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The Heartbreak of Male Performance Anxiety

I get a dozen or so messages a month on this topic. I’ve written about it in numerous postings and spoken about it in several podcasts, but still the email comes.

One of the real bugaboos for anyone, regardless of gender, is living up to our own expectations of sexual performance. So many things can get in the way, literally and figuratively, of fully enjoying ourselves and/or pleasuring our partners.

The arousal stage of our sexual response cycle is particularly vulnerable to a disruption. And when there’s trouble there, there’s no hiding it. A limp dick or a dry pussy can put the kibosh on all festivities that we may have hoped would follow.

However, performance anxiety can strike any of us, regardless of age, and at just about any point in our sexual response cycle. This is a particularly galling when it seems to come out of the blue. And regaining our composure can be more far more difficult than we imagine.

Today we will be focusing on male performance anxiety.  I’ll address female performance anxiety at a later date.

Here’s Bob, he’s 26:
Doc, this has never happened before. But I couldn’t get it up tonight, and this chick was H.O.T. Now I’m not gay at all, but I haven’t had sex in about 3 years because I was locked up…so I masturbated pretty regularly, about 3 or 4 times a week. But I can’t figure out why I was soft… the only thing I can think of is I ate clams tonight and I’ve never had them before. Could it be that or should I get checked out?

It weren’t the clams, darlin’! And I don’t think you need to get “checked out” either…at least not right away. If you could back away from the situation a bit and stop freaking out, I think you’d discover the source of your problem all on your own.

Here’s the thing—while you were out of commission there in the slammer, you relied, as you say, on jerking off. Okay, cool. We all do what we gotta do. Now the first time you try to score after your release…you go soft. This tells me you have a mild case of performance anxiety. We all get that from time to time.

There’s probably nothing wrong with you or your johnson. You just got the jitters first time you tried to get you some after being away, that’s all.

The anticipation of boning this H.O.T. chick—fueled by some predictable self-consciousness; what with just getting out of the big house and all—pulled the plug on your wood. No surprise there, right?

What I don’t want to see happen is for you to replay the incident over and over in your mind’s eye til that’s all you can think about. If you do, this proverbial molehill will become a mountain. You’ll then bring all this anxiety to your next encounter, setting yourself up for even more disappointment. You can see how this shit can snowball? If you interpret every less than satisfying encounter as a failure, your fears will become self-fulfilling. You’ll begin to avoid partnered sex and you’ll develop a full-blown sexual dysfunction. And your self-esteem will take a nosedive, too.

If you’re preoccupied with your performance, it’s less likely that you’ll be fully present during sex with a partner. This pretty much fucks up your sexual responsiveness and any hope for spontaneity. Why not just relax into the whole sex thing and not try to prove your manhood with your pecker?

Then there’s Steve with a slightly different take on this meddlesome problem:

My partner and I have been together for just over 3 years now in a monogamous relationship. I am the top and he the bottom. Our problem is not premature ejaculation on his part, but his inability to have an orgasm at all. No matter what I try and even if he masturbates, sometimes it is impossible to get him to cum. Is this a medical issue? Have you ever heard of this?

Delayed ejaculation is the difficulty one has ejaculating even with a firm erection and sufficient sexual arousal and stimulation. This problem is not uncommon. For most men, delayed ejaculation occurs during partnered sex more frequently than while masturbating. In fact, 85% of men with delayed ejaculation can usually cum by jacking off. However, in partnered sex, the guy may be unable to ejaculate at all, or only after prolonged partnered stimulation. This problem can be very frustrating and cause distress for both partners involved, as you already know.

What causes delayed ejaculation? Well, it could be a number of things. It could be something as simple as performance anxiety, or inadequate stimulation, or there could be neurological damage.

I don’t want to be too reductionist here, but most of us experts believe that the majority of instances of delayed ejaculation aren’t physical in nature, but rather are the product of psychological concerns. Simply put, there’s a difference between the psychosexual response we have when we are alone and the one we experience with a partner. There’s probably nothing wrong with your partner’s unit. It’s all in his head…or his mind, to be more exact. If I had to guess, I’d say he’s got a real bad case of performance anxiety.

