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Overcoming sexual performance fears
 Understanding the cause of your sexual performance anxiety is essential if you want to cure the problem. Just praying and wishing it will go away just won't cut it.
Most men will initially completely deny they have some sort of difficulty... or better yet, they will look outside of themselves for the cause looking for something, anything... they can pinpoint as the cause. With those thoughts in mind ... our interview continues below.
Why is sexual performance anxiety treated one stage at a time?
- Filewich "The idea is that if you're with your partner a good number of times where the expectation of an orgasm is not there, then the whole experience now starts to take on a completely different kind of flavor, so you're now realizing that there's so much more that's going in terms of you and your partner that orgasm becomes less important. When it becomes less important -- of course, if I say, "Don't think of pink elephants," you're going to think of pink elephants -- but when your mind is completely away from that and you're not focusing on that, you're not going to be thinking about performance. You're going to be thinking about other things, and you're going to actually enjoy the experience, which will result in you becoming aroused."
- Rosenberg "If people, because of anxiety, lose their erections, if you take the emphasis off the erection, off the orgasm, you kind of say, "Just enjoy it" -- in fact, the first homework assignment that we give our patients is, "You can't even have an orgasm. Erection is not the goal" -- you actually encourage the person to not even be thinking about that."
And that's in the first stage? - Rosenberg "-- and even encourage them to think of it as a violation of their homework assignment so you totally take the pressure off of them, and hopefully they begin to enjoy sex and not worry, "Am I going to have an orgasm?" because patients say, "Well, Dr. Ken said I can't have an orgasm. I can't have an erection, so that's not something for me to worry about because it's not a performance I need to do."
- Filewich "And they have permission not to achieve orgasm and it takes the pressure off, and their partner understands that they're not to have that expectation, either. So they'll move to the second stage where they'll be caressing and touching and communication without clothes. The third stage is actually being inside your partner but not thrusting, and the last stage is actually thrusting. But the focus is on the sensations. That's why they call it "sensate focus." "
One person writes, "I can't have an orgasm when my girlfriend gives me oral sex. Is this performance anxiety, and if so, is there anything I can do?" Dr. Rosenberg, do you want to take this? - Rosenberg "I don't think it's an easy question to answer without really talking to a live patient. Some people are just built that way. I think that one of the nice things that you learn in sex therapy is that if oral sex is your thing, that's great; if it's not your thing, that's okay, too. So there could be any number of reasons. It could be because they're very anxious. It could be because they have some psychological fear that the woman will devour their penis. You could create some kind of fantasy like that."
- Filewich "But a major thing to do is to really teach them how to communicate. If you're talking about it and you're not taking -- say, she's not feeling, because she can't give him an orgasm orally, that there's something wrong with her, he just may not have the certain sensory nerve endings that accommodate that, so it could be a physical thing. Then the issue becomes, "Is this a problem, and why is it a problem, and how can the two of you as a couple compromise and deal with this because he's not into it and you're into it," and maybe you could do some quid pro quo. On Tuesday you could do it, but the rest of the week you have off. So you could figure out the situation. That's a really infrequent problem, by the way. It usually goes the other way around."
Interview continued on sex performance anxiety
Drew Voight - Better Sex
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