Overcoming Performance Anxiety

Overcoming Performance Anxiety

Here's How To Overcome Performance Anxiety

One of the greatest sexual and emotional obstacles for men today is performance anxiety. Those who battle it on a regular basis know how crippling and debilitating worrying about it can be. The problem is in the term

 itself: "performance anxiety."

We have socialized ourselves to think of sex as an act, a performance, with an expected role we are supposed to conform to. Maybe our anxiety around sex comes from the expectations imposed on masculinity in our culture, from watching porn, from our depictions of how men act in the media, from fears or insecurities that fuel this need to perform. It could be because of our desire for partner or peer validation that we think we need to excel in something that every man is supposed to be a stud at doing.

How many times have you thought about your sexual performance? How long you lasted, how good or bad you were in bed, what your partner thought of the sex, a past sexual experience that didn’t go as planned? For many guys, these questions fill our minds and often stay with us. We begin to add pressure and weight on our shoulders that we carry into the bedroom. Why are we worrying about outcomes vs. enjoying the ride?

Men typically view sex as goal-oriented, performance-driven, orgasm-centric and erection focused. How un-sexy is that sentence? Imagine what sex would be like if we came from a place of pleasure, intimacy, sharing of sexual enjoyment, no judgment? Men set themselves up for performance anxiety by creating expectations that are often too difficult to achieve — expectations that don’t really even matter. Not only are these expectations hard to live up to, but they work against the very nature of what sex is: pleasure enjoyed by two people. If you see sex as a task or a job, you just may miss the important stuff beyond the physical and behavioral.  

According to Laumann et al. in 1999, about 30% of men experience premature ejaculation (PE), about 15% have a lack of interest in sex and about 8% of men experience delayed ejaculation (DE) and cannot reach orgasm during sex. These numbers represent clinical concerns. Most men don’t have clinically diagnosed sexual issues but will have occasional bouts with PE, DE or libido concerns throughout their lives.

In 2003, Kubin et al. found that about one-third of men experienced some type of erectile dysfunction (ED) at least once a year. They also found that psychological stress was at the top of the list for men as a predictor of ED. We also know that the older men get, the higher the rates of ED. Studies have found that by age 50, almost 60% of men experience ED, and by age 70, over 80% have experienced it.

1997, Elliot and Brantley asked college males if they’ve ever faked an orgasm. Seventeen percent of straight guys and 27% of gay and bi guys answered yes. Why would a guy fake an orgasm? Some reasons may be to avoid disappointing or hurting their partners’ feelings, communication difficulties, to get sex over with or because the performance anxiety is so intense that orgasm or ejaculation is not likely.

Why am I bringing up male sexual concerns in a performance-anxiety article? Regardless of whether the sexual concerns come before or as a result of performance anxiety, the important part to recognize is they often go hand in hand. Let’s face reality: Sexual concerns and performance anxiety are common, and it’s going to happen to every guy to varying degrees. We need to accept it as a part of male sexuality without letting this get under our skin. We need to understand that it’s human nature. We need to start talking about it. To make sexual concerns and performance anxiety secretive, or to internalize and repress them, only makes the issues worse. Until you overcome the fear of addressing your struggle honestly, there’s only so much you can do to overcome your anxiety.   

What Are You So Afraid of?

Here’s a newsflash: Men are human. We’re not infallible, we feel pain and we have feelings. We’re not made of muscle and we are not impenetrable fortresses of toughness. I don’t care how much you, your friends or society tries to BS each other into thinking this. We have more sides to our hearts and egos than meets the eye. After countless years as a sex therapist, I’ve learned that men experience all matter of body-image difficulties and anxieties about sex. So if this is going on with most of us, why are we so afraid to talk about it?  

Where Does Performance Anxiety Come From?

Anxiety was never meant to sneak its way into the bedroom and our sex lives. It had a more preventative function from an evolutionary psychology perspective. Our bodies use anxiety as a warning system for protection in response to danger, threats or hostile situations. Our bodies are telling us that we need to pay close attention to our surroundings and our well-being for survival. That works fine when we’re hunting or in battle, but during sexual interactions or as lovers in an aroused sexual state? We train ourselves to use anxiety as a protective process that alerts us to danger. Unfortunately, we reinforce this in the bedroom, too. Many cognitive theorists, researchers and brain experts believe we can strengthen the brain circuitry associated with anxiety based in part by repetitive patterns. That said, experts also believe we can rewire our brains and undo the intensity of these anxious responses. Basically, it’s possible for us to change how we respond to stressors.

