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, Robert J. Filewich PhD, Ken Rosenberg MD, David Folk Thomas
Though erectile dysfunction and other sexual hindrances can have biological causes, for many the problem is psychological. Performance anxiety can be a serious obstacle to a fulfilling sexual relationship, but it can also be overcome. Join our panel of experts for a live discussion of its causes and cures. Viewers are encouraged to submit their questions in advance, or during the live program.
DAVID FOLK THOMAS: Welcome to our
webcast. I'm David Folk Thomas, and our topic tonight is
performance anxiety. I'm a little anxious,
myself. To put that into perspective -- I think most of you know
about that -- it's mostly erectile dysfunction, and to put that in
even more lay terms, when guys have trouble "getting it up."
Joining me to discuss this and help bail me out of this a little bit are
two experts. On my left is Dr. Robert J. Filewich.
He's a clinical psychologist specializing in anxiety
disorders. He's also the Executive Director for the
Center for Behavior Therapy. That's in White Plains, New
York. Sitting next to Dr. Robert Filewich is Dr. Ken
Rosenberg. He is a psychiatrist affiliated with New York
Presbyterian Hospital and Cornell University Medical Center in New York
City. He's also in private practice in New York,
specializing in substance abuse and sexual disorders. I had a little
performance anxiety there, gentlemen, but let's get right down to
it. Dr. Filewich, what is performance
anxiety? ROBERT J. FILEWICH, PhD: Performance anxiety, in
sexual terms and with sexual problems, is where a person has an
anticipation of some sort of problem occurring in the sexual
act. As a consequence of that, they develop a sense of anxiety
which translates into an inability to become erect or an inability to go
ahead and have sex for a certain duration before they actually achieve
orgasm, or premature ejaculation. DAVID FOLK
THOMAS: Dr. Rosenberg, your turn. KEN ROSENBERG,
MD: Performance anxiety refers to just what Dr. Filewich
said. It's more of a popular term than a medical
term. You can't really find "performance anxiety" in a
medical book. It's the common term for erectile
dysfunction or impotence. It also can lead to premature
ejaculation in some. We were not made to be anxious and have sex
at the same time. When we're anxious, we're
running away from dinosaurs, we're not ready to have
intercourse. So our plumbing does not work when we become
anxious, and therefore when we're extremely anxious we just
can't perform very well sexually. ROBERT J. FILEWICH,
PhD: And the anxiety is usually fear-based.
It's the sense of fear of being rejected, fear of performing in a
certain way where you're partner's going to be
disappointed.
DAVID FOLK THOMAS: Does that happen
with couples? Does it happen when you're just meeting
somebody for the first time, or does it matter? ROBERT J. FILEWICH,
PhD: It doesn't matter. KEN ROSENBERG,
MD: There are so many reasons. There are immediate
causes, there are deeper causes. Erectile dysfunction is so
multi-determined it ultimately is a biological phenomenon.
It's ultimately a fact of the blood staying in the
penis. Why or how the blood stays in the penis could be any
number of reasons from psychological to biological to cultural reasons, as
well. DAVID FOLK THOMAS: Does this always manifest -- I
guess the stereotype seems to be you're ready for sex, maybe
you've even been turned on prior to getting down to the wire, and
then right when you're ready to go the wind goes out of the sails,
so to speak?
ROBERT J.