Can Therapy Really Help with Sexual Performance Anxiety?

Sex is supposed to be pleasurable, right?

But for many people, sex doesn’t feel free, confident, or connected; it feels pressured, stressful, and full of second-guessing. If you've ever found yourself overthinking your performance in the bedroom, worrying about how your body is responding, or feeling frozen in moments that are supposed to feel intimate, you’re not alone.

Sexual performance anxiety is incredibly common, but it’s rarely talked about even in therapy spaces. And unfortunately, the silence often makes things worse. The good news? Therapy can help, and not just in a surface-level way. It can address the deeper emotional and relational patterns that keep performance anxiety in place and help you (and your partner) move toward real, connected intimacy.

Let’s break it down.

What Is Sexual Performance Anxiety?

Sexual performance anxiety is a form of anxiety that shows up in sexual situations whether you're about to have sex, thinking about sex, or trying to be intimate with a partner. It can affect people of all genders, sexual orientations, and relationship types.

It often sounds like this:

• “What if I can’t keep it up?”

• “What if I don’t finish?”

• “What if I don’t feel anything?”

• “What if they think I’m bad in bed?”

• “What if my body doesn’t respond the way it’s supposed to?”

• “What if I disappoint them?”

For some, performance anxiety leads to avoidance (e.g., avoiding sex, closeness, or even conversations about intimacy). For others, it shows up during sex as intrusive thoughts, tension, or a sense of being disconnected from your body. This can be frustrating, isolating, and, let’s be honest, deeply painful, especially if it’s affecting your relationship.

Common Causes of Sexual Performance Anxiety

Sexual performance anxiety rarely shows up out of nowhere. It's often connected to one or more of the following:

1. Cultural or religious shame about sex

Messages you received growing up about sex being "bad," "dirty," or only for reproduction can linger in the body and mind, even years later. These messages about sex can lead us to think we are ‘wrong’ for wanting to be intimate or thinking about engaging in sex with our partners.

2. High pressure to perform

Especially for men, there's often pressure to “initiate,” “stay hard,” “last long,” or “satisfy your partner” all while being relaxed and confident. That's a lot of pressure for something that's supposed to be mutually enjoyable.

3. Body image concerns

If you're worried about how your body looks or functions during sex, it's hard to be present.

4. Past sexual trauma or negative experiences

Unresolved trauma or even one awkward, painful, or embarrassing sexual encounter can shape how you feel about intimacy moving forward.

5. Relationship issues

Ongoing conflict, lack of trust, or emotional disconnection can make sex feel like a performance instead of a shared experience.

6. Stress, anxiety, and mental health

Generalized anxiety, depression, and chronic stress (especially from work, parenting, or caregiving roles) can impact desire, arousal, and confidence.

So, Can Therapy Really Help?

Yes, and here’s how. At Embrace Sexual Wellness, we work with individuals and couples who are dealing with the emotional, relational, and physical challenges of sexual performance anxiety.

Therapy can help you:

1. Understand what’s really going on

Performance anxiety is rarely just about what’s happening in the moment. Therapy helps uncover what’s fueling the anxiety, whether it’s past experiences, shame, fear of failure, or relational dynamics. You get to explore your story in a safe, supportive space.

2. Interrupt the anxiety-thought cycle

In therapy, you’ll learn how to identify and challenge anxious thoughts before they spiral into shutdown or panic. This might involve CBT techniques, mindfulness practices, or somatic awareness, all aimed at helping you stay present and grounded during intimacy.

3. Reconnect with your body

Performance anxiety pulls you out of your body and into your head. Therapy helps you rebuild a relationship with your body that feels safe, attuned, and responsive, not judgmental or critical. This can be especially healing for people who’ve experienced dissociation or discomfort during sex.

4. Communicate with your partner more openly

If you're in a relationship, therapy can support both of you in having honest, shame-free conversations about sex. You’ll learn to express needs, set boundaries, and understand each other’s triggers so sex becomes a space of trust, not pressure.