For humans, anxiety and stress can create cortisol and adrenaline, which produces a feeling that simulates a heightened state of alert. It’s the opposite of feeling relaxed and calm in the moment and not ideal for sexual interactions. Many sexual concerns such as premature ejaculation, erectile concerns and delayed ejaculation are associated with high levels of stress and anxiety, which can inhibit blood flow, make erection more difficult, increase muscular and body tension, as well as desensitize the genitalia. Notice how the anxiety helps create more issues to worry about. We call these negative feedback loops.  

Negative feedback loops are negative cycles we reinforce by repeating the same patterns and experiences over and over. Men with performance anxiety often recreate negative sexual experiences in their minds before, during and after sex. It’s a sexual self-fulfilling prophecy that forces us to re-experience the trauma, pain, frustration, embarrassment, shame and guilt that we may have felt during an anxious sexual experience.

Often a cycle looks like this: A person has a sexual experience they perceive as bad, unsuccessful or a failure. They think about it, dwell on it, get down on themselves about it. They chip away at their sexual confidence, self-esteem and begin to believe the negative self-talk and thoughts they perceive about themselves (strengthening the neural pathways of sexual performance anxiety). They solidify our negative thoughts and feelings, and then become core beliefs. When the next sexual opportunity presents itself, anxiety is now the initial, reinforced response, and perceived failure is on the forefront of the mind. If we think it’s going to happen, it’s more likely to happen. When it does, a vicious cycle of sexual performance anxiety forms, loaded with insecurities, worries, PE, ED, DE and all the other mental and emotional baggage we choose to carry on our shoulders into the bedroom.

Cognitive distortions also add to our negative feedback loops and challenge our reality thinking. Catastrophizing is where we expect disaster and exaggerate, or shrink the importance of something. An example of exaggerating (magnification) can be losing an erection. We might make it out to be the end of the world, but realistically, is it? Another cognitive distortion is called jumping to conclusions, which often fuels mind-racing thoughts. If a person ejaculates quickly, he may assume or anticipate what his partner is thinking, feeling or experiencing. Polarized thinking is when a person thinks in extreme terms with no middle ground. Filtering is when we pick out a negative detail or insecurity, dwell on it and discount the positives or reality.   

What Can I Do About My Performance Anxiety?

There is a lot people can do to work toward managing their anxiety around sexual performance. Many may use techniques to help themselves, while others may benefit from seeing a GP, psychiatrist or sex therapist.

Here are 20 tips to help you work on your performance anxiety.

1. Erase life stressors that create anxiety. If you have stress all around you from work, family, relationships, etc., it’s bound to take a toll on your sexual functioning. Manage the anxiety around you.

2. Incorporate anxiety reducers in your life. Yoga, nature walks, workouts, hobbies. How many of you have seen a stressed-out Buddhist monk? Live a life that promotes mindfulness and calmness.

3. Breathing exercises can decrease anxiety, regulate heart rate, have positive effects on blood pressure, self-soothe and decrease muscle tension. They can be used outside and inside the bedroom.

4. Mindfulness techniques. The experience of attention to thoughts, emotions, physical sensations and surroundings during any given moment. Being present, learning to limit and manage intrusive thoughts that affect your concentration on pleasure, enhancement, sensation and breath. Not having judgment, creating a safe and secure environment that embraces being one with the moment and with your partner. Anxiety and stress are distracting, the arch nemesis of mindfulness. Learn to clear your mind using meditation, relaxation techniques or visualization exercises. Practice outside the bedroom for improved regulation affects regulation inside the bedroom.

5. Communication. Talking about your fears, concerns and what you need to feel safe and secure. This communication can open up doors to comfort. Being honest with yourself and your partner is key in managing your anxiety.

6. Focus on pleasure. The point of sex is to enjoy pleasure. What sensations do you enjoy, what are your needs, what are your partner's desires? Be playful, keep things light, tickle, get kinky, share fantasies, get swept away by pleasure.   

