Imagine a friend who starts flaking on your plans with no real explanation. After a continued pattern, you get fed up and decide that you are no longer going to make any plans with her and set yourself up for disappointment. There may have been positive memories of the past, times where you really enjoyed each other’s company and went on fun adventures. But the new state of affairs has brought you to a point where you feel like the best thing you can do for your sanity and emotional health is to detach from this friend. No more making plans, no more expectations, no more hoping.
I often see this idea play out for a woman when she begins having painful sex or encountering difficulty with orgasm. Anger, disappointment, confusion, and sadness may sprout; she may feel bewildered as to why, after years of not having a problem, there seems to be a problem that is more than a phase and isn’t going away. She begins to feel let down by her body, frustrated with her vagina and the pleasure she is grieving due to dysfunction. Consequently, a detachment process may develop. She may avoid sexual activity altogether; not just the moments where she is struggling, but all of it. Perhaps every now and then she has an inkling that maybe this time it’ll be different, but alas, she once again feels let down, and she decides (often not consciously) that sex is no longer on her radar.
But whereas a friend is person outside of you and you can actually detach, a woman feeling detached from her vagina has to walk around with that internally detached feeling. Of course, there are moments where the magnitude of the detachment is pronounced, but it’s amazing how much a person can habituate to a disjointed feeling inside. It is thus important that treatment for sexual dysfunction not only incorporate the medical piece and physiological functioning, but also assess and value the mind-body connection and internal integration. Therapies like EMDR, Internal Family Systems, Somatic Interventions, mindfulness, and meditation can be transformative in healing the rupture and restoring a sense of inner connectedness, and I have seen many patients find new hope and inner peace that enables them to “make up” with their body parts that aren’t functioning as they want and feel positive again about their sex lives and relationships.
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