5. Heal from past experiences

Whether you’ve been through trauma, rejection, or simply years of sexual avoidance, therapy offers a chance to heal. You don’t have to carry the weight of old experiences into every intimate moment.

6. Create a new sexual narrative

Instead of sex being about performance, pressure, or expectation, therapy helps you define what you want sex to mean. Perhaps it’s connection, pleasure, playfulness or safety or a combination. You get to rewrite the script.

What to Expect in Sex Therapy

You don’t have to show up with all the answers. You don’t need to be in crisis. You just need to be willing to be curious and honest with yourself and your therapist.

We’ll create a space that’s affirming, nonjudgmental, and tailored to you. Some clients come for individual therapy; others come as a couple. Either way, therapy is always consent-based, collaborative, and deeply respectful of where you are in your journey.

We often hear clients say things like:

“I wish I’d started this sooner.”

“I am so relieved I found you to help us.”

“I thought I was broken, but I just needed someone to help me understand what was really going on.”

You’re not broken. You’re human. And you don’t have to figure this out alone.

Sex Therapy in Chicago

At Embrace Sexual Wellness, we offer specialized comprehensive care in sex therapy that targets your goals. While we are based in Chicago, Illinois, we’re also licensed to support clients in Idaho, Indiana, Kansas, and Louisiana. Whether you're local or working with us virtually, you’ll receive compassionate, expert care grounded in science and rooted in human connection.

TLDR

Sexual performance anxiety can make intimacy feel like a test you’re always failing, but it doesn’t have to stay that way. Therapy can help you understand your anxiety, shift your mindset, reconnect with your body, and build a sex life that actually feels good for you and your partner. You don’t need to power through, shut down, or pretend everything’s fine. You can talk about it. You can work on it and find new strategies to approach intimacy with more ease.

16 Ways Shame Shows Up During Sex and How It Can Impact Your Relationship

Shameful messages about sex often stem from societal, cultural, religious, and familial beliefs that label certain sexual behaviors, desires, or identities as "wrong," "dirty," or "immoral." These messages can deeply affect how people perceive themselves and their sexuality. Here are some common shameful messages about sex:

1. Sex is Only for Reproduction

• Message: "Sex is only acceptable if it's for having children or in a committed marriage."

• Impact: This message shames people who engage in sex for pleasure or outside of traditional marriage, reinforcing the idea that sexuality is only valuable when linked to reproduction or procreation.

2. Sex is "Dirty" or "Wrong"

• Message: "Sex is inherently dirty or sinful, and people who enjoy it are morally flawed."

• Impact: This leads to feelings of guilt or shame about sexual desire or activity, even within consensual, healthy relationships. It may also foster a sense of "uncleanliness" after sex, making it harder to embrace sexual expression as a natural part of life.

3. Women's Sexuality is Shameful

• Message: "Women should not express desire or pleasure in sex; they should be passive, chaste, or only interested in sex for their partner's sake."

• Impact: This message can lead to women feeling ashamed of their sexual desires, fantasies, or pleasure, and might cause them to suppress or ignore their own needs. It can also reinforce the idea that women’s sexual pleasure isn’t as valid as men’s.

4. Sexual Fantasies are Wrong

• Message: "Having sexual fantasies, especially about taboo subjects, makes you a bad or immoral person."

• Impact: This message induces guilt about natural fantasies, which are a normal part of human sexuality. People may feel embarrassed or ashamed about their thoughts, even though fantasies are private and don't necessarily reflect real-life desires.

5. Sex Outside of Heterosexual Marriage is Bad

• Message: "Sex is only acceptable within a heterosexual, monogamous marriage."

• Impact: This message stigmatizes LGBTQ+ people, those who practice polyamory, or people who have casual sex. It can foster shame about one's sexual orientation, relationship structure, or sexual choices.

6. Sexual Repression is Virtuous

• Message: "People should remain sexually abstinent or 'pure' until marriage."

• Impact: This can create shame for anyone who has sex outside of marriage, leading to feelings of self-judgment, fear of rejection, or fear of being perceived as "loose" or immoral.

