Conquering Performance Anxiety

" Welcome to our web casts David. That our topic tonight. Is set performance anxiety I'm I'm a little anxious myself. And to put that into perspective I think most of you know about that it's mostly erect tile dysfunction and to put that even more lay terms when guys have. Trouble getting an update. Joining me did discuss this and help bail me out of this a little bit -- experts on my left is doctor Robert. -- which he's a clinical psychologist specializing in anxiety disorder she's also the executive director for the center for behavior therapy. That's in white plains new York and sitting next to doctor Robert -- which is doctor Ken Rosenberg he's a psychiatrist affiliated with New York Presbyterian Hospital. And Cornell university medical center in New York City is also private practice in New York. Specializing in substance abuse and sexual disorders I have a little performance anxiety -- gentleman but let's get right down to a Dr. -- which. What he's performance anxiety. Well."

" Performance anxiety in sexual terms and in the sexual problems is where a person half dozen anticipate 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 an inability to become -- who -- ability to go ahead. In half sacks for a certain duration before they actually achieve orgasm were premature ejaculation. Doctor Rosenberg your --"

" Performance anxiety it refers adjustment Doctorow said. It's it's more popular term and medical term you can. You can run fine performance anxiety in a medical book I think it's that common term for lower erectile dysfunction. Or -- it also can lead to premature ejaculation. In some. We were not mean 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 to to have intercourse so. Our plumbing does not work when we become anxious and therefore when we're extremely anxious. Which can't perform -- actually and the anxieties usually fear based. It's a sense of fear being rejected. Years of performing a certain way we -- partners will be disappoint. And does that happen with couples as it happened when you're just meeting somebody for the first time -- doesn't matter. Doesn't matter can have so many reasons I mean there's a meeting clauses in his deeper causes. -- tile dysfunction is so multi determined it ultimately is the biological phenomenon means ultimately. A fact of the the bloodstain in the penis. And and and wire -- policies and -- could be any number of reasons from psychological the biological. -- cultural reasons as well."

" Now it does this always manifest just what I guess that stereotype seems to be. 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. You wind because out of a sales in the city it can happen. Whereby you do get -- and that's about as you're about to have sex you lose your reaction. Working being when you're actually in the in the course of having intercourse you lose direction. So we can happen in or or you don't get correct at all. And so it can happen in any of those kinds of ways. Usually what happens is that the person he is focusing more or less on the final goal which is reaching orgasm were pleasing to partner with an orgasm. And not really focusing on all the rest of what goes on and sexual encounter which is really one of the things that we try to do as stair -- try to. And get the person to focus more on the relationship hand these sensory. Experiences that you're having as opposed to the final -- more. Focusing on a process rather than product. And we'll stick with the concentrating on this mail part of the issue but her two women also are they subject to perform works."

" Women women suffer from that NB -- it. Again it's not -- reforms inside for women it's more of a characteristic it would be an orgasm and the inability to have an orgasm. Or fashion this missed the inability to allow them the penis with a finger for that matter -- the vagina because a woman so anxious says -- Vaginal muscles there contracting. And so for women anxiety certainly is pleasant Rowland became her techniques medicines and couples therapy in all sorts of therapies can be is enormous benefit for women as instrument."

" Now it your men and and this is a problem -- you're having. And you go to seek treatment what what is the treatment when they're actually a multitude of different treatments. One of the treatments that was developed for some time ago by masters and Johnson is what is known as a sense they focus technique. 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 orgasm and 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 war 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 of pleasure each other. And it takes the focus off of what's happening at the end. And so you'll store for the stage where you keep your clothes on. And you actually just go ahead and touch each other and and communicate with each other -- and once you're doing that for a while you're comfortable with that move to the second stage. Which is you have to the second stage during that session normally that is after several sessions of you -- costs -- one stage at a time hit it. And these -- the idea is that if if you're with your partner. A good number of times we -- the expectation. Of an orgasm is not there. Well then the whole experience now start to take on a completely different kind flavor. So you're now realizing that there's so much more that's going on terms reviewing your partner -- orgasm becomes less important. And becomes less important. Of course you know if I say no I don't think of pink elephants to think of pink elephants but when. Your mind is completely away from that not focusing on that you're not gonna be thinking about performance -- be thinking about other things and you can actually jewel if you experience. Which will result in you becoming."

" Around I mean if people because of anxiety if it insurrections if you take the emphasis off the off the erection off the -- Kind of -- just enjoy it and in fact the first homework assignment that we give our patience is. You can't even have an orgasm came in wearing corrections now -- goals so you. You actually encourage a person's not even thinking about that. And that's and first aid and an evening carriages and I think that as a violation of their homework assignment -- Connolly take the pressure off of them. And hopefully they beacons when George sex and night. Coming up an orgasm because they could -- You know patients say well doctor -- said I can't have an orgasm right looking at directions -- psychics so that's not something for me to worry about it is not."

