Sex Therapy for Performance Anxiety
Things I hear my clients say…..
"I get so anxious around sex that I can't get / keep an erection and I have no idea why"
"I've tried everything - I've done a ton of online research, my testosterone levels are normal, I've talked to a urologist, I'm taking Viagra or Cialis. Nothing seems to work!"
"I dread sex now and even avoid it entirely - I just don't want to fail again"
"This issue is causing huge issues in my relationship / dating life"
*These are generalized statements and not direct quotes from any clients.
The number one issue I hear from my clients is that they find themselves getting so in their heads with anxious thoughts during sex that they become dissociated: completely removed from the experience and unable to achieve an erection, orgasm or ejaculation when they want.
These thoughts are different for everyone, but here are some of the most common ones I hear:
“Stay hard, stay hard, STAY HARD!”
“What’s my penis doing? Does it feel hard still? Will it stay hard? What if it doesn’t stay hard? What if I never get hard again? Will my partner leave me?”
“Ok, this is the moment. Don’t screw it up this time!”
“No turning back now…you’ve initiated sex and now you are officially obligated to get an erection!”
“If I get into my head, the whole experience will be ruined.”
“Why am I thinking like this? Why can’t I just enjoy the moment? What’s wrong with me?”
The irony is that, when we try to control for erections and orgasms in ourselves and in our partners, we tend to become disconnected from the very things that fuel our arousal and we unwittingly sabotage our own experience.
In addition to that, by trying to force our bodies to do things that are outside of our control, we often put ourselves into a state of activation (or fight or flight) which cause physiological changes in the body that make arousal very difficult. Erections are often the first thing to go!
Sex therapy can give you the tools to heighten your sexual pleasure and arousal while teaching you to quiet and soothe the anxiety that is pulling you out of the moment. It can also help you hone your communication skills and deepen your relationships so that your partners can improve their pleasure alongside you.
I've worked with countless folks to overcome their performance anxiety where testosterone treatments, PDE-5 inhibitors (such as Viagra or Cialis), shockwave therapy and many other quick fixes have failed.
If you're ready to try the psychological approach, I invite you to book a free consultation with me today.
Frequently asked questions.
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Absolutely - in short, anxiety has a tendency to take us out of the moment and into a state of monitoring and dissociation. When we get too in our heads or distracted by our fears, we lose access to the sensations that feed arousal.
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It's always a great idea to talk to your doctor or urologist in conjunction with sex therapy. They can help you address any organic issues that might be contributing to erectile function, including cardiovascular issues or testosterone levels. A good rule of thumb is if you find yourself able to masturbate with little to no issue, it's probably a psychological issue, in which case therapy is the place to start.
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A good sex therapist will leave no stone unturned - it's important to get a full sexual history to understand the beliefs, experiences and values that shape who you are as a sexual being so we can understand what kinds of unrealistic expectations, shameful messages, or relationship dynamics might be getting in the way of you having the sex you want. From there, we help you write a new script for what healthy sexual pleasure can look like for you and give you the tools to manage your anxiety in the moment.
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Yes, porn can be a contributor to erectile dysfunction, but it's never as simple as just cutting it out completely (which is what most people try first). In fact, abstaining completely can make it even harder to connect sexually with partners! This is why it's so important to get a full picture of your sexual history to better understand the complex web of factors that shape your sexual scripts. This allows us to identify opportunities for revision and expansion of those sexual scripts so you're not having to contort yourself to try to have an experience that might not be accessible or fun.