I had heart surgery to insert a mechanical valve and now I can hear it ‘ticking’ away loudly when I am on top during intercourse. I can’t stop worrying about the noise. It is a continual spiral and I can’t seem to overcome the fear of losing my erection. What can I do to get over this performance anxiety? Of course, my partner worries that it is her that I don’t find her attractive, but that is not true.
Many people find that intrusive thoughts, images and other distracting stimuli affect their ability to sustain arousal through to orgasm. But if the experience itself is largely imbued with pleasure, the waxing and waning of an erection as a perfectly normal part of the process really doesn’t matter, does it?
The idea that a sexual experience must start with desire or arousal then continue straight through to climax without a hitch is simply mythology. Try to embrace this idea and relax. Focus on the giving and receiving of pleasure without having a goal of reaching orgasm in a specific or timely fashion – or even at all. Reframe the sound of your marvellous new heart beating during sex as a testament to the miracle of your sustained existence, your lust for life and your continued capacity for sex. And if you need to use private erotic fantasy to help assuage your anxiety at any point – go for it!
•Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.
•If you would like advice from Pamela Stephenson Connolly on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Submissions are subject to our terms and conditions: see gu.com/letters-terms