When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes the pressure off the couple. From there we begin to rebuild the partnered psychosexual response one step at a time. We begin with sensate focus training (Sensate Focus is a series of specific exercises for couples that encourage each partner to take turns paying increased attention to their own sensations. More about these helpful exercises in the weeks to come.), stress reduction and relaxation exercises. These applications are designed to reduce performance pressure and instead focus on pleasure. The idea is to get them to stay in the moment; absorb the pleasure present without worrying about what is “supposed” to happen.

Finally we address as frankly and openly as possible any fears or anxieties that they may have—as individuals or as a couple. I have the greatest confidence in this method; it succeeds over 90% of the time.

Ok, let’s recap shall we?

Overcoming sexual performance anxiety is dependent on five simple things.

  • First, a guy needs to be attuned to his sexual response cycle — arousal, plateau, orgasmic and resolution phases. He should know what kind of stimulation he needs at each phase to fully enjoy himself and satisfy his partner.
  • Second, the more worried a guy is about a performance issue, the more likely that problem will present itself. A bad experience in the past can often set the stage for its recurrence.
  • Third, don’t be afraid to talk this over with your partner. Withdrawing from your partner or shying away from sex altogether will only increase the likelihood that the problem will persist.
  • Forth, be proactive! Fearing the loss of your sexual prowess or feeling sorry for yourself is counterproductive. Confront the challenge head on. Employ sensate focus training stress reduction techniques and relaxation exercises to help you push past this temporarily impasse and regain your self-confidence.
  • Fifth, free yourself from the mindset that your dick is the center of the universe. Your manhood or your capacity to be a great lover does not reside in your genitals. Expand your sexual repertoire. Remember, pleasure centers abound in your body as well as your partner’s.

Good luck!

Review: An Intimate Life: Sex, Love and My Journey as a Surrogate Partner

Hey sex fans!

I have another swell sex-positive book to tell you about today. Anyone who frequents this site will already be familiar with my dear friend and esteemed colleague, Cheryl Cohen Greene. If ya don’t believe me type her name into the search function in the sidebar to your right and PRESTO!

Not only will you find the fabulous two-part SEX WISDOM podcast we did together, (Part 1 is HERE! And Part 1 is HERE!) you will find a posting about the movie The Sessions. You’ve seen it right? It’s the award-winning film staring John Hawkes, Helen Hunt, and William H. Macy. It’s the story of a man in an iron lung who wishes to lose his virginity.  He contacts a professional surrogate partner with the help of his therapist and priest. Ms. Hunt plays Cheryl, the surrogate partner in the movie

Cheryl also contributed a chapter on sex and intimacy concerns for sick, elder and dying people for my book, The Amateur’s Guide To Death And Dying.

With all that as a preface, I now offer you Cheryl’s own story: An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner. The first thing I want to say is this book is it’s not a clinical or technical tome. It is an easily accessible memoir. And that, to my mind, is what makes it so fascinating.

She writes in the Introduction:An Intimate Life

I started this work in 1973, and my journey to it spans our society’s sexual revolution and my own. I grew up in the ‘40s and ‘50s, a time when sex education was—to put it mildly— lacking. As I educated myself, I found that most of what I had been taught about sex was distorted or wrong. The lessons came from the playground, the church, and the media. My parents could barely talk about sex, much less inform me about it.

What follows is a candid and often funny look into the personal and professional life of a woman on the cutting edge of our culture’s movement toward sexual wellbeing.

Cheryl comes out of her conservative Catholic upbringing and her often tortured family dynamics with what one would expect—her own sexual awakenings as well as the conspiracy of ignorance and repression that wanted to stifle it. This is a common story, the story of so many of us.

Starting when I was around ten, I masturbated and brought myself to orgasm nearly every night. … If my nights began with anxiety, my days began with guilt. I became convinced that every earache, every toothache, every injury was God punishing me. … I couldn’t escape his gaze or his wrath. Sometimes I imagined my guardian angel looked away in disgust as I touched myself and rocked back and forth in my bed.

The miracle here is that this troubled tween would blossom into the remarkable sexologist she is today.

rsz_1greenecherylSome of the chapters in her book describe one or another of her hands on therapeutic encounters as a surrogate partner, but equally important and compelling are the chapters that describe Cheryl’s own sexual struggles as she moved to adulthood and beyond. Cheryl’s acceptance of her own sexuality enables her to build a career out of helping others do the very same thing.

Everyone has a right to satisfying, loving sex, and, in my experience, that most often flows from strong communication, self-respect, and a willingness to explore.

