I'm still trying to wrap my head around vaginismus and its treatment, and we are about 3 days removed from class. I never realized how serious this condition was! I recall learning about it during undergrad, but at the time maybe I wasn't taking it seriously or it was presented in a way that made it seem a little milder than it is. The Strange Sex video really put things into perspective with a poor woman struggling to consummate her marriage because of vaginismus. It's so hard to imagine an uncontrollable feeling pushing a loved one away as she described it. Obviously I'm not a woman, but the thought still makes me cringe inside, which I feel gives credence to just how serious of a problem this can be. Biopsychosocial factors all play a role, and they also should play a huge role in treatment too, which for the most part seemed to be the case. Dilators addressed physical aspects of the problems while a therapist would aid the client in psychological and social contributors to the problem. On the other hand, the newer treatment we saw in class that used Botox, really concerned me. Chrissy brought up a good point as to whether or not the Botox would affect orgasm, and in my opinion, there have to be side effects. I'd be amazed if the procedure left clients without side effects. And on top of that, inserting a dilator into a clients vagina will still under sounds way too extreme to me.
Aside from the very funny images and memes on the Orgasm disorders page, one of my biggest take aways from the presentation was the effects of SSRI's on orgasm. I wonder how many couples struggling with orgasm are aware of the effects SSRI's have, if they are taking them. Because of the seriousness of other side effects while taking SSRI's I'm sure a decreased likelihood of orgasm is put on the back burner so pharmaceutical companies can cover their backsides. Having a therapist that is aware of these side effects can help educate clients struggling with this problem and help get medication changed through a psychiatrist. Therapists could also help the clients realize its not something wrong with their bodies, which may be reassuring for some.
Friday, March 13, 2015
Monday, March 2, 2015
Dr. Berman video reflection
These thoughts are pretty far removed from when we all watched the Dr. Berman video so bare with me as I try to understand the notes I wrote about a week ago. Before writing this I went back to the Principles and practice book to read over highlights I made in sections regarding assessment. It was amazing to see how what I highlighted aligned pretty closely to most of my notes regarding what was useful in Dr. Berman's assessments. She focused on the chronology of the problem, quality of sex, sexual scripts, trauma, etc. She did it all in my opinion. One thing that I found extremely effective was towards the end of the video, I think. It was in regards to understanding emotions and the underlying processes where one of the female clients mentioned feeling sadness, which Dr. Berman explored a little more revealing that the sadness was actually caused by feelings of longing and vulnerability. If I had typed this out earlier I probably could explain more but I'm hoping everyone else is able to recall what I'm talking about.
It was also enjoyable to watch Dr. Berman's interventions take place, even during the awkward footages of couples doing their intimate things with a cameraman in the room. My favorite aspect of her interventions was with the couple where the husband was wealthy afraid of his wife's vagina due to what he had seen during child birth. Talk about an interesting case to work with. Among dealing with a lot of the man's semi-out there thoughts and feelings, I felt Dr. Berman did a good job at not reacting to a lot of what he was saying. Most of us in class were cracking up at some of his statements, but she was able to remain professional and stay the course, which I imagine being extremely important in sex therapy. Anyways, her approach to desensitize him was really interesting. First having him think about what it looks like, then looking at it for a certain amount of time, eventually building up to performing oral sex. The process seemed so smooth to convince a guy that I honestly thought had no chance of making a change, based off of the initial interview with him.
I also found the separate counseling session to also be effective. It may have been how the show was put together but it seemed as though the separate session came just at the right time allowing both partners to convey things to Dr. Berman that they may have not disclosed to their partners. One part in particular I remember was when the black women disclosed her fantasy of another man, potentially her husband's pseudo-boss, taking her. Those conversations in therapy led to conversations outside of therapy where both partners were curious what the other had said and eventually led to a nice discussion of each others fantasies. It was enjoyable to watch!
It was also enjoyable to watch Dr. Berman's interventions take place, even during the awkward footages of couples doing their intimate things with a cameraman in the room. My favorite aspect of her interventions was with the couple where the husband was wealthy afraid of his wife's vagina due to what he had seen during child birth. Talk about an interesting case to work with. Among dealing with a lot of the man's semi-out there thoughts and feelings, I felt Dr. Berman did a good job at not reacting to a lot of what he was saying. Most of us in class were cracking up at some of his statements, but she was able to remain professional and stay the course, which I imagine being extremely important in sex therapy. Anyways, her approach to desensitize him was really interesting. First having him think about what it looks like, then looking at it for a certain amount of time, eventually building up to performing oral sex. The process seemed so smooth to convince a guy that I honestly thought had no chance of making a change, based off of the initial interview with him.
I also found the separate counseling session to also be effective. It may have been how the show was put together but it seemed as though the separate session came just at the right time allowing both partners to convey things to Dr. Berman that they may have not disclosed to their partners. One part in particular I remember was when the black women disclosed her fantasy of another man, potentially her husband's pseudo-boss, taking her. Those conversations in therapy led to conversations outside of therapy where both partners were curious what the other had said and eventually led to a nice discussion of each others fantasies. It was enjoyable to watch!
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