Hypno-Desensitization Therapy of Vaginismus
Fear and anxiety are most important in the production and maintenance of a symptom. Vaginismus, a reaction of avoidance of an anxiety-producing situation, is readily amenable to treatment by systematic desensitization. This may proceed in either of two main ways: “in vitro” or “in vivo.” In order to strengthen and accelerate the desensitization process, a hypnotic technique was combined with the above-mentioned methods.
The “in vitro” treatment proceeds with the imagery, under hypnosis, of an “anxiety hierarchy” of increasingly erotic and sexually intimate situations, which are then reproduced at home with the partner. In the “in vivo” method, in self-hypnosis, the patient inserts into her vagina first her finger, then Hegar dilators of gradually increasing size. First the physician, then the patient, and then her partner, members of the therapeutic team, are successively involved in the insertion of the dilators. This continues until the “female superior position” practiced first with the largest dilator is reproduced by the couple at home in intercourse.
With these techniques from 1965 to 1974, complete success was obtained in 68 of 71 patients suffering from severe vaginismus. Follow-up of the 68 patients showed that these couples were leading a normal sexual life with no symptom substitution.
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