When a traumatic event happens, there is a timestamp on it. For instance, if an event happened when a person was a young child, there is part of them that feels as scared and vulnerable as they were then, even if they are now a high-functioning adult that is not currently under any direct threat. Sometimes this continuing intense fear can express itself as psychosomatic issues such as vaginismus. Our Director Heather Mayone recently spoke to The Cut about the importance of working to deeply understand the underlying emotional root of psychosomatic experiences.
In “Am I Doomed to a Life of Painful Sex,” writer Bindu Bansinath reveals her own years-long recurring struggles with vaginismus, which she defines as “a disorder in which the muscles surrounding the vagina involuntarily spasm in response to penetration or its anticipation, making sex painful or even impossible.” In order to learn more about how vaginismus can be treated, she reaches out to experts including Heather who emphasizes the utmost importance of not simply applying a Band-Aid fix. “Even if you resolve the pelvic pain but you’ve not resolved the emotional issue, the pain will show up somewhere else,” Heather explains. “We don’t want to just fix the symptom. We want to really understand what caused the symptom to begin with.”
While not in the article, Heather notes that people who experience vaginismus often feel they already know what the issue is and where the fear comes from. Some may have sought help repeatedly. Heather recalls patients who have said: “Man, I’ve talked about this thing that happened to me a ton, but I am still having this issue. What gives?” There can be a well-meaning hope that an issue like vaginismus is from an isolated traumatic event—that if a patient talks about it and revisits it enough, the pain will simply go away. Often it’s more difficult than that. If you’ve revisited something but it hasn’t resolved, that absolutely means something is being missed.
When someone comes to therapy knowing exactly what the issue is, it’s essential that a therapist both honors and takes that seriously while also not being so organized by this preexisting narrative in a way that shuts down curiosity and exploration. Healing can be a nonlinear process, keeping open the question of what happened so nothing is missed. Sometimes in revisiting a traumatic event again, even years into therapy, new information and sore spots can be discovered.
There is also an integral difference between knowing and feeling. If you know something happened but are not connecting to the feeling, that means you are defending against something—likely something too big or scary for you to fully feel. When fear from the past gets internalized to the extent that it becomes vaginismus, that means whatever happened was so scary that you cannot fully connect to it consciously. To be able to heal requires being able to connect to that past self and how frightened you were at the time.
Therapy helps people feel strong enough to connect to what happened fully and then, move and work through it. As things become known and felt, even the most traumatic past memories can be accessed even if they remain unsettling. Once you are able to allow the experience of the traumatic event to become conscious—to feel, remember, and speak about it, it will not become unconscious again. And it will not revert back into something that is so deeply rooted that it can only express itself in a psychosomatic way.