7. Sex is Only About Physical Performance

• Message: "Sex is all about physical performance and pleasing your partner; if you fail to meet certain standards, you’re a failure."

• Impact: This message pressures individuals to view sex solely through the lens of performance and appearance, which can lead to body shame, anxiety, and a fear of not measuring up in bed.

8. Pleasure for Women is Less Important

• Message: "It doesn’t matter if women orgasm or enjoy sex; their role is to satisfy the man."

• Impact: This creates shame for women who experience difficulty with orgasm or feel their pleasure isn't as important as their partner's. It can also lead to feelings of inadequacy and emotional disconnection in sexual relationships.

9. Men Should Always Want Sex

• Message: "Men are always sexually ready and should be the initiators of sex."

• Impact: This puts pressure on men to constantly desire sex, making it difficult for them to express discomfort, fatigue, or disinterest in sex without feeling inadequate or "less manly." It can also ignore the complexity of men’s emotional and physical needs.

10. Masturbation is Wrong

• Message: "Masturbating is sinful, shameful, or unnatural."

• Impact: This message creates guilt around self-pleasure, making it difficult for people to embrace their own bodies and sexual needs. It can also foster shame in exploring one's own sexual desires.

11. Sexual Abuse is the SURVIVOR’S Fault

• Message: "If you were sexually assaulted or harassed, you must have done something to provoke it."

• Impact: This harmful narrative places blame on survivors of sexual violence, leading to shame, guilt, and a reluctance to seek support or speak out. It can also discourage survivors from seeing themselves as worthy of respect, consent and pleasure.

12. Sexual Diversity is Unnatural

• Message: "Anything other than heterosexual sex between a man and a woman is unnatural, sinful, or perverted."

• Impact: This message stigmatizes LGBTQ+ individuals, making them feel that their sexual identity and orientation are wrong. It can cause significant emotional distress and contribute to feelings of isolation and shame.

13. Sex is Only for Young People

• Message: "Sex is for the young and desirable, and older people or those with disabilities shouldn’t have sex."

• Impact: This can create shame around aging or physical limitations, making people feel that they are no longer sexually valuable or worthy of intimacy once they get older or experience changes in their bodies.

14. Sex is Always Supposed to Be Spontaneous

• Message: "Sex should always feel spontaneous, passionate, and effortless."

• Impact: This can make people feel ashamed of their need to plan for sex or incorporate communication and effort into their sexual lives, as it assumes that sex should just "happen" naturally. It ignores the reality that sexual relationships often require communication, care, and intentionality.

15. Consent Doesn't Matter if You're in a Relationship

• Message: "If you're in a relationship, you don’t need to communicate or ask for consent because sex is an assumed part of the relationship."

• Impact: This can lead to the invalidation of a person's right to say "no" or set boundaries, fostering a sense of shame if they ever feel uncomfortable saying "no" to sex or questioning consent.

16. Shame Around "Virginity"

• Message: "Your worth or purity is tied to being a 'virgin.' Losing your virginity makes you less valuable or 'dirty.'"

• Impact: This creates intense shame for individuals who haven’t had sex, or for those who have lost their virginity in ways that don't align with cultural expectations, such as without love or in casual situations.

These messages often lead people to feel alienated, confused, or guilty about their sexuality. It can take time and effort to unlearn them and replace them with healthier, more open views of sex and sexuality. Cultivating sexual self-acceptance and seeking supportive, non-judgmental spaces for exploring sexuality can help challenge these shameful messages and promote a healthier relationship with one's sexual self.

5 Somatic Techniques for Self-Soothing

In the hustle and bustle of modern life, finding moments of tranquility can seem like a challenge. Amidst the chaos, people utilize somatic techniques to approach healing and self-soothing. These practices delve into the intricate connection between the mind and body, offering a pathway to release tension, ease anxiety, and nurture inner peace. In this blog, we'll explore somatic techniques, how they can be practiced for self-soothing, and their effectiveness in promoting nervous system relief.

What is Somatic Healing?