Despite the frank discussion of sexual topics within the book, there is no prurience or sensationalism. For the most part, Cheryl’s clients are regular people, mostly men, who have pretty ordinary problems—erection and/or ejaculation concerns, dating difficulties, as well as self-esteem, guilt and shame issues. Cheryl helps each of her clients with the efficiency and confidence of the world-class sex educator she is. Most of her interaction involves her supplying her clients with some much-needed information, dispelling myths, and giving them permission to experiment. As she says;

I continue to be amazed at how solid education delivered without judgment can eradicate much of the guilt and shame that turns life in the bedroom into a struggle instead of a pleasure.

Her most famous client, Mark O’Brien, the 36-six-year-old man who had spent most of his life in an iron lung after contracting polio at age 6, was the author of How I Became a Human Being: A Disabled Man’s Quest for Independence, in which he writes about his experience with Cheryl. This, of course, was adapted into a film, The Sessions, which I mentioned above. For her part, Cheryl delivers a most poignant remembrance of Mark early in her book.

I explained Sensual Touch to Mark. Although he was paralyzed, he still had sensation all over his body, so he would feel my hands moving up and down. … I encouraged him to try and recognize four common reactions: feeling neutral, feeling nurtured, feeling sensual and feeling sexual.

An Intimate Life chronicles Cheryl’s life-long interest in human sexuality. Her life and sometimes-turbulent loves are on display, but in the most considerate fashion. She teaches by example. She’s even able to speak with great compassion of her time living with and through cancer.

As I inch toward seventy, I appreciate more and more how much I have to be grateful for and how fortunate I’ve been. I was lucky to find a wonderful career and to be surrounded by so many smart, adventurous, caring people. My personal sexual revolution auspiciously paralleled our culture’s, and in many ways was made possible by it. I am eternally grateful to the pioneers, rebels, and dreamers who made our society a little safer for women who embrace their sexuality.

There is so much I loved about this book, but mostly it’s the humanity I found in abundance. Cheryl’sdr.-cheryl-cohen-greene enlightened soul shines brightly from every page. Her no nonsense approach to all things sexual is an inspiration. And her perseverance to bring surrogate partner therapy into the mainstream is laudable.

…what separates surrogates from prostitutes is significant. When people have difficulties grasping [that], I turn to my beloved and late friend Steven Brown’s cooking analogy that I’ve so often relied on to help me through that question: Seeing a prostitute is like going to a restaurant. Seeing a surrogate is like going to culinary school.

Finally, An Intimate Life is the culmination of Cheryl’s life as a sex educator, her surrogate partner therapy practice being just part of that mission. I highly recommend you read this book. You will, I assure you, come away from it as I have, a better person—enriched, informed, as well as entertained.

Cheryl, thank you for being in my life and being such an abiding inspiration. Thank you too for this marvelous book; now you can be in the lives of so many others who need you so that you can inspire them along their way.

Be sure to visit Cheryl on her site HERE!

A molehill becomes a mountain

My problem is Sexual dysfunction, I can have a hard on and keep it for penetration but if I have to use a condom I lose my erection, most of the time. I also take to much time to cum. Most of the time I loose my erection and I can’t finish what I’ve started. I would like to find a solution for this, because I have been like this for a long time, and it is really frustrating for me. I do appreciate your help and look forward to hear from you.
Miguel.

Sounds to me like you’re racing to the finish line. Hey, where’s the rush? You may be experiencing a bit of performance anxiety, but I don’t think it’s a full-blown sexual dysfunction quite yet.

Look for the category pull down menu in the sidebar to your right. Scroll down till you find the category — Sex Therapy. Under that category you will find a subcategory labeled PERFORMANCE ANXIETY.

You’ll find loads of information about this issue in both written and podcast form.performance anxiety

Here’s an example of what you’ll find…

Simply put, there’s a difference between the psychosexual response we have when we are alone and the one we experience with a partner. There’s probably nothing wrong with your unit. It’s all in your head…or your mind, to be more exact. And I’m not being flippant.

Here’s how performance anxiety works. Say I have a less than satisfying sexual experience for one reason or another. Before I know it, I’m replaying the incident over and over in my mind’s eye till that’s all I can think about. The proverbial molehill has become a mountain, don’t ‘cha know. I then bring my anxiety to my next encounter. My hyper self-consciousness primes me for more disappointment. And I’m all prepared to interpret the disappointment as a failure. Well, you can see where I’m going with this, huh? My fears become self-fulfilling and I find I’m beginning to avoid partnered sex and my relationship flounders, I develop a full-blown sexual dysfunction and my self-esteem takes a nosedive. My preoccupation with my problem makes it less likely that I’ll be fully present during sex with my partner, which pretty much scuttles my sexual responsiveness and any hope for spontaneity.

