We all know that feeling. That pesky little voice in our head that tells us we're not good enough, smart enough, or sexy enough. It's the voice of anxiety, and for a lot of us, it can be debilitating. Anxiety can make it difficult to focus on anything else but our own perceived flaws. 

So how does anxiety interact with desire? For starters, anxiety can make us feel undeserving of love or pleasure. It can also cause us to doubt ourselves and our partner's feelings for us. Worst of all, it can keep us trapped in negative thought loops that prevent us from enjoying ourselves or our relationships. We see this often in sex therapy and relationship therapy sessions at Rouse.

We can think of anxiety and desire as incorporating two distinct systems in our body, nervous systems to be exact. Our arousal and desire are connected to our parasympathetic nervous system while anxiety and stress activate the sympathetic nervous system. 

What does that mean? For the most part, your body and your physiology can’t get turned on and aroused when you’re facing stressful situations. Under stress and anxiety your sympathetic nervous system is activating necessary hormones to adapt into survival mode, which in turn shuts down your parasympathetic nervous system. Your parasympathetic nervous system is more known for its “rest and digest” speed. 

Your parasympathetic nervous system is to thank for allowing more of the necessary blood flow and muscle relaxation associated with intimacy and sex. 

Side note: Sex anxiety can show up in a few ways.  We’ll cover when stress and anxiety can lead to A LOT of sexual activity in later articles. 

A few things can cause someone’s sympathetic nervous system to get activated even in the face of consensual sexual experiences. Some examples being:

• Negative body image

• Resentment towards a partner 

• Some substances like stimulants 

• Trauma history

• Distrust of partner

• Painful sex like vaginismus 

• High expectation of performance of sex or definition of “successful sex”

• Gendered expectations related to body image and/or performance

Reflect on this:

Has anxiety ever been a barrier to being present during sex or vulnerable moments? What do you think was contributing to this experience? Anything on the list above resonate with you? Would you add anything?

There’s no pressure to have an answer right away. Take some time reflecting on this prompt.

Articles like these can be helpful for those who experience sex anxiety, but also for their partners and therapists. For partners, it can help them understand that it’s not a reflection of their attraction to you,as well as give insight towards ways of offering support. For therapists, if not already known it can be useful to help your client narrow down their underlying issue.

Further reading:

I recommend checking out Bonk by Mary Roach for further reading on the history of studying sex. This is a pretty entertaining read that also includes studies on sex and sexuality.

Press mentions:

I recently had the wonderful opportunity to participate in an expert roundup of sex therapists and coaches on re-igniting sexual desire. Check out some tips I recommend as well as 39 other professionals! It’s a solid collection of a variety of suggestions.

I sat down with Sucias are my Favorite to talk about Confidence and conversations with your partner.

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Talk to y’all next week!

Hearts and handbags,

David Khalili, LMFT

Bio: David Khalili, LMFT is a sex therapist and couples therapist in the San Francisco Bay Area, and founder of Rouse Relational Wellness. He works with individuals and relationships via telehealth focusing on sex and anxiety, multiheritage couples, and burnout. David enjoys spending time with his fam, watching trash TV, and exploring his new found “outdoorsy” self.

Disclaimer: Some links above are affiliate links where the profits go back into providing free comprehensive and sex-positive information.

Rouse Relational Wellness is a sex and relationship wellness center featuring sex-positive, trauma-informed therapy for individuals and relationships. We also offer couples intensives, professional consultations, and workshops. All of our services are available online and our office is located in the Castro district of San Francisco, California. If you would like to learn more about our services, please visit us here.