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Treatment:
An aversive reaction is created when an unpleasant emotional reaction is associated with a situation or behaviour. Treatment is aimed at discovering and resolving the underlying problem, and trying to stop the unpleasant reactions when the situation is present.
Medical
History and Examination: to determine if there are any physical causes which can be treated [vaginismus], and explore and deal with past and existing psychological causes [rape, incest].
Drugs: SSRI’s or benzodiazepine [antidepressant or anti-anxiety] drugs protect the woman from anticipatory anxiety and panic attacks. Once these attacks have diminished, and anxiety has been brought under control with medication, sexual tasks are designed progressively so that they don’t provoke anxiety, until the woman can comfortably cope with sexual interactions. Stress management and relationship therapy may be indicated.
Sex Therapy: [2]
Ideally both you and your partner should be involved. Several assignments are suggested, and you should attempt what feels comfortable for both you and your partner, and then each following assignment should start by performing the tasks which have been tolerated and have been comfortable, before proceeding.
All sexual activity, except for those specified in the following assignments is banned.
Your partner may masturbate before or after these activities [not during], in order to relieve sexual tension and reduce resentment and urgency.
Self-pleasuring [see: Sexual Assignments] allows you to recognize which are pleasurable and which are anxiety-provoking sensations which you can then share with your partner. This can should be done on your own, and concurrently with the other assignments. Gradually progress within your level of comfort to include erotic sensations that can be accepted as pleasurable without creating tension or phobic symptoms.
Examples of assignments:
An aversive reaction is created when an unpleasant emotional reaction is associated with a situation or behaviour. Treatment is aimed at discovering and resolving the underlying problem, and trying to stop the unpleasant reactions when the situation is present.
Medical
History and Examination: to determine if there are any physical causes which can be treated [vaginismus], and explore and deal with past and existing psychological causes [rape, incest].
Drugs: SSRI’s or benzodiazepine [antidepressant or anti-anxiety] drugs protect the woman from anticipatory anxiety and panic attacks. Once these attacks have diminished, and anxiety has been brought under control with medication, sexual tasks are designed progressively so that they don’t provoke anxiety, until the woman can comfortably cope with sexual interactions. Stress management and relationship therapy may be indicated.
Sex Therapy: [2]
Ideally both you and your partner should be involved. Several assignments are suggested, and you should attempt what feels comfortable for both you and your partner, and then each following assignment should start by performing the tasks which have been tolerated and have been comfortable, before proceeding.
All sexual activity, except for those specified in the following assignments is banned.
Your partner may masturbate before or after these activities [not during], in order to relieve sexual tension and reduce resentment and urgency.
Self-pleasuring [see: Sexual Assignments] allows you to recognize which are pleasurable and which are anxiety-provoking sensations which you can then share with your partner. This can should be done on your own, and concurrently with the other assignments. Gradually progress within your level of comfort to include erotic sensations that can be accepted as pleasurable without creating tension or phobic symptoms.
Examples of assignments:
- You and your partner sit close together anywhere except in the bedroom, in a relaxed fashion. Be aware of your own and your partner’s bodies and being close, without touching, and settle down until you are comfortable. Proceed to hold hands or put an arm around each other’s shoulders and relax, recognize sensations of tension, and allow them to pass before proceeding. You should start and also set the pace of “pleasuring” each other on exposed parts of the body [massaging face and hands], without concern for arousal. Concentrate on being aware of physical pleasure as opposed to tension. Indicate to your partner if you feel anxious, and relax together without proceeding until you are comfortable.
- Both lie close together on your bed while fully clothed, and become aware of one another’s breathing. Then proceed to do sensate focus exercises on the exposed parts of your bodies, stopping if negative feelings become intense until they are tolerated comfortably before proceeding.
- Lie in your bath (nude) and call your partner to sit with you while you bath. When you are comfortable, ask your partner to soap, wash and dry you.
- Lie unclothed on your bed while your partner is clothed until you are able to relax. Then do sensate focus exercises [See: Sexual Assignments]. As your comfort increases, your partner increases intimacy by undressing, and extends the pleasuring exercise to genital stimulation for you, stopping at any time the phobic sensations arise.
- Gradually, pleasurable sensations should replace phobic sensations within your level of comfort. Progress should be slow but steady.
- Only once you are comfortable and confident then you can proceed to intercourse. As sexual aversion is almost invariably associated with vaginismus, you must be sure that this is treated before attempting intercourse [See: Sexual Pain in Women].
