True stories

Anxious overthinking and nothing works

For some men, premature ejaculation ruins their lives. Learn exactly why anxiety and fear underlies the problem, and how to successfully nail it.

Nathan’s story: premature ejaculation worries ruining my life

Nathan’s PE worries had escalated into full-on obsession.

It was my secret, pathetic weakness. A two-pump chump. On the outside, I was confident, masculine and jacked. Inside, I had literally given up on myself.

Nathan is good looking and had no problem attracting girls. At 26, he’d already achieved significant career success. His Instagram was full of travel destinations, cocktails and smiles. But when he contacted me, his insecurity and self-loathing around sex was threatening all of this. His struggle to make sex last had become a relentless source of anxiety.

Nathan explained that he’d pretty much turned celibate. He wanted sex, needed it even, but it caused him too much stress. He’d tried to fix the problem. He’d poured his energies into researching the causes of PE, reading books on how to last longer, subscribing to online courses.

Along with many of the other guys in this book, he’d become something of an expert on kegels and edging and anything else he could do to somehow reprogram his body. He’d been on Reddit and the forums, scouring for any further insights that might explain what was wrong. He’d studied the reviews of creams, wipes and supplements.

But nothing had helped Nathan to last longer. On the increasingly rare occasions that he hooked up with a girl, he would become gripped by performance fears.

If I try to chill out and forget about it, I ejaculate too soon. If I try really hard to stay in control, I ejaculate too soon. No gains… stuck like this forever.

Nathan’s PE anxiety wouldn’t let up. At the gym, out with friends, watching Netflix. Thoughts of his perceived inadequacy would strike at any time. Even at work, he would feel like a fake, an impostor. His imagination would spin up terrible outcomes of further failed romances, of being permanently alone.

He fretted that somehow women would see right through his confident game and mock his shortcomings behind his back. He harboured intense resentment towards the men who took their sexual abilities for granted, able to have sex for hours and do all the positions they desired.

Nathan knew he wasn’t the only man with this problem – all those PE books on Amazon were testament to that. But this didn’t give him any respite. It didn’t stop him from constantly ruminating on all the sex he would never have.

It was no exaggeration to say that anxiety was ruining his life, and it all stemmed from how long he lasted in bed.

What’s going on?

To the uninitiated, it’s hard to believe that PE worries can have such a negative impact on men’s lives. But it’s absolutely for real, and Nathan’s experience is far from unusual.

Premature ejaculation causes a great deal of frustration and embarrassment, but for many men the problem runs deeper. Sexual struggles threaten our core psychological needs.

Here are some of the fears that I frequently hear in my therapy sessions with men:

  • Threat to intimacy: Sex is a fundamental part of relationships. If I can’t perform, I will always be alone.
  • Threat to our sense of our own competence: I can’t get the basics right. Some men go for hours, I can only last for seconds.
  • Threat to privacy: Every time I have sex, I reveal my inadequacy. I’m sure she will tell her friends.
  • Threat to giving and receiving attention: One minute of giving and receiving is not enough, for her or me.
  • Threat to our sense of autonomy: I can’t even control my own body.
  • Threat to status: Most men are better at sex than me.
  • Threat to our sense of meaning: What is my relationship without good sex – a companionship arrangement? What is she doing with me? Why am I like this?

And when our fundamental psychological needs are threatened, our mental health suffers. No wonder Nathan felt anxious; that’s a hell of a lot of threats.

Sexual insecurity followed Nathan through his life, unremitting and constant. He ruminated, resented and obsessed over finding a solution. He always retained a bit of hope that things might be better, but couldn’t muster the energy or focus to really do anything about it.

The more he fixated, the more his mind went to work on how terrible it was. Whenever he read about men with the same issue, his imagination ran with the negative stats, the broken relationships and feelings of despair.

When sexual opportunity came along, Nathan’s performance anxiety inevitably ramped up to the max. It’s impossible to be positive or put any techniques to good use in such an anxious state. Despite his best efforts, his whole body was in flight-or-flight mode. He was like an awkward, fumbling beginner every time.

What works better?

In the face of any challenge, we’re all equipped with natural resources. We have two billion years of evolution and adaptation to thank for that.

But sometimes, we are inclined to misuse our resources. This leads us into frustration and hopelessness.

Nathan was applying his resources to this problem. He’d done his research and tried to apply his rational mind to possible solutions. He delved into a community to search for answers. His memory tried to understand the patterns and make sense of his sexual history. And most significantly, his imagination latched onto his PE at every possible opportunity.

We worked to identify where he might have been misusing his resources, inadvertently making the problem much worse.

