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Maybe It's Psychological

“Is there something psychological going on?” This is one of the main questions people are struggling with when they call me about sexual concerns. Whether the issue is erectile problems or trouble having an orgasm or anything else, if there is not a clear physical problem, we presume a psychological cause.

But what does that mean, exactly? “Something psychological” sounds kind of vague and mysterious. Let’s simplify that concept though, because being able to identify what is going on psychologically is one of the first and most important steps in addressing the problem. So what are some psychological contributors to sexual concerns?

  • Anxiety: This is probably the most common psychological experience that interferes with sexual functioning. You may feel worry, fear, numbness, feeling “uptight,” holding your breath or shallow breathing, feeling disconnected from your body. You may think things like: Am I performing well? (E.g., am I hard enough? Am I close to orgasm?) Is my partner enjoying this? Do I look bad?

  • Guilt / Shame / Embarrassment: May come up if you’ve learned negative messages about sex, your body, or what you enjoy sexually.

  • Anger / Sadness / Disappointment: May come up if you’ve had past difficult sexual experiences, had other difficult experiences recently, or are upset with your partner.

  • Difficulty focusing / Easily distracted: Makes it difficult to get or stay aroused because your mind is elsewhere. Often goes along with anxiety.

This is not an exhaustive list of what psychological factors can interfere with sexual functioning, but it’s a start. The main point is that if there’s “something psychological” going on, you can identify what it is! You can put a name to the feeling or thought that is happening if you pay attention to your experience. “Something psychological” doesn’t have to mean some vague experience from childhood, or some unconscious difficulty that only a therapist can unearth. Often “something psychological” is everyday thoughts and feelings that are getting in the way of sexual arousal for one reason or another.

So if you think you might have “something psychological” going on, the first step is to BE A SCIENTIST and gather data about your own internal experience during sex. From there, it is easier to figure out what to do about it.

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