What are the conditions that make it possible for a person to engage in satisfying sexual behavior?
For a person to become sexually aroused and to function normally, he or she needs to have a feeling of self-confidence, freedom from anxiety, the presence of arousing mental and physical stimulation, and the ability to focus attention on sexually arousing thoughts or behavior. Anything that interferes with these conditions can disrupt a sexual encounter. If one or more of these conditions is routinely absent, an inability to perform can become a lasting problem.
Self-confidence includes a belief that you'll be able to perform sexually, a belief that the partner finds you attractive, and a feeling that the partner has good intentions. If one of the partners routinely belittles or threatens the other, such confidence can be undermined.
Any type of anxiety can lead to an episode of sexual failure. The most common type of anxiety is performance anxiety, in which the person is afraid that he or she won't be able to become aroused and function normally. This fear of failure is self-perpetuating because the anxiety interferes with arousal. The inability to become aroused then increases the anxiety.
In order to become aroused, people generally need the mental stimulation of a partner they love or find attractive, combined with appropriate physical stimulation. The need for direct physical stimulation increases with age.
In order for stimulation to be arousing, it is necessary for a person to be able to pay attention to it. If someone is distracted by thoughts of possible failure or a lack of self-confidence or has concerns about how the partner is reacting, this will distract from the arousing sexual activity.
How can people identify whether their sexual activities or attitudes about sex might be unhealthy?
Unhealthy sexual behaviors generally involve recurrent intense fantasies, urges, or behaviors involving nonhuman objects, children or nonconsenting partners, or lead to suffering or humiliation. Some people can't become aroused unless they imagine or act out such fantasies. In these situations, consulting a health care professional is strongly advised.
Infidelity also may lead to very difficult psychological stresses and, often, a shattering of valued relationships. And sexual activities that result in a sexually transmitted disease have a direct impact on physical health.
When should people seek help for a sex-related problem?
A couple should consider seeking help if they're experiencing repeated failures in sexual performance or when there's strong disagreement about sexual practices that they can't resolve. Performance problems include difficulty getting an erection, lack of sexual desire, difficulty reaching orgasm, premature ejaculation or a lack of satisfaction from sexual activity. Since medical problems can cause sexual dysfunction, the family physician is a good starting point for discussion of these problems. A therapist might be needed to explore marital and psychological issues that could be contributing to the problem.
Last Updated: 12/02/2004
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