Can Therapy Really Help with Sexual Performance Anxiety?
If you’ve ever found yourself overthinking in the middle of an intimate moment worrying about whether your body is “doing what it’s supposed to,” questioning your ability to perform, or feeling more anxious than connected, you’re not alone.
Sexual performance anxiety is one of the most common issues we help clients work through at Embrace Sexual Wellness. While it can be deeply distressing, it’s also highly treatable with the right support. In this post, we’ll explore what performance anxiety looks like, where it comes from, and how sex therapy can help you (or you and your partner) move toward a more connected and fulfilling sex life.
What Is Sexual Performance Anxiety?
Sexual performance anxiety involves persistent worry about how you’ll “perform” during sex—whether that’s maintaining arousal, achieving orgasm, satisfying your partner, or simply feeling like you’re “doing it right.”
It often manifests as:
Difficulty getting or maintaining an erection
Premature ejaculation
Trouble reaching orgasm
Lack of arousal or interest, despite wanting to be close
Feeling physically present but emotionally disconnected
Avoiding sex altogether
While the symptoms are physical, the root causes are often emotional, psychological, or relational.
What Causes Sexual Performance Anxiety?
There’s no one-size-fits-all explanation. For many of our clients in Chicago and beyond, performance anxiety is a mix of several factors:
1. Cultural or Religious Messaging
Growing up with shame-based or restrictive views around sex can make it difficult to feel confident, relaxed, or deserving of pleasure.
2. Perfectionism and Pressure
If you’ve internalized the idea that sex should always go a certain way, or that your worth is tied to your sexual “success”, you may feel immense pressure during intimacy.
3. Body Image and Self-Esteem Issues
Concerns about how your body looks or functions can take you out of the moment, increasing anxiety and reducing pleasure.
4. Past Negative or Traumatic Sexual Experiences
A single experience of rejection, pain, or trauma can have long-term impacts on how safe and confident you feel during sex.
5. Emotional Disconnection in the Relationship
If you and your partner are feeling distant, misunderstood, or overwhelmed with other life stressors (like parenting or work), sex may become a source of tension rather than connection.
6. Underlying Mental Health or Stress
Generalized anxiety, depression, burnout, and even untreated ADHD can affect arousal, attention, and sexual function.
How Sex Therapy Helps with Performance Anxiety
The good news is that you do not have to live with performance anxiety long-term. Sex therapy, especially when provided by a qualified and experienced therapist, offers a structured, nonjudgmental space to explore what’s happening beneath the surface and learn new ways to approach intimacy.
Here’s how therapy can help:
1. Normalize and De-Shame the Experience
One of the most immediate benefits of therapy is hearing that you are not alone. Performance anxiety is common, and it is treatable. Therapy can help you understand the physiological and psychological reasons it’s happening—and reduce the shame that often makes it worse.
2. Interrupt the Anxiety Loop
Sexual anxiety is often reinforced by a cycle: you worry you won’t perform well, your body reacts to that stress, and the reaction confirms your fear. In therapy, we use cognitive and somatic tools to break that loop, helping you stay grounded in your body and connected to the moment.
3. Develop a Healthier Relationship with Sex
Therapy helps you reframe sex as a space for connection, exploration, and mutual pleasure—not performance or pressure. Over time, this shift can reduce anxiety and improve your ability to enjoy intimacy.
4. Incorporate Mindfulness and Body-Based Tools
Anxiety around intimacy gets in the way of being able to feel in the moment during sex. Many clients benefit from structured mindfulness practices that increase awareness of sensation and reduce intrusive thoughts. Sensate focus exercises and meditation, for example, can reintroduce physical touch in a way that feels safe and pressure-free. Developing a meditation practice may help reduce sexual anxiety and help people feel more present in the moment.
5. Improve Communication with Your Partner
Trying to grapple with anxiety alone, especially when it involves partnered sex, can be paralyzing. That’s why it can make a world of difference to be transparent about your feelings and experience with your partner(s). Perhaps there are certain activities you can agree on that would ease some of the anxiety.
If you’re in a relationship, sex therapy can help both of you understand each other’s perspectives, reduce blame, and create a shared language around intimacy. We often see that when communication improves, performance anxiety naturally decreases.
6. Heal Underlying Emotional or Relational Wounds
Whether it’s unresolved trauma, long-term avoidance, or emotional disconnect in the relationship, therapy offers a safe space to unpack the roots of anxiety and move toward repair.
What to Expect in Sex Therapy
At Embrace Sexual Wellness, based in Chicago, we specialize in helping clients with performance anxiety, low libido, and relational disconnection. Therapy is always collaborative, we’ll move at your pace, explore your concerns with compassion, and build tools that are practical and personalized.
You do not need to be in crisis to start therapy. Many of our clients begin therapy when they notice avoidance, frustration, or tension around sex and want to address it before it gets worse.
We offer both individual counseling and couples therapy, virtually or in-person at our Chicago office, and are licensed in Illinois, Indiana, Idaho, Kansas, and Louisiana.
Why Local Care Matters
If you’re searching for a “sex therapist near me” or a “sex therapist in Chicago”, you may already know that finding someone who understands your situation including your values, your pace of life, your relationship dynamics, makes a difference.
As a Chicago-based therapy practice, we understand the unique pressures of city living, career demands, parenting stress, and the challenges that high-functioning individuals and couples often face in their intimate lives. Our approach is evidence-based, trauma-informed, and always tailored to your real-world experience.
When to Seek Support
You don’t have to wait until things fall apart to seek help. You may benefit from sex therapy if:
You regularly feel anxious or disconnected during intimacy
You or your partner avoid sex due to fear or pressure
You’re stuck in cycles of miscommunication or shutdown
Physical symptoms like erectile dysfunction or lack of arousal persist without medical cause
You want to rebuild a satisfying and sustainable sex life
Next Steps
If you're in the Chicago area and looking for a sex therapist you can trust, we’re here to help.
You can schedule a free consultation to learn more about our approach. Whether you're looking for individual therapy, couples work, or just a place to talk honestly about what’s going on, we’re ready when you are.