Get thee to a sex-positive therapist ASAP! Believe me this is nothing to fool around with. Check out the directory at The American College of Sexology for a therapist near you.  If you can’t find anyone near you and you really need to talk to someone, check out my Therapy Available page.  I do remote therapy/counseling via Skype or phone.

When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes a great deal of the pressure off the couple. From there we begin to rebuild the partnered psychosexual response one step at a time. We begin with sensate focus training, stress reduction and relaxation exercises. I have the greatest confidence in this method; it succeeds over 90% of the time.

Good luck

He Can’t Cum!

Name: Alice
Gender: Female
Age: 19
Location: Minnesota
My new boyfriend is really frustrated and doesn’t want to have sex anymore because he can’t come. He says he’s had this problem for a while and hasn’t come with any girl for over a year. I see how upset he is and I know he still wants to sleep with me, but says it hurts when he gets excited and nothing happens. Is there something I can do? I tell him to see a doctor but I don’t think he will. Thanks a lot!

Wow, that’s a bummer Alice. Unfortunately, you don’t supply me with enough information for me to make an educated guess about what might be up with him. Does he have erections? Does he masturbate? Is he on any medications? These are the first questions I’d ask him. Since he isn’t here and neither are you, I’m gonna make a stab in the dark.cover up

If I had to guess, I’d say your man is suffering from a real bad case of performance anxiety. He doesn’t need a medical doctor; he needs to learn to relax and be in the moment. If this is an arousal phase issue then that should help. If it’s and orgasmic phase issue, relaxing and enjoying the pleasure will also help.

Here’s how performance anxiety works. Say a fella has a less than satisfying sexual experience for one reason or another. Before he know it, he replaying the incident over and over in his head, till that’s all he can think about. The proverbial molehill becomes a mountain. He brings his anxiety to his next sexual encounter. His hyper-consciousness primes him for more disappointment. And he’s ready to interpret all disappointment as a failure. And this can interrupt either the arousal phase or orgasmic phase of our sexual response cycle.

Well, you can see where I’m going with this, huh? His fears become self-fulfilling. Before he knows it, he begins to avoid sex. His relationships suffer. He develops a full-blown sexual dysfunction. And his self-esteem takes a nosedive. His preoccupation with his problem makes it less likely that he’ll be fully present during sex with his partner, which pretty much fucks up his sexual responsiveness and any hope for spontaneity.

It sounds to me like performance anxiety is putting a damper on his sexual arousal and thus short-circuiting the rest of his sexual response cycle, including orgasm.

This is nothing to fool around with, especially for someone at his tender age. When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes a great deal of the pressure off the couple. From there we begin to rebuild the partnered psycho-sexual response one step at a time. We begin with sensate focus training, stress reduction, and relaxation exercises. I have the greatest confidence in this method. It succeeds over 90% of the time.

Good luck

Monkey on my back

And now for one of our regular, semi-obligatory Meth-related questions. I get at least a half dozen of these questions a month. And each and every one of them breaks my heart. I know nothing about the fellow writing me; I don’t know where he lives or his age. I don’t suppose it really matters, does it?

I need some help and I hope you can point me in the right direction. I am recently divorced and trying to move on in life but I’m depressed all the time and also using meth a lot. I have tried to have different sexual partners since my divorce and every time I’m with someone new I can get a erection when we are messing around with no problem, but soon as its time for penetration I loose my erection I feel like I’m having anxiety issues and also I’m very nervous, and I’m not impotent so can it be the meth preventing me to keep it up, or do I need medication for my anxiety? How can I overcome this problem?

I’m certain I can point you in the right direction. Thanks for asking. Allow me to speak plainly. Quit the meth! Quitting won’t solve all your problems, but it is the first and most important step. And frankly, if you choose not to quit, all your other efforts to pull your life together are doomed.

MonkeyBackMeth is not a therapy for depression, nor is it gonna help you connect with a new partner. It most assuredly will not help your erection problems; in fact, it is the cause of your erection problems. But I’ll wager you know that already, huh?

