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Understanding Performance Anxiety

by Stanley Ducharme, Ph.D.

Millions of men, regardless of age, relationship or orientation suffer from sexual performance anxiety. This condition in sexual situations occurs when a man anticipates some form of problem occurring during the sexual act. As a result of this anticipation, the man becomes anxious or panicked while attempting to be sexually active. This translates into problems with erections, premature and delayed ejaculation or a lack of desire to have sex.

Although performance anxiety can also occur with women, it is less understood and less common. Often it is called anorgasmia or the inability to have an orgasm. Sometimes, it is called vaginismus or the inability to relax the muscles of the vagina.

In this short paper however, our primary focus is on male performance anxiety since the term usually refers to a manís anxiety about his sexual performance. This anxiety can be deep routed. Many sex therapists believe that a manís anxiety about sex is related to his underlying fears and insecurities. Frequently, many of these feelings have never been verbalized.

Anxiety about sex can take many forms. Some men have fears about being rejected, disappointing a partner or becoming embarrassed about the quality of an erection. Other men have fears regarding their reputation or anxieties related to their masculinity or sexual orientation. In this area, feeling inadequate can be especially painful. Performance anxiety hits a man in his most vulnerable and insecure areas. Itís different for each man.

Medications such as Viagra, Cialis or LaVitra are very effective for many men. Often, they are extremely helpful in restoring a manís confidence as well. They allow him to worry less about his erections and to focus on other areas of the sexual act. Sometimes however, even these medications donít completely remove the anxiety and a manís fears regarding his performance. These anxieties can be deeply rooted.

Having anxiety about sex is a difficult situation to reverse. Unfortunately, it is very common and can happen to anyone at any age and at any time. Sexual performance anxiety can start from a very brief simple event even in very stable, emotionally healthy individuals. Sometimes even a single time in which the man loses an erection can be enough to raise doubts and cause anxiety the next time. Although this happens to every man at certain occasions, it can begin a downward spiral causing problems of confidence in and out of the bedroom. The more frantic you become the worse the problem will become. This can be a very slippery slope!

Anxiety is intended by Nature to be a warning system of a threat or danger. In such cases, your brain becomes alert, your muscles tense for running or battle and other parts of your body, such as digestion, shut down while you are in stand-by mode. In the sexual situation, if our warning system tells us that there may be a problem then we are more likely to have a problem. The warning system causes the problem. This is a self fulfilling fear.

So, if a manís brain warns him that there may be a problem during sex, there will be a problem because of the warning. A manís warning system releases chemicals that interfere with his sexual performance. We were not made to be anxious and have sex at the same time.

Sex therapists use a technique called sensate focus to help men with performance anxiety. This technique encourages a couple to remove all stress from the sexual act. Sensate focus was first used by Masters and Johnson and aims to get a man to stop thinking about erections and his performance. Instead, the goal of sensate focus exercises is to get the man to focus on the feelings and sensations of sexual arousal. Rather than thinking about performance, the goal is to experience each touch, sensation, smell, movement, sound and taste of the sexual act.

Men who are experiencing performance anxiety tend to perceive sex as an ďobligationĒ or a ďjobĒ that needs to be accomplished. Performance anxiety diminishes sexual drive. As a result, men with performance anxiety often avoid sexual activity. For these men, sex is no longer fun and enjoyable because they have lost sight of the pleasures involved in sexual contact. Performance anxiety causes the man to focus on the mechanics of sex rather than the pleasure, sensations and excitement. They are thinking about sex rather than enjoying it. Sex is best when you can shut the mind off and stop thinking.

To accomplish this goal of getting a man to enjoy sex again, sex therapists try to take all the expectations and pressure away. They instruct the couple not to have intercourse and not to be concerned about the erection. This may be difficult and therapists realize that not everyone can ignore the erection and the goal of having intercourse. The idea is that if the couple can be together a number of times without the expectation and pressure of performing then the whole experience begins to take on a completely different flavor.

What is important during sex are the sensations that the couple experience; the ways they learn to pleasure each other; the sexual fantasies and the feelings of each becoming aroused. If a couple have difficulty not thinking about the mechanics of sex, the therapist might suggest that they keep their clothes on or wear their underwear for the first few times. Then, it really doesnít matter if the manís achieves an erection or not. Without the pressure, hopefully the man can begin to relax

When the couple feels relaxed in this situation, the next step might be for them to communicate, caress and touch without clothes. The focus however is always on the pleasure and the enjoyment. Without worry about the erection or his performance, sex for the man is not a job that needs to be done. It can be a positive and pleasurable experience.

When the manís performance becomes less important heís not going to be thinking so much about it. Heíll be experiencing other things like erotic sensations, sexual pleasure or the emotional closeness between the two people. Without the worries, most men will begin to actually enjoy the experience of sex which will result in arousal. This is an example of reverse psychology! The less you care about your arousal the better it will be.

In summary, many men with sexual difficulties tend to over-think about their performance rather than staying in the moment and enjoying the sexual sensations and feelings. In the instant that you began to think about performance or worrying about how you are doing, you become an observer rather than a participant. At that time, the bodyís warning system becomes activated and your sexual arousal becomes diminished.

Performance anxiety is a common situation for most men at different times in their life. Changing how a person thinks and learning to forget about the quality of the sexual act is certainly easier said than done. The key to overcoming this problem however is in being completely honest with yourself. This mean really convincing yourself deep down inside that it is ok if your erection and performance are not perfect.

If you can convince yourself that sexual performance and erections are not essential then there is a much better chance that your body will become sexually aroused. Great sex is about not thinking. It is about letting yourself go and sinking into the experience of physical and emotional intimacy.

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