In my practice, I have seen anxiety be the cause of many different sexual dysfunctions. Anxiety usually comes in the form of worries about performance, worries about not satisfying a partner, self-esteem worries, guilty feelings, or any other negative feelings associated with sex. Other ways that anxiety can wreak havoc with your sex life is when there is a lot of conflict between a couple or one partner feels responsible for the other’s emotional state—to make them happy or keep them from getting upset.

Anxiety messes up sex in general.

This makes sense when you understand that anxiety triggers a stress response (“fight or flight”) in the body, which is exactly the opposite of what needs to happen for sexual arousal to continue uninterrupted. Arousal is under the command of the “rest and digest” response (rest and repair, relaxation, or whatever else you want to call it), but can be short-circuited if the stress response is triggered. This is true because the stress response is designed to overrule the relaxation response in order to keep you alive in times of danger. Unless stress levels are lowered, most people will have some difficulty with getting into a deep state of sexual arousal. It sounds paradoxical, but you have to be relaxed to get sexually excited.

Orgasm is controlled separately from sexual arousal.

Orgasm is another story altogether. It seems that orgasm is actually under the control of the stress response such that a person has a physiological switch from one state to another in order to trigger orgasm. The entire process is still not completely understood, but it seems that some people switch from the relaxation phase to the stress phase just before they reach orgasm. It is thought that men with premature ejaculation have a “faulty switch” so that it goes off much quicker than they would like. But anxiety can produce the same results in men.

Worrying about it actually makes it worse.

When a person has an anxious thought, it is sensed by the mind as a small stress that then creates a response in the body—a small release of adrenaline. Even though it only takes about 90 seconds for the body to metabolize that adrenaline, one anxious thought usually leads to another with a whole cascade of anxious thoughts to follow. This continuous release of adrenaline continues to activate the stress response until eventually it takes over. Unfortunately, some people have a much lower threshhold to when this stress response wins over arousal, which is probably the case for men with premature ejaculation. Any of the above examples of anxiety can then be the precipitating factor for coming very quickly.

How can a man improve a pattern of quick ejaculation?

By learning to calm the mind and change the anxious pattern of thinking, a man can greatly improve the time that it takes him to reach orgasm and ejaculation. As I discuss in my book Wanting to Want, the brain can learn to be less anxious by paying attention to its thought patterns and learning to move one’s focus to something more calming or immediate. In meditation, it’s about focusing on the breath. In sex, I often tell people to focus on whatever is most erotic for them at the moment. With practice, a man can become more attune to his sensations but not immediately trigger the stress response which will push him into orgasm. Changes in the brain over time have even shown that it actually changes in response to less anxious patterns of thinking. Since this happens with time, practice and patience are the best avenues to achieving this. A good sex therapist can also be a great help in directing you to learn to last longer in bed.

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