[Dr. Pacik]

This is a valuable series of posts whether you are struggling with secondary or primary vaginismus. I agree that dilation is key to successful intercourse, once you overcome the fear and anxiety associated with penetration. It has been my experience that most women dilate incorrectly and this slows their progress. It is a mistake to go directly to the larger dilators. I recommend starting with a small dilator or better a finger to start the physiologic process of natural vaginal dilation which is a normal response to anticipated intercourse. This in association with getting wet makes intercourse easier. It is best to spend a few minutes dilating to the larger sizes, one size at a time to prepare the vagina for penile penetration. The number 7 and 8 glass dilators can be purchased individually at crystaldelights.com crystaldelights.com
Once you have achieved an easier time with penetration you can move more quickly through the steps. Spooning is a comfortable position when first attempting intercourse because both partners are in a relaxed position.
Congratulations on your success!!

[Dr. Pacik]

Avoidance and procrastination seem to go hand in hand as seen in the care of many of my patients. We have made significant progress in this field during the past 10 years. Maze is well trained in the treatment of vaginismus and has continued excellent results. They have a strong team that can get you to where you want to be. The decision to get treatment should not be delayed. Too much depends on it.

[Dr. Pacik]

My patients have often told me that they feel that they were progressing quicker physically (using dilators) than emotionally (progressing to intercourse). Fear and anxiety continue to be overwhelming to many women who struggle overcoming vaginismus. One needs to be aware of this. Overcoming vaginismus is a process that takes time. Support from the partner is helped by tip only intercourse, no thrusting the first few attempts at intercourse. Don’t burden yourself further with feelings of failure, it simply takes time. There are many other problems that sometimes surface including poor lubrication, low libido, inability to orgasm and disgust issues. Getting support from a psychologist skilled in vaginismus counseling can be very helpful.

[Dr. Pacik]

Both Kegels and reverse Kegels work to make dilation easier. Some women find that doing a series of 4-5 strong Kegels, holding the Kegel for a few seconds then completely releasing makes dilator insertion easier. Conversely, inserting a dilator when doing a strong Kegel (reverse Kegel) also works. It just depends on which approach makes dilation easier.
Kegels are over-rated for achieving intercourse without using dilators first.
I agree that using a vibrator can be very helpful in that it relaxes the pelvic floor. An orgasm in association with the use of a vibrator relaxes the pelvic floor even more. This was taught to me by my patients. Dr. Pacik

[Dr. Pacik]

SEXUAL SAFETY

“Understand that if we decide to have sex whether safe, safer, or unsafe, it is our decision and you have no rights in our lovemaking.”
~ Derek Jarman

In the animal kingdom, birds, bees and beasts instinctively know how to reproduce and rear young. They even know to digest specific herbs, shells, bones, and barks to cure disease or rid themselves of parasites, without any veterinarian’s prescription. But human beings must be initiated into sexual life and taught how to keep ourselves safe and healthy. As young people, we learn the mechanics of sexual intercourse mainly by description (often provoking considerable surprise!) And we must study safety. In fact, the evolving social complexity of our species distances us increasingly from our natural instincts. Ironically, our reliance on experienced others for survival rules creates a novel risk, since caregivers may teach the negative, fearful thinking or self-destructive tendencies they learned, and thus lay the groundwork for children’s retraumatization as adults.

Such harm occurs so often that many people don’t feel safe in safety. It isn’t familiar. What’s familiar is having the rug pulled out from under them. Their experience demonstrates why transparency, recovery, and accountability are so important. Only once we’ve learned how to be safe with ourselves–once we’re not unconsciously trying to kill ourselves–can we be, and feel, safe with others. For example, some may see unprotected sex as symbolic of intimacy, freedom, and honesty. But in reality it can be a cold, disconnecting act to ignore personal safety and peace of mind. If someone sees sex as only something that happens between body parts, then, sure, anything less than bare skin can’t satisfy. But when we learn to value our entire body and well-being, healthy sex includes caring for our safety and the safety of others. More explosively intimate than a part touching a part is a heart touching a heart. This sacred vulnerability necessitates the safety of sober love.

DAILY HEALTHY SEX ACTS
• How safe is your sex? Can you distinguish healthy risks from flirting with disaster? On a piece of paper, draw two columns marked “SAFE” and “UNSAFE,” and list your actual and potential sexual and romantic activities in the column that fits.
• Fire Drill Kits are healthy tools to use when triggered. These include phone numbers of your therapist, sponsor, or supportive friends; self-regulating exercises to restore emotional sobriety; and inspirational readings to remind you of your integrity. Assemble a fire drill kit today and keep it close.

