Our Sex Therapist explores performance anxiety and the relationship with erection problems on ABC 891 Radio with Peter Goers.


I was given the opportunity to be a guest on ABC Radio on Tuesday 14th May 2013 as a segment of Peter Goers program ‘Evenings with Peter Goers’. The segment was titled “Sexual difficulties and expressions” and together on the show was psychiatrist  Dr Penny Roughan.

This radio segment was live to air with a very broad focus , the brief being that we would be talking about sexual issues with listeners having the possibility to ring and ask questions.

For the people who missed it, we discussed several very interesting and important issues relating to sex and intimacy. The discussion covered a range of areas including couple counselling, sex addiction, vaginismus, erection problems, performance anxiety/pressure to perform, gender identity disorders and BDSM. We also explored how to get help for sexual problems, medical conditions contributing to sexual problems, the development of sex therapy, cultural differences towards sex and the goals of sex therapy.

Many of these are areas that deserve further exploration in future blogs.  Additionally, one of the most interesting questions raised by a listener was “ How come there is so much knowledge and broadcasts about violence but there is almost nothing about sex/intimacy?’”.

Today I would like to reflect on one of the most topical issues –performance anxiety and the relationship with erection problems.

‘Pressure to perform’ is a regular contributing factor to the development of psychological disorders (anxiety related). Maybe this is due to a continuously more demanding society with higher goals and expectations? Maybe this is related to our increased knowledge as humans of how the world works and our expectation of being able to do anything or fix anything? Maybe when we relate it to intimate relationships, we are required to perform flawlessly otherwise we will be at risk of losing the relationship. Is this because people are more demanding, because the morals about marriage have changed, because it has become easier and more acceptable to split up or divorce, because we are taught to defend our rights and be more assertive?…..There can be a lot of possible explanations for this, based on your own values and perspective.

In respect to ‘performance anxiety’: this is a major contributing factor in sexual dysfunctions, especially erection problems. For example, it may develop like this: A man may, at some stage in life, maybe once, maybe more often, be disappointed in his ability to achieve an erection. The next time he is planning to make love, he is fearful of his physical performance. His mind becomes caught up in negative thoughts. During the sexual activity he is constantly monitoring his physical performance, without paying enough attention to the possible arousing thoughts and feelings, so his brain processes this as distraction, so ‘it’s time to stop the arousal’. As a consequence the arousal will drop and the erection will disappear. This is exactly what this man feared!  Treatment of erectile dysfunction (not solely caused by physical problems) thus has to address this negative circle of performance anxiety. The man is taught to pay attention to the arousing feelings and thoughts instead of the fear. The partner can be of major assistance in this process when she/he is aware of the disturbing thoughts and mental processes going on in their partners mind to help them to overcome this. This can all be addressed in sex therapy successfully.

Remember, if you or your partner has any issues with sexual performance anxiety or erection problems, sex therapy may be a useful treatment to address this issue without the need for medication.

For more information and to make enquiries, visit our Sex Therapy Adelaide page. 

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