill,10mg of tadalafil=Cialis.

Well at least there's that. As for the rest of it, I really can't say. It's easy to let things get inside our heads and I myself have had hard times trying to get out of my head. But then, I tend to overthink things like this.