Performance Anxiety

Performance anxiety can occurs in a variety of public and private situations including sports, acting, singing and musical presentations, test taking, public speaking, and sexual intimacy. 

Performance anxiety is a very disruptive level of anxiety that can develop in any situation where you have to perform an activity. Performance anxiety occurs in both public and private contexts but, whatever the situation, the pattern of behavior is usually the same.

First, you start to worry thinking about the things that could do wrong.  Then anxiety develops and the anxiety gets in the way of your own performance - a self-fulfilling prophecy.  For example, sexual performance anxiety can become a major issue within a relationship. Whether from premature ejaculation, impotence or some other sexual difficulty, anxiety around sex develops and this only makes things worse. Ultimately, a vicious circle is created, when worrying about your performance exacerbates the original problem, until the sexual performance anxiety becomes a problem in itself.

Performance anxiety is a common sexual problem in which anxiety about engaging in sexual activity becomes an block to sexual feelings and thoughts.  Performance anxiety can result in avoidance of sexual encounters, lowered self-esteem, relationship problems and actual sexual dysfunction.

Typically, an awareness of performance anxiety produces so much preoccupation with the anxiety itself that the person becomes less fully involved in the sexual interaction, bringing about the very failure that is feared.

Erectile dysfunction is a disorder that can develop as an outgrowth of performance anxiety. While the occasional experiences of not getting an erection, losing an erection, or early ejaculation are so common that they are in the range of normal and expected behaviors, if either partner does not take such incidents in stride, it can set the stage for a performance anxiety problem.

Fears of sexual performance are not limited to men or to worries about physical responsiveness but in women can include concerns about vaginal lubrication and both male and female climaxing. Fears can also reflect anxiety about one's sexual response on a broader level, such as how much passion, tenderness, intimacy and sensitivity a person feels toward his or her partner.

You have to, or want to, perform an activity. You start to worry about it, thinking about all the things that could or do go wrong. Then this anxiety and worry get in the way of your own performance - a self-fulfilling prophecy.  If you try not to worry, you may still be in the wrong frame of mind since you are still thinking, when you need to be experiencing.  In order to get rid of performance anxiety you have to break up this this self-fulfilling prophecy. 

Therapists can help people to develop coping skills to manage their fear and anxiety. This involves understanding and adjusting thoughts and beliefs that help create the anxiety, learning and practicing specific behavioral social skills to increase confidence, and then slowly and gradually practicing these skills in real situations.  Individual psychotherapy, reality therapy and cognitive behavior therapy can be effective.

Relaxation and stress relief techniques are frequently an accompaniment to other therapeutic approaches.  Relaxation techniques may include things like specific ways of breathing, muscle relaxation training, guided mental imagery, or soothing self-talk.

Medications are sometimes used to help relieve the symptoms associated with performance anxiety.  Although medication does not solve the whole problem, it can reduce anxiety so the person can more easily deal with their problem.

Hypnotherapy can also be very effective.  This usually consists of systematic desensitization and other therapeutic techniques conducted under hypnosis by a clinical hypnotherapist.

For more information about performance anxiety and other mental health problems, please click on the linked websites listed below.

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