Conquering Performance Anxiety

" Well let's ask David. Our topic tonight is. -- performance anxiety I'm I'm a little anxious myself and to put that in to perspective I think most of you know about that it's mostly erect -- Dysfunction and puts out even more -- terms when guys have. Trouble getting an -- joining me to discuss this and help bail me out of a little bit do experts on my left is doctor Robert de. Phillips he's -- clinical psychologist specializing in anxiety disorder he's also the executive director for the center for behavior therapy. And White Plains, New York. And sitting next to doctor Robert Zoellick is doctor Ken Rosenberg he's the psychiatrist affiliated with New York presbyterian hospital. And Cornell University medical under New York city's also private practice in New York specializing in substance abuse and sexual. Disorder I have a little performance anxiety there gentleman but let's get right down to what doctor -- which. What -- performance anxiety. Well performance anxiety in sexual terms and with sexual problems is where a person as an anticipated anticipation. Some sort of problem occurring in this sexual."

" Act and as a consequence of that they develop a sense of anxiety which translates into and inability to be on the record who weren't ability to go ahead. It has six for a certain integration before they actually achieve work where premature ejaculation. Doctor Rosenberg your turn. Performance anxiety. Refers to -- would actually -- it's it's more popular retirement and medical army you can. Unity camera fine performance anxiety in a medical book I think it's that common term for our rexrodt dysfunction. Or in demands it also can lead to premature ejaculation. In sum. We were not need to be anxious and have sex the same time we were not. You know when we're anxious for we're running away from dinosaurs were not ready. Had intercourse so. Art plumbing does not work -- become anxious and therefore when we're extremely anxious we can't reform process. In the anxieties usually fear based. It's a sense of fear of being rejected. Fear of performing a certain way when your -- going to be disappointed. And does that happen with couples as happened when you're. Meeting somebody for the first timer doesn't. So many reasons I mean there's immediate causes is deeper causes. Wrecked our function is so multi determined. Ultimately is the biological phenomenon means ultimately. The fact that the the blood stain in the penis. And and and wire helplessness in the -- can be any number of reasons from psychological and biological. This cultural reasons as well."

" Now does this always meant assess just what I guess stereotypes seems to be. And you're ready for sex maybe you've even been turned on prior to the getting down to the wire and then right when you're ready to go. So you wind it was out of a sales."

" It can happen. And -- by you do get erect -- as a -- as you're about to have sex you lose your reaction. Or can be when you're actually in the in the course of having intercourse you lose the erection. So it can happen in the or org you don't get correct at all. And so can happen in any of those kinds of way. And usually what happens is that the person is focusing more or less on the final goal which is reaching orgasm were pleasing the partner -- an orgasm and not really focusing -- all the rest of what goes on sexual encounter. Which is really one of the things that we try to do as darkness to try to get the person to focus more on. That the relationship you know the sensory. Experience is that they're having as opposed to the final goals or. Focusing on process threatened the proper."

" And we'll stick with the concentrating on this mail part of the issue Basra two women also. -- they object to perform works women women suffer from that and it. Again it's not called reforms inside for women it's more character it would be an orgasm and the inability to have orgasms. Or vastness and the inability to allow. That's the penis with a finger for that matter and the -- because a woman so anxious that that her. Vaginal muscles there contracting. So for women anxiety certainly -- plays Roland behavioral techniques and medicines and couples therapy and all sorts of therapies and it is an arms -- for women as informant. Now if your man in in the is a problem that you're having and you go to seek treatment what what is the treatment."

" Well they're actually a multitude of different treatment. One of the treatments that was developed some time ago by masters and Johnson is what is known as a -- they focus techniques. And through a series of really force stages. What a person begins to learn to do is to stop focusing on the end result which is word hasn't been worrying about whether or not you can go ahead and achieve that war. Provide your partner with the opportunity to achieve that and start focusing more on. What the sensory stimulation is like. What it feels like to actually enjoyed being stimulated. What are the ways in which you can go ahead and pleasure each other and it takes to focus off of what's happening at the end. So you'll store for the stage where you keep your clothes on. And you actually just going to head and touching each other and communicate with -- each other. And once you're doing that for -- couple that moved to the second stage. Which we have to the second stage during that session of normal and several sections that you're getting cost once stage at a time yeah. The idea is that if if you -- your partner. A good number of times we -- the expectation. Of orgasms are there. Well then this whole experience now starts to take on a completely different kind flavor. So you're now realizing that there's so much more is going on in terms -- viewing your partner that orgasm becomes less important. And it becomes important of course you know fight satan and don't think of intelligence I think intelligence but went. Your mind is completely away from Nat -- focusing and that cannot be thinking about what can be thinking but I things and you can actually enjoy the experience. Which will result in you becoming around I -- people."

