Role of the Sex Therapist in the

Management of Vaginal Pain.

An Integrated Approach.

SEX THERAPIST

FAI

www.sexualfocus.com.aufai-kur@sexualfocuswa.com.au

0412 147 917

Sexual Focus …

Some stories are so sad you just want to cry with them, for them.

I get upset, frustrated, angry!

It can take them years to find out what’s wrong.

Gp’s . Gyni’s . Counsellors often have no clue about sexual pain

How long have they been searchingfor answers?

How many people have they gone to?

All of these experiences affect them.

HOW DID THEY FIND OUT WHAT MIGHT BE WRONG? HOW LONG DID IT

TAKE THEM?

Relationship Concerns

Ways of introducing or re-establishing intimacy

He is scared to touch me now

He never touches me – not in anyway

I don’t want him to touch me –

my body just rejects him

it makes no sense I want it and then my body fails me

If I don’t sort this out he will leave me

It feel like we are just friends

WHY THEY COME IN TO SEE METhey might say:

They might sayI don’t know what’s wrong with meSex hurtsI don’t feel like a womanI’m not normalIt hurts, it can’t get in, we have tried and triedDo I have a vaginaDoctors tell me they can’t see anything that’s wrong down thereWho will want meAll of my friends talk about the amazing sex they are having – I just sit there quietly and say nothing.

We want a baby / family pressure to have a baby

Fear of the process

Fear of the pain

Embarrassed about not being normal,

Not feeling like a real woman.

Revealing their body to you

This now means they will have to do something about it

They may have had a negative experience in the past

e.g. with a gyni

Or physio didn’t seem to work

BARRIERS TO REFERRING MY CLIENTS TO YOU

Calling us a sex Therapist may not be the way to go with all clients.

They are not even having sex yet so how can we help them.

* Create a title that matches where your client is at

They may not be ready to talk to someone about this

How can talking help

Fear of being judged

Will I reveal something that they don’t want to know.

Why refer? … The list is endless

REFERRING THEM TO A SEX THERAPIST

BARRIERS TO REFERRING

in the

Assessment and Management of

Female Sexual Dysfunction

Find out their story

Why they have come in now

What they think the problem is: Libido, Orgasm, Intimacy, Pain

Contributing factors

Ask a crazy amount of questions: Look at history, sexual scripts, beliefs, experiences, relationship factors, kissing, hugging etc.

Ways of communicating with their partner

Other factors: Stress, health, pain, time, family

Also ask how this has affected their partner, what do they say, how do they make you feel about this.

Where is the problem? Her Body, Her response to him, being able to feel aroused, orgasm,

or Is there pain and physical problems we need to review.

Are these Always present or only sometimes.

Was it like this initially or has something changed.

THE ROLE OF THE SEX THERAPIST

Help them understand why they might be experiencing pain

What might be happening in their body

Review the physical experience of pain- When did it start hurting- where does it hurt- How badly does it hurt – does it always feel the same?

Review the Emotion source –

What was happening in your life around then? In the past?

Where you scared that sex would hurt?

The emotional affect it has had on them

SEXUAL PAIN

Is their body actually getting hurt,

Or

or is the pain already there and we are finding it

E.g. neck massage

The physical experience of

The body might be experiencing a whisper

WHAT’S HAPPENING IN THEIR BODY

BUT INSTEAD YOUR BODY IS SHOUTING AT YOU

That’s when I send them to

YOU!!

We work on their Sex lifeYes all the fun bits that don’t include

penetration.

SO WHILE YOU GUYS DO AN AMAZING JOB HELPING THEM

ANDI DO AN AMAZING JOB

MOTIVATING THEM, SUPPORTING THEM ANDWORKING THROUGH ANY PAST, OR PRESENT ISSUES THAT MAY BE AFFECTING

THEIR PROGRESS

Would you like to know how I talk to my clients about

Libido

Intimacy

Sexual Arousal

Desire

I’m going to take you on a Journey

How I break these down for them and help them get back in touch

with their own body and their partners body, while working on

their sexual health concerns in tandem

BE A FLY ON MY WALL…

Relationship

Intimacy

Pain, Fear, Understanding pain, the message the body is sending them, motivation

Self Image, Self Esteem, Identity, Past, Present Future….

HOLISTIC APPROACH

The body does not know that they are safe. It has learned over time that Intimacy can lead to sex > Can lead to touch

> Can lead to a pain

We need to slowly let it know (The Amygdala) that you are safe

Otherwise it might do you a huge favour and make sure you have no desire or arousal -to protect you from moving

towards intimacy and sex.

Physios might do this through breath work to help clients relax the muscles.

I get them to do this as a pathway through touch and intimacy

AIM – GO SLOW-LET THE BODY KNOW IT”S SAFE

SLOWLY MOVE TOWARDS AROUSAL AND DIRECT

TOUCH

Where did their libido go? Why their body can’t feel pleasure

How was it in the past?

Did they enjoy it?

What does intimacy mean to them?

How is it now?

What do they want more of, less of?

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Who initiates now?

How do they respond?

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Do they engage in foreplay?

What did they used to do?

What do they do now?

Do they enjoy foreplay?

Is their body able to get aroused?

CONNECT INTIMATELYINTIMACY | FOREPLAY

We want to know more about them

Do they Know what sex is

• Do they know that the penis can fit into the body

• Some have done nothing but try to push the penis

inside her (no touch, no kissing – nothing)

• Cultural factors

Prior to entering the bedroom

Why are they trying to be intimate?

Connection, love, communication.

Coming from a heart connection

Viewing him as the person she loves, cares about

(may not be right for all clients)

I Try help them find a WHY be intimate that is different to just achieving Penetration

While working with me we are working on ‘all the stuff’ that we desire to happen before penetration is even considered.

Helping to validate their exploration of intimacy, touch and foreplay

Helping them to connect with each other and helping her connect with her body, helping him connect with his, (Explore

their story and other barriers to intimacy)

WHY ENGAGE IN INTIMACY

Helping him work through issues that have arisen for him

e.g. wanting her even though he knows it might hurt her

Having not had penetrative sex

Feeling helpless

When trying to penetrate he may loose his erection

His libido may have been affected

Permissions for him to having feelings about the situation

Help him understand the situation better

The role that sexual arousal and desire will play as they move

forward in their relationship.

If spilling seed is an issue then this adds a new layer to the conversation.

Most religions will allow this if it’s viewed as medical, temporary, necessary.

I can talk to their Priest, Rabbi etc

HELPING HIM

The community is blessed to have you guys

Saving lives and families!

We need you.

Go out there and be AMAZING!

Thank youxxx Fai xxx

www.sexualfocus.com.au

THANK YOU

SEX THERAPIST

FAI

www.sexualfocus.com.aufai-kur@sexualfocuswa.com.au

0412 147 917

Sexual Focus …