[Joe]

Peter requested that I respond to this post, as I am a clinical social worker and certified sex therapist who has experience treating people with sexual pain issues. One of the tragedies of sexual pain is the development of secondary relational and sexual problems such as phobic avoidance of sexual behavior, desire and arousal issues, as well as difficulty with how one experiences orgasm and pleasure.

For the individual that struggles with sexual pain, there is often a sense of fear that any physical touch, or even intimate conversation, may lead to a sexual encounter and, not surprisingly, sexual pain. This fear may take on the guise of anger, sadness, resentment, and a variety of other emotional and physical symptoms that, initially, appear to be unrelated to sexual pain. Over time this may lead the person with sexual pain to feel like “damaged goods”, isolated from their partner, shamed, and hopeless that the situation will ever change. Many people who struggle with sexual also pain feel as if their bodies have turned against them, which can further add to struggles with ones sense of attractiveness and positive self regard compounding their desire to avoid sexual intimacy. For the partner that does not experience sexual pain there is often a lack of understanding about their partners’ pain resulting in confusion, rejection, frustration, and the perception that their partner no longer desires them.

There is an old saying that the three things that people don’t discuss with potential partners are “money, kids and sex.” Many couples feel unprepared to discuss sexual pain issues openly with one another. Here are some tips for communicating effectively with your partner about sexual pain.

Be prepared to share the following information with your partner; 1) where specifically the pain is located on, or in, your body, 2) the experience of the pain, e.g., burning, sharp, dull, stabbing, etc., and 3) the pains intensity level, e.g., on a scale ranging from one to five, where one is no pain and five represents excruciating pain, what level of do you experience during sex. Share with your partner how you feel this pain has impacted your sense of self and sexuality and ask how the absence of sex has impacted your partners’ sense of self and sexuality; discuss how the sexual pain has impacted your shared experience as a couple. This will also help both of you to begin working together to address the problem and can, for many couples, create a collaborative effort to begin looking for ways to address the problem together.

There are many professionals who specialize in the treatment of sexual pain issues. Two resources that can be helpful in locating professional assistance in treating sexual pain issues are The American Association of Sexuality Educators, Counselors and Therapists, or AASECT, and The Society for Sex Therapy and Research. These organizations provide people with access to therapists who have extensive training and experience in treating a variety of sexuality difficulties, including sexual pain issues. There are multiple options to treat sexual pain issues that range from psychotherapy, behavioral exercises, mind body approaches, state of the art medical interventions, to integrated modalities that involve all of these approaches. There is no need to suffer the agony of sexual pain. Help is available for both of you!

Joseph Winn MSW, LICSW, CST
180 Massachusetts Avenue Suite 301
Arlington, MA.
02474
P: (617) 461-8479
Website: http://www.josephwinnlicsw.com

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