From the MIRROR OF INTIMACY book The Daily Meditation Book by Alexandra Katehakis and Tom Bliss

[Dr. Pacik]

Hi Katy
I remember you well and am sorry to hear that you are still struggling. I have had patients who struggled for a 12-14 months post procedure, but with enough effort were able to be successful. This can be very stressful and deflating.
Here are some suggestions:
Send me either your daily dilation logs or let me know what you are up to in a narrative.
I recall you advanced to the #5, but from your post you appear to be stuck at the #4 level. There were indications you needed to advance to #7.
It would be fine to start the lidocaine jelly again either 1% over the counter or 2% with a Rx. This will not hurt you.
Try putting the dilator in the fridge so it is nice and cold when inserting. This may help. A cold dilator can be combined with the lidocaine can be helpful.
When you communicate with me let me know your level of anxiety.
I would be happy to speak to you by phone once I bring myself up to date with your dilation schedule.
Hope this helps.

[Dr. Pacik]

Birth control is well known as a culprit reducing libido and causing emotional changes. There is considerable literature on this topic that is worth reading.
This could be a meaningful topic to discuss on the Forum.

[Dr. Pacik]

I couldn’t agree more. It is so important to overcome the embarrassment of this condition and to think of vaginismus as a medical problem that needs treatment. The only way we will educate the medical community is if we know more than they do and are willing to teach them one clinician at a time.

[Dr. Pacik]

Hi memcna

I am sorry to hear of your difficulties. Your discovery of vaginismus is typical of what women go through who have this condition. Firstly do NOT be embarrassed. You have a medical condition with likely spasm of the entry muscle, much like an uncontrolled tic of the eye over which we have no control.
You need to educate yourself by reading the website. I would also suggest reading my book available from Amazon.com in book or Kindle
http://www.amazon.com/When-Sex-Seems-Impossible-Vaginismus-ebook/dp/B004GNFTNU
If you are able to tolerate some penetration, start off using dilators and use them consistently as described in the book. A DVD on correct dilation can be purchased from[url] Shellie. http://crystaldelights.com/shop/dilators/ [/url]
If you do not make progress I would suggest contacting Maze for further information.
Let us know how you are doing.

[Dr. Pacik]

LONELINESS
“Let me tell you this: if you meet a loner, no matter what they tell you, it’s not because they enjoy solitude. It’s because they have tried to blend into the world before, and people continue to disappoint them.”
~ Jodi Picoult

We always hear that getting love begins with loving our self. Depending on others to ease our pain or erase our loneliness eventually weakens us and, therefore, proves dangerous. If our self is weak and needs other people to prop it up, it can become unable to function and can keep us from attaining emotional self-reliance. This form of weakness keeps us in toxic relationships where mutual using marks the drumbeats of the codependent dance. On the other hand, the absence of family, community and friendship can lead to isolation and depression. Lack of companionship, while seemingly the opposite of emotional dependency, withers our soul equally.

When loneliness is a constant state of being, it harkens back to a childhood wherein neglect and abandonment were the landscape of life. Without consistent, caring contact with adults, a young person will be left with emptiness, uncertainty about personal identity, and a fear of being alone. As is natural for such a child, either using other people to feel better or isolating into an inner world will be the “go to” survival options. But both these choices fail to allow them, as adults, to reach out to others for love, comfort, and companionship as a healthy way of validating and meeting their needs.

Both using people and isolating from them pale in effectiveness compared to seeking genuine human relatedness. If you had to use either of these maladaptive options and now live with loneliness, choosing to fill that void is a herculean feat requiring courage and diligence. Start now. Set the intention to change your pattern, then take one small step to connect sincerely with one other person or with a community. That’s all it takes to begin your ascent out of loneliness. When two people gather with honesty, magic can happen.

DAILY HEALTHY SEX ACTS
• Take a moment to think about your closest relationships. Are they a two-way street? Do they strengthen and nurture both of you, or are you taking advantage?
• Do you know the difference between loneliness and being alone? Being alone and enjoying your own company is a sign of mental health. When you are alone, do you always have the TV or music on for distraction? Can you tolerate silence or does it raise your anxiety? Challenge yourself to a silent experiment this week and turn off all distractions. Are you alone or lonely?

From the MIRROR OF INTIMACY book The Daily Meditation Book by Alexandra Katehakis and Tom Bliss

[Dr. Pacik]

EXALTATION

“The soul is placed in the body like a rough diamond, and must be polished, or the luster of it will never appear.”
~ Daniel Defoe

Exaltation signifies a peak experience–functioning at full capacity in an elevated state. In astrology, a planet is exalted when it’s in the sign allowing its greatest expression (so, only 1/12 of the time). We, too, long for exaltation, but like the planets, our lives achieve it only rarely. In love and sex, exalted feelings can easily overpower other emotions and experiences–and thank the stars for that, since initial infatuation helps us overlook personal differences long enough for a loving bond to take root. We all have euphoric recall for our exaltations: when we hit the ball out of the park, when our words had meaning and were felt and understood, when our jokes made people laugh, when we thrived in joy.

