Sexual performance anxiety (SPA) is when you experience stress, anxiety, or fear related to sexual activities. Especially we, penis owners, feel an underlying pressure to perform. We either want to meet our own standards or that of our partner/s. 9 - 25% of men experience SPA (Pyke, 2020). Since SPA contributes to both premature ejaculation and erectile dysfunction the whole thing quickly becomes a self-fulfilling prophecy. Once we feel like we've failed during a sexual encounter this fuels our performance anxiety. Baam! More performance anxiety. The next time we get intimate, our anxiety makes it even more likely that things won't happen the way we want them to happen.

Breaking this devil's cycle can be difficult. I'm currently creating a comprehensive guide on how to come out victorious. I'll link it here once it's done. Until then, these relaxation techniques will keep you grounded. I've hand-picked the most effective relaxation exercises for sexual anxiety based on my personal experience, my client's feedback, and the scientific community. The self-help strategies I discuss draw from Cognitive Behavioral Therapy, Mindfulness Training, and Neuroscience. 

 

1. Performance visualization

Performance visualization refers to imagining the moment that you don't want to screw up in your mind. Picturing a successful performance is a common practice for elite athletes. One famous example is Michael Phelps, the most successful Olympic athlete of all time, who extensively visualized his races before jumping in the water.

Now, I don't want to further emphasize the idea that sex is a performance. It really isn't. However, you are reading this because for you sex feels like a performance. In this case, performance visualization is an effective method to calm nerves and prepare you for your next sexual experience. This is also in line with Ayres and Hopf (1985; 1992) who found that a mental rehearsal before a speech performance has reduced anxiety for their subjects and they also did much better. 

A man swimming in a pool
Photo by Guduru Ajay bhargav on Pexels

How to [NSFW, trigger warning for porn addicts]:

  1. Imagine yourself free from any sexual challenges. Create a version of yourself that doesn't know anything that might cause you concern, a version of you as a great lover. 
  2. Visualize step-by-step how intercourse with your partner or date starts. Feel how you confidently undress, full of excitement for their body. You want to provide and receive pleasure. Mutual enjoyment is the focus. 
  3. Smell your partner's perfume, feel their skin touching yours, notice how you stay calm and confident.
  4. Recognize how your arousal grows and your erection rises as you are kissing, teasing, and rubbing each other passionately. 
  5. Dwell on how amazing your partner feels as you enter them. You are in full control, you decide if and when you want to ejaculate.
  6. Play with your partner, bring them pleasure until their twitches and moans culminate in a throbbing orgasm. They are looking you deep in your eyes and just can't stop grinning. 
  7. Listen how they beg you to cum as you allow it to happen. Amazing. 
  8. You two are cuddling while warmth, coziness, and happiness are washing over you.

Feel free to adapt this based on your own preferences. If you are bottoming then this of course needs to be rethought entirely. Once you have done the general visualization a couple of times, you want to add things that can go wrong (like a premature ejaculation event). Think about how you would handle it if you weren't insecure about it. This way, you are much better prepared and don't drown in awkwardness if it happens the next time. 

You can watch Michael Phelps' coach Bob Bowman talk about how paramount visualization was for the Olympian's success: 

 

When to:

Performance visualization needs a small amount of practice to be effective. Use visualization before going to bed and right before the date/encounter with your partner. You can even go to the bathroom and do a quick visualization before you get intimate. Visualizing how to deal with challenges that might come up should be done fairly regularly so that you can act calm and collected without freaking out when things don't go the way you'd like them to go. 

 

2. Guided Meditation

Meditation in general has been proven to reduce stress and anxiety (Peterson & Pbert, 1992). Meditation seems particularly relevant for forms of performance anxiety. Researchers (Chang, Midlarsky & Lin, 2003) conducted a study with musical students and found that meditation seems to be effective at reducing their performance anxiety (this is a common issue for professional musicians). 

A man meditating
Photo by cottonbro on Pexels

 

How to:

Meditation is a tool that usually requires training. Luckily, guided meditations are great at making the benefits of meditation accessible to beginners. You can find a particularly good 10-minute guided meditation below: 

 

When to:

Please note that you need to practice meditation regularly to harvest the calming benefits as they are developing over time (Lin et al., 2008). That means that meditation is more a long-term practice that reduces your general level of anxiety and stress instead of an ad-hoc stress-reliever.

 

3. Diaphragmatic Breathing

Diaphragmatic breathing is also known as belly breathing or deep breathing. The key is to consciously control your breathing with your diaphragm. The diaphragm is basically a big muscle that sits under your lungs. When you inhale, it contracts and when you exhale, it relaxes. That's why your belly expands during diaphragmatic breathing. 

This way of breathing reduces the level of anxiety significantly as it seems to trigger the body's relaxation response (Chen et al., 2017; Ma et al, 2017). 

There are many variants of deep breathing, the one I described below should be particularly effective as the inhalation is shorter than the exhalation which signals the body to relax even more (Huberman, 2021). 

 

How to:

Start your first practice while lying down. After you have understood the basic principle you can also sit upright. Place one hand above your belly button and the on your chest. If done correctly, you should feel your belly lifting up rather than your chest:

  1. Take a deep breath through your nose. Inhale slowly as you count 4 seconds.
  2. Hold your breath for 5 seconds. If this feels uncomfortable it's okay to shorten the duration of the breath-hold.
  3. Let the air slowly flow out of your mouth (count 6 seconds). As you exhale, blow the air through your lips as if you were blowing through a straw. If you don't understand, simply grab a straw and try it. 
  4. Repeat this process for a minimum of 1 - 3 minutes in an emergent stress situation (like a hookup) where you have only a limited time. For general practice, you can do this method for 5 minutes at a time and up to three times a day. 