7. Sensate focus exercises. Non-genital and non-intercourse intimacy exercises that help a person explore connection, comfort, intimacy and eroticism without anxious expectations. Exercises that focus on eye gazing, hugging, touch, partner communication, massage, masturbation in front of partner, mutual masturbation, oral and exercises are just a few of the possibilities. These are not goal oriented. Instead, they teach a person to be present and mindful of pleasure with their partner.

8. Increase your sexual comfort. The origins of anxiety may be rooted in sexual discomfort or inexperience. Read about sexuality, learn sexual techniques, have a better understanding of your partner’s pleasure cues, breathing, body language, sounds and pelvic rocking,

9. Take your time. It’s not a race to the finish line. People feel more relaxed when they can get into a groove and find a flow. Sex is not about the destination; it’s about the journe

10. Take responsibility for your own orgasm. Have a chat with your partner and discuss this important topic. When we decide that we’re responsible for our own orgasms, it can alleviate the pressure of thinking we need to give our partner an orgasm. If she wants one, she can communicate what she needs from you, grab a vibrator to pleasure herself or take care of herself manually. You need to do the same for your orgasm. This can reduce the tendency for some to focus too much on their partner. Focus instead on pleasure, passion, breathing, enthusiasm and sensation.

11. Use positive self-talk. It’s time to challenge the negative self-talk using the power of positive thinking and psychology. Use positive reinforcement, affirmations and statements to create more positive energy directed toward yourself. There are community colleges and universities that teach positive psychology theory and techniques classes that can be very helpful as well.

12. Automatic thought records. A classic cognitive therapy technique that helps challenge cognitive distortions and encourages us to work on noticing our distorted thoughts and replacing them with alternative thinking.

13. Hypnosis. A wonderful technique that can help individuals work through anxiety and stress.

14. Changing your diet, sleep and exercise regimens for improved body system regulation. It’s no secret that working toward better eating habits, sleep cycles and workout routines works wonders for our bodies and our anxiety levels.

15. Realistic expectations. It’s realistic to expect a wide variety of sexual experiences. Some pleasurable, others that are duds, and everything in between. Expect a few sexual difficulties, be realistic in both your expectations and your reactions.

16. Professional help. Consider a sex therapist to help you navigate any difficulties. They can help you look at your history of anxiety, attachment, childhood, family issues, as well as your sex history and relationship history. I’ve treated a lot of men with performance anxiety, and the one thing I’m certain of is each man has his own personal story of where it likely comes from and how it affects him. The American Association of Sexuality Educators Counselors & Therapists (AASECT) is a good start toward finding qualified sex therapists near you and if you’re in Los Angeles (you can find me at  www.drhernandochaves.com). A primary-care physician can help rule out a physiological issue. Get checked out.

17. Porn star sex vs. reality lovemaking. I’ve noticed a lot of men compare themselves to the guys they see in porn. If that’s your experience, it might be wise to challenge your ideas of sex, relationships and how porn influences those. In the real world, penises are average-sized, most women aren’t into huge penises, the average lovemaking time for heterosexual couples is 3 to 13 minutes and our partners like us for a lot of reasons, not just for sex. Remember, porn is fantasy and not intended to be sex education or used for performance comparisons. 

18. Be careful of substances, drugs or alcohol. Some drugs help short term with managing anxiety, lowering inhibition, increasing desire or arousal, and even increased sensation. Sure, they’re fun and offer physiological spikes with some neurotransmitters and hormones, but long term, many drugs do the exact opposite of what you hope for. Many men feel more anxious when using substances, which can affect sexual functioning.

19. Don’t distract yourself. Thinking about Margaret Thatcher, baseball stats or NFL teams is the exact opposite of what you need to do. Thinking about anything other than pleasure and enjoyment defeats the purpose of sex. Why would you want to avoid something that is meant for enjoyment? Avoidance is rarely the answer in sex. See mindfulness techniques.

20. Take the emphasis off erection. When their erection joins the pleasure party, many men feel an immediate need to use it. They create a state of pressure and anxiety, and feel the need to rush into intercourse. There’s no need to pressure ourselves. For most men, erection is simply a sign of arousal and not always the signal to stick it in. Sensate focus exercises are helpful tools. It’s OK to be with your partners, erect or flaccid, and be present with them, regardless of penetration. To begin to assume power and control over your anxiety, you’re going to have to stand up to it. Tell your erection when you want to use it. Don’t let your ejaculation, fears or performance anxiety dictate your thoughts and your sex

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