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University Lecture. Helping students understand the role of the sex therapist so that they can help their clients seek our help. Help them understand the barriers we face when we try to refer client to someone for physical management of vaginal, pelvic pain.
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Role of the Sex Therapist in the
Management of Vaginal Pain.
An Integrated Approach.
SEX THERAPIST
FAI
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?
--
Who initiates now?
How do they respond?
--
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
0412 147 917
Sexual Focus …