Sex and Anxiety
We are justified in being anxious about how we will face up to a new specific situation, and since we are predominantly rational beings, as soon as the threat of the unknown has vanished, our anxiety disappears.
Irrational anxiety is quite different, for by definition it exists when there is no obvious or apparent danger. No amount of persuasion that there is no need for worry will convince, or, indeed, that if there is any cause for worry, the situation does not warrant the degree of worry evinced.
People who suffer from this type of anxiety often develop peptic ulcers, and others develop colitis (inflammation of the large intestine) or asthma, while extreme forms can bring about heart disease.
These physical complaints obviously require medical treatment, but this on its own rarely brings about more than an alleviation of the condition. It should be accompanied by psychotherapy which will rid the mind of the mental origins of the neurosis.
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The persistent worrier does not often develop the physical symptoms mentioned above. Though their worrying may be utterly irrational, it does not seem to give rise to obsessive anxiety, for the reason that they are constantly changing the situation they are worrying about. They are usually people of a predominantly pessimistic outlook on life.
Worries can inflict themselves on us at all periods of our lives. Even children are susceptible to mild attacks of irrational anxiety.
They worry about their misdeeds (which they inflate), they worry lest they lose the love and affection of their parents, they worry about a subject they are studying with, to them, not very great success, even though they are not doing so badly when compared with their classmates and the teacher has made no adverse comment on their work.
Fortunately, these irrational anxiety states are short-lived, but they may produce, while they are operative, bed-wetting, chronic headaches, nightmares, acute stomach aches, diarrhoea or vomiting. Once the child is reassured that his/her worries are groundless, which pre-supposes that the cause of the anxiety is discovered, the physical disorders and the mental worries can be quickly dispelled.
At the other end of the scale is the late-middle-aged man or woman who worries about his/her continuing ability to function sexually as he/she enters later life. Unfortunately, such cases are all too frequent.
The worry begins when the sexual functioning is more than adequate. Within a short period, however, he/she is experiencing sexual dysfunction.
Because the mind has such a powerful influence over physical sexual functioning, the tension and mental – and consequent physical – fatigue caused inevitably by the anxiety, makes the sexual organs practically always the first of the organs to be affected.
On the other hand, irrational anxiety about sexual dysfunction, which occurs at all ages, is one of the commonest causes of actual sexual dysfunction.
I know a young man of 22. Since he was fifteen he has suffered from an anxiety neurosis that he will never be able to father children. As a result, he suffers from retarded ejaculation. The consultant has looked at specimens of his semen under the microscope, and they are chock-a-block with vigorous sperms.
On the first occasion, I told him that though his semen contained active sperm, there were not quite enough of them to assure fertility. So I prescribed courses of Vitamin E. As a placebo, this has worked well. He is convinced that the administration of the vitamin has increased the frequency of his libido and the volume of his semen. This may be so, but he equates increase of semen-volume with fertility.
At the fourth examination of his semen, which contained a high sperm-count, I made him look for himself, after which his anxiety neurosis has disappeared. He functions normally; retarded ejaculation is a thing of the past. I am convinced that if I had let him see the sperm-content of his ejaculate the first time, he would have persuaded himself that I had tricked him, and he would still be believing that he was infertile.
But it is as the man or woman enters middle-age that anxiety neuroses based on sexual function become a more frequent problem.
Again and again and again there is no physical symptom that suggests a weakening of the libido, or failure to obtain and sustain an erection in men, or the comparable responses in women.
Yet the number of men and women who convince themselves that now they are growing older their sexual power has definitely begun to wane are myriad. This conviction then develops into anxiety that sooner rather than later the sex-life will end completely.
Naturally it happens that the production of sex-hormones does begin to decrease as one gets older, but even in old age there are sufficient quantities of the hormones present to permit full sexual activity, albeit with a lower frequency.
Certainly this is so with men, and in those women where the hormone supply does peter out, the libido remains active for several years thereafter. There is certainly no valid reason why so many men are impotent by the time they reach middle-age nor why so many women become sexually unresponsive. In almost every case an anxiety neurosis centering on this fear of the loss of sexual power can be detected.
The trouble is that unless professional help is sought at the onset of impotence and unresponsiveness to remove the anxiety, even a short period of both conditions can make it difficult to restore the actual physical functions. So if you find you are getting into this state of mind, seek help at once.
What I term partial impotence i.e. impotence that only occurs when the man is in a sexual situation with a woman, occurs in young men and more mature men as a result of irrational anxiety. The inability to obtain or sustain an erection, or to control ejaculation, is directly caused by anxiety that the man will not be able to satisfy his partner.
The counterpart of this in the woman is the inability to achieve orgasm in a sexual situation with a partner. This may be because she fears being unable to satisfy the partner physically, Or it may be that by not responding physically, she undermines her partner's sexual confidence, so that, even if he stays in the relationship because he loves her, he will be physically and psychologically unable to satisfy either her or himself.
In any sexual situation the key to success is confidence – confidence in your ability to satisfy your partner's needs and your own. So long as you have this confidence, you will never fall prey to irrational anxiety.