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Sex & Performance Anxiety: What’s Really Going On with Dr. David Rowland
If you’ve ever felt your body shut down the moment sex begins (your arousal just disappears, or you become consumed with worries about your performance), this episode will help you understand why.
In part one of this series, I talk with researcher Dr David Rowland about what sexual performance anxiety actually is, how it develops, and what’s happening in your brain and body when anxiety takes over. We unpack why pills can help penises but not people, why avoidance keeps the cycle alive, and how cultural expectations fuel shame.
You’ll learn:
- The three ingredients of performance anxiety: expectation, evaluation, and consequence
- Why anxiety and sexual arousal can’t coexist in the body
- What happens when you avoid sex to “protect yourself” — and why it backfires
- Why thinking you're going to fail, increases the likelihood you will
- How and why the brain can sometimes create a preferred response toward anxiety
Timestamps:
00:23 – Introducing Dr. David Rowland
01:24 – Dr. Rowland’s Background
03:29 – The Need for Sex Education
05.25 – How Medication for Erectile Dysfunction Changed Our View On Performance Anxiety
06:14 – Pills vs. People: The Limits of Medication
06:34 – Why Sexual Anxiety Still Exists Despite Pills
06:57 – 3 Aspects of Sexual Performance Anxiety
09:14 – The Function of Anxiety
11:21 – The Brain and Anxiety Response
13:19 – How Anxiety Affects Sexual Response
15:00 – Anxiety, Masturbation, and Sexual Function
16:40 – How The Brain Can Develop A Preferred Response To Anxiety
20:01 – Avoidance as a Coping Mechanism
22:18 – Over-Preparation and Mindfulness
25:30 – The Role of Anxiety in Sexual Problems
31:00 – Cultural Ideals and Male Sexual Performance
33:33 – What to Do About Performance Anxiety
47:54 – My Sex-Therapist Take On The Impact of “Soft” Sexual Problems
48:18 – Pleasure, Productivity, and Underfunding
50:00 – The Brutal Cultural Ideals Surrounding "Performance"
51:33 – What to Do About It
52:19 – Closing Thoughts & Resources
The study discussed in this episode is A theoretical model for sexual performance anxiety (SPA) and a clinical approach for its remediation (SPA-R) by Rowland & Kirana, published in Sexual Medicine Review.
Interested in my services? Check them out here
Join my 1:1 online program Re:Desire here.
Do you want to submit a listener question for the podcast? Here's the link
View all episodes
By Leigh Norén | Sex Therapist and Relationship ExpertIf you’ve ever felt your body shut down the moment sex begins (your arousal just disappears, or you become consumed with worries about your performance), this episode will help you understand why.
In part one of this series, I talk with researcher Dr David Rowland about what sexual performance anxiety actually is, how it develops, and what’s happening in your brain and body when anxiety takes over. We unpack why pills can help penises but not people, why avoidance keeps the cycle alive, and how cultural expectations fuel shame.
You’ll learn:
- The three ingredients of performance anxiety: expectation, evaluation, and consequence
- Why anxiety and sexual arousal can’t coexist in the body
- What happens when you avoid sex to “protect yourself” — and why it backfires
- Why thinking you're going to fail, increases the likelihood you will
- How and why the brain can sometimes create a preferred response toward anxiety
Timestamps:
00:23 – Introducing Dr. David Rowland
01:24 – Dr. Rowland’s Background
03:29 – The Need for Sex Education
05.25 – How Medication for Erectile Dysfunction Changed Our View On Performance Anxiety
06:14 – Pills vs. People: The Limits of Medication
06:34 – Why Sexual Anxiety Still Exists Despite Pills
06:57 – 3 Aspects of Sexual Performance Anxiety
09:14 – The Function of Anxiety
11:21 – The Brain and Anxiety Response
13:19 – How Anxiety Affects Sexual Response
15:00 – Anxiety, Masturbation, and Sexual Function
16:40 – How The Brain Can Develop A Preferred Response To Anxiety
20:01 – Avoidance as a Coping Mechanism
22:18 – Over-Preparation and Mindfulness
25:30 – The Role of Anxiety in Sexual Problems
31:00 – Cultural Ideals and Male Sexual Performance
33:33 – What to Do About Performance Anxiety
47:54 – My Sex-Therapist Take On The Impact of “Soft” Sexual Problems
48:18 – Pleasure, Productivity, and Underfunding
50:00 – The Brutal Cultural Ideals Surrounding "Performance"
51:33 – What to Do About It
52:19 – Closing Thoughts & Resources
The study discussed in this episode is A theoretical model for sexual performance anxiety (SPA) and a clinical approach for its remediation (SPA-R) by Rowland & Kirana, published in Sexual Medicine Review.
Interested in my services? Check them out here
Join my 1:1 online program Re:Desire here.
Do you want to submit a listener question for the podcast? Here's the link