The Fundamentals of Sex

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Performance anxiety results when someone fears they have to deliver something specific to their partner.

Healthy adults know how to manage disappointment and surprise in various life domains.

We shouldn't think of sex as a place to prove anything, because then we can fail—an idea that ruins sex.

Performance anxiety doesn't live in sex—it's created by individuals.

Every week, patients want to talk with me about “performance anxiety.” It’s one of those terms that everyone now uses, so people expect that I know exactly what they mean.

But as with most things that patients say, I usually respond by asking “what do you mean?” And that’s when patients start disclosing the troubling details.

We often end up talking about power. Or unspoken threats. Or unrealistic expectations. Or conflict that has no obvious purpose.

When people say “performance anxiety,” they generally mean “I get anxious about being able to deliver a particular thing that someone else values.”

In the sexual realm, that often starts with erections: What if I don’t get hard enough for intercourse? It can include lubrication: What if I don't get wet enough for easy intercourse? And it also extends to orgasm, a common concern for people of every gender: What if I don’t climax? Or I climax too quickly, or too slowly?

Even enjoyment can be a commodity delivered insufficiently: What if I’m not enthusiastic enough, or satisfied enough, or moan enough?

So that’s the "what" of the issue. Now let’s unpack the why: Why are people concerned with their sexual “performance?”

The innocent answer begins “because I want my partner to have pleasure. I want to share closeness with them. I want us to have a good experience.” This sounds both reasonable and wholesome—except for the anxiety part, which we’ll get to below.

Some people do feel anxious out of altruistic concern about a partner’s pleasure (which isn’t necessary, although I understand it). But the dark side of this involves efforts to prevent a partner from feeling bad—and apparently that can take many shapes.

Some people create anxiety by imagining their partner being sexually frustrated (even if they swear they aren’t). Sometimes the anxiety results from a partner explicitly complaining, “If you loved me, you’d...” Or “If you found me attractive, you'd...", or "If you really desired me, you'd…”

Some people stake their own sense of sexual adequacy on their partner’s “performance”: “If I were a good lover, you’d... and since you don’t, I guess I’m not.” In this situation, people have sex defensively—wanting to protect themselves from the pain of causing their partner pain. And again, that creates pressure.

Pressure can even come in benign-sounding language: “Oh, honey, I just want things to be fair. You give me so much pleasure; you deserve the same for yourself.” The result is still pressure—the sense that someone has to experience pleasure to validate their partner. When someone’s pleasure becomes a commodity that they have to deliver to their partner, it’s easy to feel anxious.

Responses to performance anxiety vary.

One is being terribly self-conscious before and during sex, undermining the chance of enjoying the experience. Another is to simply ignore a partner’s experience altogether, which is the opposite of intimacy.

Another is to lose interest in sex—not as a conscious decision, but as an understandable consequence. When sex (or anything else) is emotionally dangerous, of course, people back away from it. This is a common reason that people come to therapy. People often don’t realize that their performance anxiety can have such a large impact on them.

The Fundamentals of Sex

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So, What to Do About the Pressure?

Whether the pressure comes from one’s partner or from within, anxiety is a choice (yes, even if a person has a disorder or feels previously traumatized). If so, what are the other options?

Talking is better than isolation. Having preferences is better than trying to be “normal.” Calibrating expectations is better than fear of failing. Curiosity is better than anxiety.

We all prefer that our bodies behave in certain ways during sex. But this is only a problem if you can’t manage when it doesn’t—which is what we do in the rest of life. We’re continually facing disappointment, surprise, and alternative scenarios regarding health, money, parenting, and recreation. Most healthy people accept this, massage a situation as best they can, and get on with life. “Anxiety” makes that almost impossible. So realizing that you have choices is a valuable first step.

I help patients walk through “so what if…” scenarios of sexual disappointment. What if he won’t believe you’re attracted to him? What if she insists that you create an unrealistic experience for her? What if another guy would get an erection in a situation that you don’t? What if you’re the first guy your boyfriend couldn’t make climax?

I also help people describe what’s important about sex to them. Sexual “function” isn’t an end in itself; it’s just a means. A means to what? Pleasure. Closeness. Playfulness. Self-expression. When people pursue these things with an open mind (and a partner they trust), they can experience them regardless of how each other’s genitalia behave. In that situation, there are always alternative erotic behaviors if your body (or your partner’s) doesn’t do exactly what you want.

I encourage people to discuss these things with every person they have sex with—and what kinds of experiences they would therefore enjoy, regardless of how their genitalia behave. For straight people, for example, understanding that intercourse is not “real” sex, but rather just one kind of sex, is crucial.

Unrealistic Expectations

Much performance anxiety is a response to the unrealistic expectations of one or both partners. Porn, of course, portrays fictional characters doing things that can only result from editing. People who think they should duplicate the unusual bodies and activities depicted in porn will almost always fail.

But some unreasonable sexual ideas have been floating around our culture for decades, independent of porn: that women should climax from intercourse; that sex should happen spontaneously, without planning; that men should get erect from a single moment of visual stimulation; that people should have youthful, flexible bodies at every age.

When patients disclose that they have some of these ideas, I ask them to explain why they think ordinary bodies and people would behave in these ways. That’s the first step in eventually saying, “What you expect of yourself, or what your partner expects of you, is simply not realistic. So quit being surprised or dismayed when your body doesn’t do that.”

Ultimately, people need to believe that anxiety isn't an inevitable feature of sexual situations—people create anxiety. People can rewire themselves to enjoy a wider range of experiences and to take disappointment more lightly. And almost anyone can replace the identity of "anxious lover" with something, well, sexier.

© Psychology Today