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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Im not sure how long of a question I can ask here, so Ill

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I'm not sure how long of a question I can ask here, so I'll try to keep it brief.

When my mother was young, she was the victim of sexual assault. I believe this is what caused her to raise me with the idea that I should be ashamed of having sexual thoughts about women, and that the whole act of sex was just disgusting in general. As I'm not a professional I can only speculate how this has affected me as I went through my teens/20s. The relationships I had usually only lasted a few weeks. I've had numerous one night stands, and tended to wind up in "friends with benefits" situations frequently. I eventually decided that these pointless "flings" needed to stop.

Fast forward to present day. I've been seeing a woman who I've actually known for some time as a good friend. Her opinion, unlike most of the girls in the past, actually really matters to me. She's got a good head on her shoulders, and is very well balanced. The issue is that in the bedroom I just don't seem to be able to perform. At all. It's happened three times now, and each time I feel worse and worse about myself. This has never happened to me before, and I fear that my paranoia about it is just building up stronger and stronger mental blocks, making it harder and harder to actually get aroused.

I have no idea if this is normal, but I feel like it really isn't. I'm at a loss for what steps I should take, or what kinds of things I can do to try to relieve some of this anxiety.

I hope this wasn't too drawn out, and I really appreciate your time.

Dr. Z :

Hello I believe I can help you with your concern

Dr. Z :

I am so sorry that you are having these issues, I can imagine how distressing this must be for you

Customer:

Yeah it's relatively unnerving, but I'm trying to be more focused on why it's happening instead of being in too much of a panic

Customer:

I appreciate such a quick response by the way

Dr. Z :

I would like to ask if you went to a medical doctor at all to rule out any physical/organic causes for this? Usually we like to rule out the physical causes of possible sexual performance issues before thinking it is a psychological cause, although I do believe that this is a psychological issue as you described it

Customer:

I haven't gone to a doctor for it no. It seems to be specific to this one woman.

Customer:

It has only been over the course of the past month. Earlier in the year I was having absolutely no issues

Dr. Z :

Okay, most likely it is not an organic issue, I just wanted to mention it as a possibility because that is usually what the protocol suggests.

Customer:

oh I totally understand

Dr. Z :

So why do you think this is happening with this woman in particular?

Customer:

I've come with all sorts of reasons. At first I thought I maybe just wasn't all that attracted to her, but I don't think that's the issues as I genuinely enjoy spending time with her. After the first time I had performance issues I just assumed I was stressing myself out over it in a way similar to not being able to sleep if I keep reminding myself how much I really need to get to sleep

Dr. Z :

Okay well there are two approaches that I would like to do, one is the non-medical and one is the medical approach. If you use both combined then it should help with this issue.

Dr. Z :

The non-medical approach would be the use of Cognitive Behavioral Therapy (CBT), which is considered the most evidence based therapy to date to effectively treat anxiety. CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen.

Dr. Z :

So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more objective and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

Dr. Z :

In addition, these two worksheets are very good at helping lessen anxiety symptoms. It can help you focus on the big picture and the objective/positive thoughts and outcomes.

Dr. Z :

Also individuals with anxiety have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your symptoms better.

Customer:

Ok, I think I can do that

Dr. Z :

These two books are also really effective in helping manage anxiety as well.

Customer:

Thank you, XXXXX XXXXX have to check those out.

Dr. Z :

Now CBT is a gradual approach and takes months to be effective, as do most therapies, so this is why I suggest the use of a medication called Wellbutrin, which has anti-anxiety properties and actually helps reverse sexual issues like this so it will help you in the bedroom.

Dr. Z :

The Wellbutrin will usually start to be effective for you in around 2-4 weeks on average and unlike other antidepressant/anti-anxiety medications this will not hurt your sexual libido, but in fact will enhance it.

Customer:

I had toyed with the idea of seeing a therapist for a handful of issues in the past. This is sounding like it may be a good idea to follow up on that. Is wellbutrin something that would be prescribed through them? Or should I still go talk to my doctor?

Dr. Z :

You can go to a general doctor or a psychiatrist for the Wellbutrin, it is a safe medication and also one that is not addictive

Customer:

That's good to know

Dr. Z :

So I think this is the best plan of action for you right now

Customer:

I appreciate that. I'll give them a shot

Dr. Z :

Anytime, is there anything else I can assist you with?

Customer:

Well I had considered bringing this up with her, and expressing my concerns, but I wasn't too sure if that would just make things harder on myself, or even how to go about explaining it

Customer:

So I guess while I've got you here, do you think it would be a good idea to have that converstion?

Dr. Z :

Well it is a difficult thing to bring up, I would agree with you there, but actually most women are understanding of this. I think she probably already has a general idea of what is going on, so it would not hurt to bring it up, but say that it is an anxiety thing and that is all.

Customer:

Gotcha. Thanks

Customer:

Well I appreciate it. You've given me quite a bit to think about

Dr. Z :

Well I hope I gave you a good game plan on how to approach this though

Customer:

You did

Customer:

thank you

Dr. Z :

Anytime, I am always happy to help. Usually these issues are temporary as you feel more comfortable with her, so I do hope that they go away soon for you. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Customer:

I'll keep that in mind

Customer:

Thanks

Dr. Z :

You are most welcome :)

Customer:

Take care

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