Somatic healing is an integrative approach that recognizes the interconnectedness of the body and mind in processing emotions and experiences. Unlike traditional talk therapy, somatic therapy focuses on bodily sensations, movements, and postures to address underlying issues contributing to stress, anxiety, and trauma. By engaging the body's wisdom, somatic techniques facilitate the release of pent-up emotions stored within the nervous system, paving the way for profound healing and self-awareness.

5 Somatic Therapy Techniques to Try

1. Deep Breathing

Begin by finding a comfortable seated or lying position. Close your eyes and take slow, deep breaths, allowing your belly to expand with each inhale and contract with each exhale. Focus your awareness on the sensation of the breath entering and leaving your body. This simple yet powerful technique activates the parasympathetic nervous system, promoting relaxation and reducing stress.

2. Progressive Muscle Relaxation

Find a quiet space where you can lie down comfortably. Starting from your toes, tense each muscle group in your body for 5-10 seconds, then release and relax completely. Work your way up through your legs, abdomen, chest, arms, and neck, paying attention to any areas of tension. Progressive muscle relaxation helps to relieve physical tension and promotes a sense of calmness throughout the body.

3. Body Scans

Sit or lie down in a comfortable position, allowing your body to settle into a relaxed state. Bring your attention to different parts of your body, starting from the top of your head and moving down to your toes. Notice any sensations, tension, or discomfort without judgment, simply allowing them to be present. Body scans cultivate mindfulness and promote self-awareness, helping to dissipate stress and anxiety.

4. Grounding Techniques

Find a stable surface to sit or stand on, such as the floor or solid ground. Take a moment to notice the sensation of your feet making contact with the surface beneath you. Imagine roots extending from the soles of your feet, anchoring you to the earth below. Take slow, deep breaths as you visualize yourself grounded and supported by the earth's energy. Grounding techniques help to stabilize the nervous system and promote a sense of security and stability.

5. Gentle Movement

Engage in gentle movement practices such as yoga, tai chi, or qigong to reconnect with your body and breath. Focus on slow, deliberate movements coordinated with your breath, allowing tension to melt away with each mindful gesture. Gentle movement practices enhance body awareness, promote flexibility, and facilitate the flow of energy throughout the body, supporting nervous system relief and self-soothing.

Effectiveness of Somatic Techniques for Self-Soothing

Somatic techniques offer a holistic approach to self-soothing by addressing both the physical and emotional components of stress and anxiety. By tuning into bodily sensations and utilizing breath, movement, and mindfulness, these practices help to regulate the nervous system, promote relaxation, and cultivate a sense of inner calm. Whether it's through deep breathing, progressive muscle relaxation, body scans, grounding techniques, or gentle movement practices, somatic techniques effectively empower individuals experiencing PTSD-like symptoms to tap into their innate capacity for healing and self-awareness. A 2021 study suggests that engaging in these somatic techniques is effective for both traumatized and non-traumatized populations. Their effectiveness with other specific disorders and symptom sets are promising but currently being studied.

What is the Most Effective Somatic Technique?

The effectiveness of somatic techniques varies from person to person, as each individual may resonate differently with specific practices. In my experience with clients, they report that the five techniques described above are particularly helpful with stress or anxiety responses in the body. Deep breathing is a great option if you are in public as it tends to be more accessible and discreet. Progressive muscle relaxation can be helpful when you are feeling tight or clenching muscles or when you are having difficulty falling asleep. Body scans are a great way to start your day as it reinforces the mind-body connection before going about your routine. Grounding techniques seem to be most effective with clients that feel stuck in rumination and want to feel more connected to reality. If engaging in the techniques outlined above prove difficult or there is a feeling of disconnection from your body, somatic-based psychotherapy can help people reintegrate the mind-body connection.

TLDR

Somatic techniques offer a practical pathway to self-soothing and nervous system relief by leveraging the body's innate wisdom. Deep breathing, muscle relaxation, body awareness, grounding, and gentle movement practices provide accessible tools for managing stress and anxiety, fostering inner peace amidst life's demands. Seeking help to reintegrate the mind-body connection can be done through working with a somatic therapist.