Conversely, recalling peak experiences can dishearten us, convincing us that normal life is colorless or has passed us by. The vitality we feel one day to fulfill our potential can easily dissipate into doubt and despair. But the simple practice of acceptance is a great antidote for these fluctuations. True transpersonal exaltation is by definition bigger than any of us; it’s not a state we can will or manipulate into being. Still, while much of the work we do to grow our hearts is an inside job, and while the experience of exaltation cannot be commanded, it can be encouraged through a benevolent focus on others. Through affirming others’ potential with gentle, persistent knowing and support, we exalt the qualities we hold dear. And in time we will realize that we love in others exactly what we value in ourselves. Judgment or separation cannot coexist in true exaltation, which is the very best of us. And what’s the best of us? It’s all of us. Altruism is a distinct aspect of exaltation that we can all nourish and invite.

DAILY HEALTHY SEX ACTS
• Recall the exalted states and peak experiences of your life so far. Does the euphoric recall of your past inspire or inhibit your present?
• If you were to invite exaltation, what part of your life would you most like to thrive right now? Exalt in others that which you most desire in yourself. Make room to receive from life by freely giving your time, your truth and your love.
• Today, see the best in others. Imagine a warm, golden glow around everyone you meet. See beyond personalities to share in their spirit.

From the MIRROR OF INTIMACY book The Daily Meditation Book by Alexandra Katehakis and Tom Bliss

[Dr. Pacik]

It is important to do a proper assessment. The diagnosis of vaginismus is made by using a psycho-sexual questionnaire to better evaluate the source of sexual pain. This can be requested and Maze will do a complimentary assessment. This is an important first step and will help you avoid unnecessary false steps.

[Dr. Pacik]

Thank you for your post and your kind words. My experience is that when women have long term vaginismus and in addition do not respond to pelvic floor physiotherapy, the best course is to come to the US and have the Botox treatment under anesthesia. The anesthetic removes the fear and anxiety related to penetration allowing the woman to continue her dilation after she wakes up. This is often a turning point and a likely successful outcome.

[Dr. Pacik]

PLEASURE

“Many of us pursue pleasure with such breathless haste that we hurry past it.”
~ Søren Kierkegaard

In the classical myth told by Ovid, Pleasure is the daughter of Eros, the god of love, and Psyche, his earthly bride made immortal. The name Psyche shares the same root as the word psychology: spirit or mind. In one interpretation this ancient tale illustrates that pleasure is born from mindfulness (Psyche) and a uniting intention (Eros). Indeed, this sounds like the erotic formula for every coupling from Internet dating and tearoom cruising to sex surrogacy and marriage. It can be counterintuitive, but pleasure requires planning and self-knowledge in the same way vacationing can take as much effort and thought as working.

Sexual feelings set off nerve-bundles and neurochemicals within the body that are more intense and immediate than those which other enjoyable activities activate. Sex creates pleasurable sensations that are distinctly personal. Maybe this is one reason our sex organs are called private parts–not because they must be kept private, but because intense pleasurable sensations are experienced individually. It requires effort to share our sexual pleasure with a partner. But to show pleasure is to grow pleasure, for ourselves as well. Unfortunately our society often disdains any open display of unpretentious sexuality, regardless of whether it’s healthy or destructive.

When people compulsively pursue pleasure, especially in sex and love addiction, they’re not aware how much of the hunt is actually un-pleasurable. Whenever preceding or resulting pain is greater than the fleeting payoff, we should question the effectiveness of the enterprise. We can ask ourselves whether the enjoyment creates valued memories and anecdotes for years to come, or must be crushed and hidden upon consummation. Pleasure of which we are aware, and which we can share, has life and will continue to exist–much like the immortal progeny of Eros and Psyche.

DAILY HEALTHY SEX ACTS
• Consider what brings you pleasure, and how you share your pleasure with others. Do you narrate the enjoyable sensations you receive like making a report? Do you convey your feelings wordlessly, with sounds or facial expressions? Or do you count on their being communicated by themselves, as through osmosis?
• Experience pleasure today, and let yourself show it. First, practice alone and relay your feelings out loud. When you feel comfortable, practice sharing your experience of simple pleasures with other people.

From the MIRROR OF INTIMACY book The Daily Meditation Book by Alexandra Katehakis and Tom Bliss

There is considerable value to this article. Too often one does not emote ones feelings and experiences leaving the other person in the dark regarding whether something is pleasurable or not. We all rely on this type of feedback for future behavior patterns. Feedback is often more than words. During love making sounds are just as important if not more so. Given the low libido that so many women (and some of their partners) with vaginismus experience it is fairly common that individuals become closed to expressing themselves. For those who feel closed make an effort to become more open and transparent in your interaction.

[Dr. Pacik]

You need to assess the severity of your vaginismus. If you are unable to tolerate any penetration at all you are best off having the Botox treatment under anesthesia. If you are able to tolerate some penetration such as tampons and fingers then you can begin dilating yourself using the various sized fingers which also function like dilators. Once you have made progress then try inserting two or more fingers which adds to the dilation. If you are able to insert two fingers then try pulling them apart, this will add to the stretching you need.
Even if you are unable to receive packages, medical supplies should be an exception.
Let us know how you progress. This will help others.

[Author]

Posts