1st Edition

Overcoming Anxiety in Sex and Relationships A Comprehensive Guide to Intimate and Emotional Freedom

By Paula Leech Copyright 2025
    308 Pages
    by Routledge

    308 Pages
    by Routledge

    This book gives readers an accessible and comprehensive understanding of how anxiety, stress, and pressure can have a profound impact on pleasure, connection, and sexual functioning, offering practical tips and techniques for resolving common sexual struggles.

    Anxiety can influence a multitude of aspects that make us who we are, changing how we move through, make meaning of, and interact with the world around us. Paula Leech begins by defining anxiety and how it affects our physiology before guiding readers to identify some of the primary sources of anxiety in their lives, such as family, gender, culture, religion, relationship dynamics, and sexual trauma. Encouraging clients to take responsibility, she offers alternative ways of conceptualizing and defining sex, sexuality, sexual values, and a client’s ongoing sexual development as a way of addressing some of the emotional, social, and psychological barriers to intimacy. Practical and engaging, this book includes mindfulness and embodiment exercises to help clients release stored tension, work through specific sexual struggles and “dysfunctions,” and deepen their connections with their body.

    This guide is essential reading for established and training sex therapists as well as for those who experience anxiety-based sexual challenges with their partner.


    Introduction: What Sex Asks from Us


    Part 1: Anxiety and Sex


                  1            What is Anxiety?

                  2            Sex as Natural Function

                  3            Physiology and Sexual Functioning (Vaguely Defined)

                  4            Performance, Goal Orientation, Strive Mindset

                  5            Mind/Body Connection and Disconnection

                  6            Emotion, Prediction, and Association

                  7            Putting it All Together: A Word About Pleasure


    Part 2: What is My Anxiety Trying to Teach Me?


                  8            Arrested Development

                  9            Family Matters

                  10          Your Relationships

                  11          Disconnection

                                 “What Did My Ancestors Hope for Me?” Serena Payan-Hazelwood, MAIS, CSE

                  12          Insecurity and Confidence (Your Relationship to You)

                                 Gay Men and Body Categorization/Celebration, Dr. Israel Martinez, LCSW, CST

                  13          Sexual Prowess and Inexperience

                  14          Sex and Aging, Sex and Death, Grief in Sex

                  15          Sexual Trauma

                                 Racism, Trauma, Worthiness, and Sexuality, Dr. Candice Hargons

                  16          Sex as Pathology (Fantasy, Porn, Kink)

                                 Kink as Shame, Kink as Cure, Abbie Nederhoed, LCSW

                  17          Sex “Addiction”


    Part 3: Divorcing Anxiety from Your Sex Life: Actionable Steps


                  18          Taking Responsibility

                  19          Identifying and Managing Distancing Strategies

                  20          Mindfulness and Sensate Focus

                  21          Basic Practice

                  22          Advanced Practice: Erectile Dysfunction and Vaginismus


    Conclusion: Trust Fall


    Paula Leech, LMFT, CST-S, is a certified sex therapist who has worked with individuals, relationships, and families in private practice for over 10 years. She mentors sex therapists-in-training, and teaches at various institutes across the US and Canada.

    Overcoming Anxiety in Sex and Relationships is a refreshing resource that teaches readers how to build a more compassionate, mindful, and empowered relationship to the very human experience of anxiety so they can make more space for play and pleasure in their lives - something we all need and deserve more of.”

    - Anne Hodder-Shipp, CSE, award-winning sex and relationship educator, instructor, and author of Speaking from the Heart: 18 Languages for Modern Love

    "Overcoming Anxiety in Sex and Relationships is a right-on-the-mark resource at a couldn't-be-more perfect time! In a post-quarantine, COVID world with volatile, global geo-political violence, a domestic epidemic of daily shootings, and an unprecedented erosion of reproductive rights and sexual freedoms, it seems anxiety, stress and worry have become the societal norm, impacting individuals and couples in profound ways.  This easy-reading book is invaluable -- not just a great resource for sex therapists and counselors, but for anyone looking to understand how emotion, physiology and socialization combine to create obstacles to the kind of sex we want -- and most importantly, it helps us find our way through them.  Paula has taken her years of training in sex therapy and deftly condensed and simplified complex therapeutic topics, making her advice to readers approachable, relatable and actionable."

    Dr. Richard Siegel, PhD, sex therapist & supervisor, educator & trainer, author & researcher, and Co-Director of Modern Sex Therapy Institutes