You also have an underlying performance anxiety problem that needs to be addressed ASAP.

Find a competent sex therapist to help you. look to the directory of The American College of Sexology for someone near you. Or you can check out my Therapy Available page.

In the meantime, take a look at some of the stuff I’ve written and podcasts where I talk about meth. Use the pull-down CATEGORIES menu in the sidebar, to your right, and scroll down till you fine the SEX & SUBSTANCES category. It’s under that category that you will find the subcategory Crystal Meth.

You’ll also want to take a look at some of the stuff I’ve written and podcasts where I talk about performance anxiety. Again, use the pull-down CATEGORIES menu in the sidebar and scroll down till you fine the SEX THERAPY category. Under that category you will find the subcategory Performance Anxiety.

Here are examples of the stuff you’ll find.

On meth:

Name: Joey
Gender:
Age: 22
Location: Southern Calif
Love doing tina with masturbation and watching really hot porn. Think this is just social fun?

Nope, I don’t Joey. Despite the prevalence of this dastardly drug, there is nothing fun about tina…crystal meth for those unfamiliar with the term “tina”. If you love doing tina for whatever reason, I’d wager you’re hooked on that shit.

Listen, I’m not prude when it comes to using some crystalmakesmesexy.jpgdrugs recreationally. But I think that we’d do well to stick to those drugs that are more natural. The less processing involved (and meth is the worst in that regard) and fewer added chemicals (OMG, the crap they put in crystal) the better, in my humble opinion.

Despite the admitted high ya get, recent research shows that long-term meth use destroys nerve cells in the brain that regulate dopamine, muscle movement, memory, and decision-making. This damage can be wide-spread and permanent.

Your body reacts to crystal meth the same way it reacts to danger. Crystal floods the body with adrenaline — the same hormone that prepares us for emergencies. Adrenaline gives a super-charge of strength and endurance so the body can deal with danger and injury. But artificially triggering this response over and over again will have serious consequences.

When you use crystal, your nervous system shifts into high gear. The brain floods your body with “danger” messages. Your body responds immediately to what it thinks is a threat. It prepares to fight or to run away. Common body responses to perceived danger include:

  • Pupils dilate to let in more light.
  • Hair stands on end (“getting goose bumps”).
  • Blood vessels just under the skin constrict.
  • Body temperature goes up

Regular, long-term crystal use will diminish sores of neurotransmitters. Episodes of paranoia and anxiety become more frequent and longer lasting. Blocked blood vessels within the brain can lead to increased chances of stroke.

Crystal fucks with your dopamine levels. Dopamine delivers a sense of reward and pleasure. It is also associated with body movement. Too little dopamine causes paralysis or a Parkinson’s-like tremors and rigidity. Too much dopamine and a person can become paranoid, hear voices and get twisted thoughts. Sound familiar?

Crystal fucks with your serotonin levels. Serotonin is involved in regulating sleep and sensory perception. It plays a role in moods and regulating body temperature. Serotonin is involved with many emotional disorders like schizophrenia, phobias, super-aggressive states and obsessive-compulsive behavior. Too much serotonin can make it difficult (or impossible) to have an orgasm. And of course there’s the dreaded “crystal dick”…the inability to get it up.

Joey, listen up! You’re way too young with too much of your life ahead of you to self-inflict so much serious irreparable damage on yourself. If this weren’t such a troublesome drug, there wouldn’t be such a virulent anti and reformed tweeker community out there. Want to know the real truth about “tina” check in at: crystalmeth.org. You’ll be glad you did.

On Performance Anxiety:

I get a dozen or so messages a month on this topic. I’ve written about it in numerous postings and spoken about it in several podcasts, but still the email comes.

One of the real bugaboos for anyone, regardless of gender, is living up to our own expectations of sexual performance. So many things can get in the way, literally and figuratively, of fully enjoying ourselves and/or pleasuring our partners.

The arousal stage of our sexual response cycle is particularly vulnerable to a disruption. And when there’s trouble there, there’s no hiding it. A limp dick or a dry pussy can put the kibosh on all festivities that we may have hoped would follow.

However, performance anxiety can strike any of us, regardless of age, and at just about any point in our sexual response cycle. This is a particularly galling when it seems to come out of the blue. And regaining our composure can be more far more difficult than we imagine.

Today we will be focusing on male performance anxiety. I’ll address female performance anxiety at a later date.
Complete Article HERE!

Good luck

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