When he first came to me, Nathan found it extremely difficult to envisage ever being relaxed and confident in bed. Our imagination is a potent, creative force that’s essential to our success and survival, but anxiety will always try to steer it towards the negative. We tend to get the outcomes that we routinely imagine.

None of this is a criticism of Nathan, or any man in this situation; it’s our survival instinct to focus on threats. But he can learn to use his imagination more constructively, an essential step in overcoming lifelong PE.

As part of this work, Nathan and I discussed ways of noticing and categorising his catastrophic thoughts around sex. He came up with a few ‘mental buckets’ to stick them in, such as ‘cruel world thoughts‘ and ‘circus freak thoughts‘ (really). Developing this habit really helps us to get perspective, calm our negative mental chatter and get a handle on our anxieties. It’s a much better use of our imagination.

With a bit of clarity and direction of the resources we already possess, we can then turn to missing skills and habits. At the top of this list is the ability to completely, deeply relax. Nathan had tried to force himself to relax during sex, which doesn’t work. His desperation to relax and slow down made him ejaculate even sooner.

There’s a clear physiological explanation for this. In a nutshell, our nervous system has two modes of operation:

The sympathetic nervous system is ‘the accelerator‘. This is the aroused, anxious, excited state. We often describe this state as ‘fight or flight‘. It’s the mechanism that protects us from danger and, most relevant to this conversation, powers our ejaculation reflex.

The parasympathetic nervous system is ‘the brakes‘. This is our relaxed, in-control state. It enables us to calmly observe situations, think creatively and put our skills to use.

Sex requires us to shift between both of these modes, and this is where things get tricky. We need to be sufficiently relaxed to get hard and get into the groove. We start out in parasympathetic, in-control mode. Then as our sexual excitement builds, the sympathetic nervous system automatically kicks in to ‘accelerate’ us to orgasm.

As we approach orgasm, our awareness narrows right down to getting the job done. Our breathing quickens, our heart rate increases and pelvic muscles contract without us even knowing it. This is the reproductive reflex, the sympathetic nervous system doing its thing.

In neurological terms, this switch is an amazingly complex and sophisticated process. But for guys who struggle with PE, it occurs much sooner than desired.

Think about the last time you reached orgasm, and how you momentarily lost contact with a large part of the outside world. For a few exhilarating seconds, your mind was flooded with purely sexual stimuli. Those unbelievably filthy thoughts.

Maybe there was a flicker of a thought about holding on, lasting longer. But could you do anything about it, even if you tried? It’s too late; the point of no return.

This explains why performance anxiety prematurely drives us to orgasm, despite our best efforts to slow ourselves down. Anxiety and sexual excitement are closely related emotions, and they will power us past the cruising, parasympathetic stage in seconds. They key to lasting longer is lowering all this emotional arousal, and getting used to doing it on demand.

Takeaway tip: Take a minute to think about your own struggles and frustrations around sex. When did you last feel embarrassed or resentful? How does it feel to not be in control? Really try to tap into the negativity, and rate your feeling of anxiety out of 10. Maybe you can get to a 6 or higher, just by thinking about it.

Now take two minutes to try some 7-11 breathing. Breathe in for a count of 7, and out for a count of 11. The key is to take deep breaths and make the outward, relaxing breath last longer than the inward. Close your eyes if you like, and really focus on slowly breathing out all your tension.

Now score your feeling of anxiety of out 10 again, and notice how it’s gone down a bit.

This simple breathing trick, which you can practise at any time, helps to demonstrate how effectively you can shift your inner state. In my upcoming resources, I’ll describe more techniques specifically for accessing the relaxed state during sex.

With the right training, we are all capable of learning how to ease into sex in a relaxed and confident state, knowing how and when to apply the brakes if we need to. There are a whole wealth of techniques we can use, from breathing and body awareness to advanced mental rehearsal and open focus. When we effectively combine them, we truly learn how to switch back into the control state on demand.

Before coming to see me, Nathan had already tried all the things. He already knew most of the techniques and tips mentioned in my writings. But his anxiety blocked every effort to put them to use, making him feel increasingly hopeless and broken.

We had work to do. But we had plenty to work with, too. Nathan’s imagination was so good at spinning up fears and dire outcomes, it proved adept at envisaging positive change too. With his expectations realistically set, he consistently worked on relaxation and lowering his anxious arousal day-to-day. He stopped searching for quick fixes and focused on utilising the resources he already had.

The more he got things into perspective, the less he felt threatened by sex. He learned how to get his anxiety levels down, which proved useful at work too.

Nathan is putting his sexual self together, probably for the first time. When I last heard from him, he was already having sex again and would you believe… he was enjoying it. By learning how to calmly detach from the end goal, he was able to reach it. Overcomimg premature ejaculation is funny like that.

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