Anxiety is one of the most common mental health issues related to sexual dysfunction. At one point, anxiety was seen to be the leading cause of sexual dysfunction. When we struggle with anxiety, we may be trying to manage what feels like a million thoughts per minute swirling around in our heads, monitoring our own body language during interpersonal interactions, or trying to dry off our sweaty palms and hope our partner does not notice. All of these manifestations of anxiety can be disruptive to people's sexual experiences, particularly if they are having partnered sex where their ability to stay engaged sexually is tied to their own or their partner's sexual gratification.
People may experience anxiety during sex for several reasons, but common ones include having preoccupied or nervous thoughts, an adverse relational experience related to sex, or increased attention on evaluating one's sexual behaviors. The latter is known as spectatoring, a term Masters and Johnson (1970) suggested was a possible cause of sexual dysfunction.
Anxiety during sex is also one reason why some people experience sexual avoidance patterns in a relationship. Why would we want to have sex if it is going to be mentally taxing? The answer is simple: we wouldn't.
Additionally, some of the narratives in popular culture about what it means to be a sexually desirable partner encourage people to fit a specific mold, which can be fairly unhelpful for anxiety. What if you don't feel like a rock star? Does that mean you can't have a fulfilling sex life?
For those of you coping with sex-related anxiety out there, I encourage you to consider trying these strategies.
Get in touch with your body and the sensations you experience.
When people are anxious, they are often focusing on thoughts surrounding an event that has not happened yet or one that happened in the past and may happen again. This means that their minds are either ahead or behind of what is happening in the present. Imagine watching your favorite television program, but instead of being focused on the current scene, you find yourself thinking about the scene that has just happened or is about to happen. As a result, you tend to miss what is happening right in front of you. This is similar to how folks with anxiety may feel during sex.
Instead, try to focus on a specific sensation. Perhaps it's the sensation of your fingertips against your skin, the smell of your partner's hair or the way your partner's lips feel pressed against yours. Staying in touch with these sensory experiences during sex helps connect you to the current moment. This strategy is suitable for both partnered sex as well as self-pleasuring.
Be gentle toward yourself.
Sometimes we judge ourselves for having to deal with anxiety during sex. These self-criticisms are unhelpful and generally make matters worse. Try being compassionate towards yourself about your anxiety by recognizing your awareness or how far you have come or that you are actively working on addressing the symptoms. Thinking about the coping skills you can use can also be an effective way of coaching yourself through a difficult time.
Get a hold of some sex-positive, supportive literature.
While many people struggle with anxiety, there are also great anxiety workbooks that help with managing negative thoughts; this one is among my favorites. If a workbook isn't your jam, you might prefer a book written by a sexologist that directly talks about managing anxiety during sex.
Connect with a professional.
If you are still trying to navigate anxiety during sex, speaking with a certified sex therapist may be a helpful step. The American Association for Sexuality Educators, Counselors & Therapists offers a referral directory to locate a therapist in your neck of the woods. Psychotherapists with advanced training in sex therapy are experienced at treating sex-related anxiety concerns, so hopefully they will be able to help!