" Because of anxiety if it is erections if you take emphasis off of off the -- off to organize and -- kind of take to enjoy it and in fact the first homework assignment that we give our patience is. You can't even have Norton came going where -- nothing goals so you you actually. Encourage a person's not even thinking about that that -- and an evening carriages and the things that as a violation of their homework assignment. He totally take the pressure off of them. And hopefully they began to enjoy sex tonight. -- have an orgasm because they state. You know patients say well doctor -- said I can't have an orgasm right to have interactions all right so I can't so that's not something to worry about -- not --"

" And and they didn't get permission not to achieve organs and takes the pressure off their partner understands that they're not to have that expectation either. So we'll move the second stage when they'll be. Caressing and touching and and and communicating without closed the third stage actually being inside. Your partner and but not to rusting in the last stages actually thrusting but the focus is on situations -- courts and."

" That's the masters and Johnson. Figured let me we'd have a if you email questions from our audience out there and just read these -- let me just toss them out where they fit in one person -- I can't have an orgasm when my girlfriend gives me oral sex. Is this performance anxiety and so is there anything I can do doctor Rosenberg he's."

" You know I -- an -- things -- these questions and whatever it talkin' to rely stations. Some people of -- you know and I think that one of the nice things that you learn sex therapy is that. You could. If or sexist thing that's great if not -- thing that's okay too. That it could be any number of reasons it could be because they're very anxious indeed because there afraid of they have some psychological fear that the woman will be of that -- their penis and he could. Create some kind of offense that network could hate when that -- when -- did you -- to do is they're really teach them how to communicate if you're talking about it. And you're not you're not taking -- she's not feeling as though because she can't. Give him an organized and orderly that there's something with there he just may not have a certain sensory nerve endings that accommodate that doesn't -- if physical things -- well you know. And then the issue becomes well is a problem. And why is that a problem and how can you as he is who -- a couple. Compromise and deal with this because he's not into it -- into it and -- to do some quid pro quo and you know on Tuesday to do it that. But the rest of the week I've often they could kind of unity throughout the industry really -- frequent problem by the way it's usually goes the other way around."

" About when that we need to be an erect tile dysfunction problems -- see -- as a direct when he having -- And a orgasm problems. I -- and then not let me see one. One more quick one who are almost running out of time we want to get to treatments. And that's what I guess is also oral sex variety another email sometimes and start having intercourse gets so excited that I H actually within the first couple of moments. Feel embarrassed -- extra what I -- keep that up longer and can very quickly."

" Let's of different things these medications on the SS RI can inhibit. -- sexual response to the point where you don't prematurely ejaculation you can have people use technical this to squeeze and stopped technique. Where you actually usual body as a biofeedback device so you can actually learn the point of no return that she never really get to until you want to get to it. -- you can have a person who can go ahead and debate before the situation so that. If you're very very sexually aroused and they can really achieve orgasm pretty readily again but you have domestically beforehand it. It takes a -- the schedule fit and where they can have more --"

" Our debt disorder it's just for the record -- premature executives. Com and and and happens a lot for men who have extremely high. Testosterone levels are extremely sexual when things as such patients that it's. You know I understand the problem but understand you're very macho -- you know you have a high sex drive and and and that's sort of helps as well."

" And and down very quickly -- down treatments and everybody's heard about viagra this viagra that up what a big part of -- to help people with. Performance anxiety -- viagra is."

" The drug of choice nowadays use drugs wrecked out Thompson. I'm and it doesn't work to give your -- and what it does is it keeps the blood in the penis and he he's taken a half hour to an hour before. You're gonna have intercourse because it it has against Europeans have to wait for. And that about things happen. And then you also need to be simulated. And once you simulated what viagra does very nicely. And what about 80% and time keeps the blood in the penis -- really keeps the hydraulic system -- well known. And enables people to last longer and have certain -- and to wrap up doctor -- which of it has I think is important and responsible says that it has side effects and not something to be taken lightly. Doesn't take over the Internet you know doctor to prescribe and his doctor prescribed and I are seen -- educate doctors -- private -- there -- things because it could be. You know serious if not dangerous drug -- taken correctly."

" And along these lines doctor -- what to wrap up somebody out there is having performance anxiety. Unable to get an erection. No food they seek out for help -- of not getting help."

" Well don't go to a certified sex. Psychologist psychiatrist. Lower -- a psychologist psychiatrist who has had experience in the particular area. And to make sure that there will refer to and that there are people who qualify. As Saddam. You can go to someone who really isn't that -- educated or trained in the area in the Houston misinformation that actually harmful."

" There you have -- I want to thank. My guess doctor Robert -- election doctor Ken Rosenberg for coming by our topic has been performance anxiety. And we hope you learned something here on this -- I'm David folk Thomas we'll see you next time."