This video explains the general idea of diaphragmatic breathing very well: 

 

When to:

Belly breathing has an instant effect on how stressed you feel and there is also a benefit of regular practice. So you can use this method to calm yourself down in an anxious moment and regularly practicing it will enhance your overall sense of calm. You can also use this to calm yourself down rather quickly just before the intercourse during a bathroom break if needed. 

 

4. Progressive Muscle Relaxation

Progressive muscle relaxation (PMR) is another tool to effectively reduce anxiety and stress. A study found that PMR is slightly better at decreasing somatic stress levels, which means the physical manifestation of stress, compared to meditation (Rausch, Gramling & Auerbach (2006). So PMR is the way to go if you are experiencing more body-centric symptoms of anxiety such as shakiness, racing heart, sensations such as tingling. PMR is also powerful because it increases your bodily self-awareness meaning that you become better at spotting when you are having physical symptoms of anxiety or stress. 

 

How to:

PMR works by sequentially contracting different muscle groups in your body and then deliberately relaxing them (McAllie, Blum & Hood, 2006). There are various variations on how to do this and below you can find an audio script that will guide you through a PMR session:

When to:

Use PMR regularly to create an overall level of calm and to become more robust to physical forms of anxiety. PMR can be useful to calm yourself down before the date/encounter with your partner too.

 

5. The Physiological Sigh

Do you want something that works quickly and is effectively? I got you. The Physiological Sigh is a breathing technique that works with our bodies' physiology. That's why the following alleviation of our bodies' stress response is imminent and not difficult to do. The whole method takes a maximum of 30 seconds and helps us to stay in control when we are dealing with acute anxiety or stress.

"The fastest hard-wired way for us to eliminate the stressful response in our body in real-time." - Andrew Huberman, Professor of Neuroscience at Stanford University School of Medicine

The two rapid inhalations help to fully inflate the lungs and therefore allow our body to reduce CO2 levels drastically leading to relaxation. In addition, long exhalations signal the body to slow down a racing pulse which fosters relaxation as well.  

 

How to:

Inhale strongly twice before you do a long exhalation. Repeat this 1-3 times. The stronger the inhalations the better it works.

You can listen to Dr. Huberman describe the physiological sigh in this podcast among other strategies to manage stress: 

 

When to:

This is your strongest tool to calm down asap when you are feeling acute anxiety or stress. Theoretically, you could even do it during intercourse if you practice doing it quietly or your partner doesn't mind. 


You got the tools, use them. 

The psychological side of sexual dysfunctions is way to underrepresented. To beat this stuff we have to look at our existence holistically. By reading this article and taking my advice to heart you have greatly increased your odds to stand on the side of freedom.

We all feel overwhelmed from time to time and it's okay. It always is, as long as we deal with our anxiety constructively we will grow. In this moment, you got the chance to build a routine that helps you to stay in an emotionally resilient state. Don't slack. Don't wander off into the pit of self-depravation. It's tough to find your way.

Sigh.

Now, the next time you feel anxious or stressed because of sex, you got a whole arsenal to calming yourself down. Looking forward, you can manage anxiety and focus on what matters and making real progress.

Btw, other ways that are proven to help with your resilience are good sleep, healthy nutrition, sports, and cold showers.  

 

References

Ayres, J., & Hopf, T. S. (1985). Visualization: A means of reducing speech anxiety. Communication Education34(4), 318-323.

Ayres, J., & Hopf, T. (1992). Visualization: Reducing speech anxiety and enhancing performance. Communication Reports5(1), 1-10.

Chang, J. C., Midlarsky, E., & Lin, P. (2003). Effects of meditation on music performance anxiety. Medical Problems of Performing Artists, 18(3), 126-130.

Chen, Y. F., Huang, X. Y., Chien, C. H., & Cheng, J. F. (2017). The effectiveness of diaphragmatic breathing relaxation training for reducing anxiety. Perspectives in psychiatric care53(4), 329-336.

Davenport, L. (2011). Sweeter Dreams: Visualizations for Restorative Sleep. Huffpost. Accessed: 23.03.2022 URL

Dolbier, C. L., & Rush, T. E. (2012). Efficacy of abbreviated progressive muscle relaxation in a high-stress college sample. International Journal of Stress Management, 19(1), 48-68.

Huberman, A. (2021). Tools for Managing Stress & Anxiety. Huberman Lab Podcast. 

Lin, P., Chang, J., Zemon, V., & Midlarsky, E. (2008). Silent illumination: a study on Chan (Zen) meditation, anxiety, and musical performance quality. Psychology of music, 36(2), 139-155.

Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., ... & Li, Y. F. (2017). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in psychology, 874.

McCallie, M. S., Blum, C. M., & Hood, C. J. (2006). Progressive muscle relaxation. Journal of human behavior in the social environment13(3), 51-66.

McCabe, M. P. (2005). The role of performance anxiety in the development and maintenance of sexual dysfunction in men and women. International journal of stress management, 12(4), 379.

Peterson, L. G., & Pbert, L. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry149(7), 936-943.

Pyke, R. E. (2020). Sexual performance anxiety. Sexual medicine reviews, 8(2), 183-190.

Rajkumar, R. P., & Kumaran, A. K. (2014). The association of anxiety with the subtypes of premature ejaculation: a chart review. The primary care companion for CNS disorders, 16(4), 26666

Rausch, S. M., Gramling, S. E., & Auerbach, S. M. (2006). Effects of a single session of large-group meditation and progressive muscle relaxation training on stress reduction, reactivity, and recovery. International Journal of Stress Management13(3), 273.