" Forms and the Internet and friends and they didn't get permission not to achieve orgasm and takes the pressure off from the partner understands that they're not to have the expectation that. So we'll move the second stage will they'll be. Caressing -- touching thing and communicating without closed the third stages actually being inside. Your partner and but not resting in the west agents is actually trusting but the focus is on the food stations that's what -- since so."

" And that's the masters and Johnson. For me let me we have a few email questions. From our audience out there and I've just read these but let me just toss them out Etsy where they fit in one person writes. I can't have an orgasm when my girlfriend gives -- oral sex. Is this performance anxiety and so is there anything I can do -- doctor Rosenberg when it's unanimous and Japanese in these questions than answer them right talking to a lot patients."

" Some people -- built that way you know and I think that one of the nice things that you can learn -- therapies that. You could see if or sexism thing that's great if it's not your thing that's okay too. I'm so that could be any number of reasons it could be because they're very anxious could be because there. Afraid of they have some psychological fear that the woman will be about where their penis than he could. Create some kind of offense like that -- could hate -- method and yet I hate when that but the major thing to do is to really teach them how to communicate if you're talking about it. And you're not you're not taking say she's not feeling as though because she can't. Give him an organized orderly that there's something more with her. He just may not have a certain sensory nerve endings that the comedy that doesn't -- if physical thing and saying well you know it. And -- issue becomes well is this a problem. And -- that problem and how can you as -- of your as a couple. Compromise and deal with this because he's not into it in here into it and maybe could do some quid pro quo and you know on Tuesday to do it that. But the rest the -- often so you can kind of can't figure out and express and they're very -- infrequent problem by the way it usually goes the other way around."

" Well that when that would it be an erect tile dysfunction problem comes uneasiness that's in Iraq when he's having that that's an eight orgasm problem. Okay and then when we see one. One more quick one of the world's ran out of time who want to get to treatments. I'm just when I guess is also the oral sex bride in other email sometimes when I start having intercourse I get so excited that I H actually within the first couple of moments. Feel embarrassed except for a what tonight you keep that up longer and again very quickly."

" Lots of different things -- his medications on the SS RIs can inhibit. Your your sexual response to the point where you don't prematurely ejaculation. -- have people who use a technique called us to squeeze and stop technique. Where you actually usual body is a biofeedback device so you can actually learn the point of no return so that you never really get to actually wanna get to it. Now you can have a person who can we hadn't asked debate before the situation so that. They're very very sexually aroused and they can really achieve orgasm pretty readily again but she have a masterpiece beforehand if it takes a look at the original fitness where they can have more sustaining."

" Well that disorder just just for the -- is called premature objectives. And an end and it happens a lot for men who have been extremely high. Testosterone levels are extremely sexual one of the things he -- such patience is. You know I understand is a problem but understand -- very macho guy you know you have a high sex drive and and so and that sort of helps and is well. And then now very quickly backed out treatments and everybody's heard about Viagra this Viagra that was not what a big part of Viagra and help people with. Performance exciting although Viagra is in the drug of choice now there's a different use drugs -- wrecked out dysfunction. I'm and it doesn't work to give your -- and what it does is it keeps the blood in the penis he needn't need to take about half an hour to an hour before. You're gonna have intercourse -- it has to get to Europeans have to wait for. Certain at a ball things happen and then you also need to be simulated. And once you simulated or Viagra does very nicely. And works about 80% time is it keeps the blood in the penis so it really keeps the hydraulic system if you will go. And enables people to last longer and -- certain corrections -- and to wrap up Dr. Phil which of but it's it has not I think it's important to say responsible say that. That side effects and it's not something to be taken lightly. Doesn't take over the Internet you know doctor to prescribe commuters are to describe and I was sitting in educate doctors to certain actually on the car excitement because it could be. You know -- serious if not dangerous drugs taken correctly and along these lines Dr. Phil which to wrap up. Somebody out there he's having performance anxiety. Unable to get an erection. Who do they seek out for help how they go about getting help."

" Well they'll go to a certified sex. Psychologist psychiatrist. Who were a psychologist psychiatrist who has had experience in this particular area. And to make sure that there will refer -- in and that they're people who qualify. It is. You can go to someone who really -- and that will educator who were trained in the area and they give you some misinformation that actually might be harmful."

" There you have it I want to thank. My guest doctor Robert. And we hope you've learned something here on this webcast on David folk Thomas we'll see you next time."