Erectile Dysfunction

Conquering Performance Anxiety

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Summary & Participants

Though erectile dysfunction and other sexual hindrances can have biological causes, for many the problem is psychological. Performance anxiety can be a serious obstacle to a fulfilling sexual relationship, but it can also be overcome. Join our panel of experts for a live discussion of its causes and cures. Viewers are encouraged to submit their questions in advance, or during the live program.

Medically Reviewed On: July 21, 2009

Webcast Transcript

DAVID FOLK THOMAS:  Welcome to our webcast.  I'm David Folk Thomas, and our topic tonight is performance anxiety.  I'm a little anxious, myself.  To put that into perspective -- I think most of you know about that -- it's mostly erectile dysfunction, and to put that in even more lay terms, when guys have trouble "getting it up."  Joining me to discuss this and help bail me out of this a little bit are two experts.  On my left is Dr. Robert J. Filewich.  He's a clinical psychologist specializing in anxiety disorders.  He's also the Executive Director for the Center for Behavior Therapy.  That's in White Plains, New York.  Sitting next to Dr. Robert Filewich is Dr. Ken Rosenberg.  He is a psychiatrist affiliated with New York Presbyterian Hospital and Cornell University Medical Center in New York City.  He's also in private practice in New York, specializing in substance abuse and sexual disorders.

I had a little performance anxiety there, gentlemen, but let's get right down to it.  Dr. Filewich, what is performance anxiety?

ROBERT J. FILEWICH, PhD:  Performance anxiety, in sexual terms and with sexual problems, is where a person has an anticipation of some sort of problem occurring in the sexual act.  As a consequence of that, they develop a sense of anxiety which translates into an inability to become erect or an inability to go ahead and have sex for a certain duration before they actually achieve orgasm, or premature ejaculation.

DAVID FOLK THOMAS:  Dr. Rosenberg, your turn.

KEN ROSENBERG, MD:  Performance anxiety refers to just what Dr. Filewich said.  It's more of a popular term than a medical term.  You can't really find "performance anxiety" in a medical book.  It's the common term for erectile dysfunction or impotence.  It also can lead to premature ejaculation in some.  We were not made to be anxious and have sex at the same time.  When we're anxious, we're running away from dinosaurs, we're not ready to have intercourse.  So our plumbing does not work when we become anxious, and therefore when we're extremely anxious we just can't perform very well sexually.

ROBERT J. FILEWICH, PhD:  And the anxiety is usually fear-based.  It's the sense of fear of being rejected, fear of performing in a certain way where you're partner's going to be disappointed.

DAVID FOLK THOMAS:  Does that happen with couples?  Does it happen when you're just meeting somebody for the first time, or does it matter?

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