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Performance anxiety can block natural sexual arousal by diminishing the pleasurable sensations that would produce them. Marty Klein, sex therapist and author of Sexual Intelligence: What We Really Want from Sex and How to Get It, describes this experi­ence. "Many people are watching themselves during sex more than they are experiencing sex, which typically undermines sexual enjoyment" (Klein, 2012a, p. 16). For example, a woman monitoring how aroused she is because she believes that she should have an orgasm during a sexual experience—and she should hurry up about it—can inter­fere with her experiencing the physical and emotional feelings that could arouse her

(Lavie-Ajayi & Joffe, 2009). Studies found that men were more likely than women to be distracted by performance concerns during sexual experiences (Meana & Nunnink, 2006; Nelson & Purdon, 2011) A transitory sexual problem, such as an inability to achieve an orgasm or erection because of fatigue or just not being in the mood, can produce enough anxiety for the problem to occur in the next sexual encounter as well (Benson, 2003). Problems with erectile dysfunction frequently begin with the worry that follows a first-time incident. Inhibited orgasm in both men and women can result from extreme performance pressure and an inability to be "selfish" and pursue one’s own heightened arousal instead of focusing on the partner’s pleasure (Apfelbaum, 2000).