Vulvodynia - should I go and see this practitioner ?

Hi everyone,

I haven't posted in a while. I'm still struggling with vulvodynia after having had a lot of success with TMS-work for back pain/sciatica/fibromyalgia-type pain.

I'm watching Dan Buglio's videos as his approach resonates a lot with me and I definitely recognize why I'm still not better : I'm still thinking too much about the pain, judging myself and others constantly in my head (nasty little self-talk), have been stressing out a lot about everyday things (difficult coworkers, struggling to get pregnant because of PCOS, etc.), etc.

But I'm having a harder and harder time to control my fear of the symptoms, as they were very mild in the beginning three years ago, and have only been getting stronger since. I think I've had one or two times when I had a liiiiittle bit less pain during sex, but I'm not that sure it was due to making progress TMS-wise. It has expanded to pelvic pain. I'm trying not to panic at the idea of not being able to have sex anymore, and to not have a baby (we're supposed to start treatment for that at the beginning of 2023).

I'm frustrated as hell that despite being in a way better place mentally than three years ago, I'm not seeing even a tiny improvement.

Thing is, I recently heard of a midwife in the city I work who specializes in pelvic pain. The association she got her training from emphasizes stress reduction (haha !) but also prescription of topical treatment and pelvic floor therapy.

Do you think that it would further hinder my progress if I got an appointment with her and asked for lidocaine cream ? It's a course of treatment that's sometimes prescribed to anesthesize the vulva and "reprogram" the brain so that it stops associating sex with pain. I'm very cautious about it because I don't want to go back to thinking physically, and I guess she will find something wrong with my pelvic muscles. Stopping all physical treatments worked for my previous back pain, and I feel like treating vulvodynia differently would convey to my brain that this is a super special kind of pain...

What do you all think ?

 

Dr. Sarno was well-known for saying that it's legitimate to use medication as a tool to jump-start recovery - as long as you know that this is the goal, and that it must be temporary.

Does this practitioner offer a complete program of stress-reduction and body-awareness in addition to prescribing? One that you plan to follow? Because I do have an issue with the fact that you came to this forum seeking approval and/or reassurance to take this route. I mean, it's not my issue - what I'm trying to say is what you already essentially said about yourself, which is that you don't have enough self-esteem or trust in yourself, to be able to make this decision for yourself.

So Yes, you're overthinking and intellectualizing and not getting to the core issues. If you haven't been able to develop that on your own by now, how about therapy?

 

Just wanted to say I feel your frustration. I have also had success in treating areas of chronic pain with this approach, but symptoms of vulvodynia have also been tough for me to work through. Sending you hope and support.

 

Thanks Jan et junglebiscuits.

I finally got out of panic mode and I'm slowly regaining confidence I can beat this.

@Jan : I'm not sure if this specific practitioner offers a complete program of stress-reduction, just that they take it into account. I'm really only interested in getting some lidocaine to help change my perception of sex = pain. I decided to get an appointment in three weeks from now just to stop thinking about it. I'll see how I feel about actually going a few days before. I saw a good psychologist for two years and it helped, but at some point I realized there was nothing more she could help me with - I hadn't a lot more to talk about with her.

@junglebiscuits : sending you hope and support too, I know we can get better !

 

Well, @Ludmilla, perhaps a TMS coach would be more helpful for you at this point, because you do need to find a way out of fear - as long as fear is in control, you can't heal, that's the long and short of it.

The thing is, when we see people struggling like this and not getting better in spite of belief and in spite of therapy, my guess is that there is some other inner conflict going on that is unconsciously continuing to be repressed. Another way that I've been putting it lately is that your brain, for reasons unknown, is extremely resistant to letting go and going deep.

You could certainly have a try at one of our programs - the only thing I can say about them is that they are only effective if they are done with 100% self-honesty. Anything less is a waste of time. Our TMS brains try to get us to just skim the surface of a self-directed program, letting us believe we are doing the work without accomplishing anything meaningful. Sadly, resistant brains are expert at this.

~Jan

PS: you inadvertently tagged someone with the actual username of "Jan" - inactive since 2014

 

I'll have a look at the programs, as I've never done any of them. I'm sick with covid at the present time, so I have a few "just for me" days before me.

Also, sorry for the tag .

 

Just jumping in here to say that anything you can do to soothe symptoms and reduce fear WHILE you do the tms work is fine. Folks get in trouble when they run from doctor to doctor and AVOID the tms work of looking at emotions etc.
Also big hugs to you. Pelvic pain is no joke and has the added element of such an intimate body part.

 

I agree with the need for 100% self-honesty in dealing with repressed emotions. The difficulty is that one can easily become programmed for self-dishonesty. Here is what I mean by that.

In Healing Back Pain, Sarno explained how people can become programmed to repress their anger. He related a story about the mother of a fifteen-month old who stopped his temper tantrums. One day when when the young child started to have a tantrum, she splashed ice water in his face. Sarno wrote: “It worked beautifully. He never had another tantrum. At the ripe age of fifteen months he had learned the technique of repression. He had been programmed to repress anger because it produced very unpleasant consequences.” The cold water on his face might have been unpleasant, but it was fleeting. The serious unpleasant consequence was that his loving and attentive mother, who was so important in his life, suddenly became the opposite of loving and attentive. Sarno said the fifteen-month old would carry the “dubious talent” of repressing anger “with him throughout his life,” and “when confronted with the multitude of frustrating, annoying, sometimes enraging things that happen to people every day, this man automatically internalizes his natural anger, and when that anger collects and builds up, he will have TMS or some such physical reaction in response to it.” In short, the young child had learned to fear experiencing anger and quickly learned a way or ways to repress it.

Sarno did not elaborate on the way(s) by which repression happens. Alan Gordon goes into that in the Day 16 lesson of his Pain Recovery Program that is available for free on this tmswiki website. The title of the lesson is Emotional Repression. He asks you to imagine you have a blind date at 7 pm at a restaurant across town, and the woman fails to show up on time. Gordon wrote:

“She’s probably stuck in traffic,” you think.
Then it hits 7:30, and you’re awkwardly fidgeting with your phone. “Maybe she had to work late,” you reason.
Now it’s 8 PM . . . .
Finally, you get a text from her: “Omg, I’m so sorry, totally lost track of time…reschedule?”
You think to yourself, “She’s really busy, it could happen to anyone.”
. . . .
This is the defense mechanism of rationalization – your mind conjures up a way to justify her behavior. You never even feel the anger that is likely bubbling under the surface. Our brains have a lot of defense mechanisms: denial, dissociation, projection, etc. And defense mechanisms are unconscious, which means we’re not even aware that we’re using them. This can pose a challenge, since it’s hard to overcome what we can’t see.
​

Gordon says there are a lot of defense mechanisms. Actually, there are more than than a hundred. Jerome S. Blackman, 101 Defenses: How the Mind Shields Itself (contrary to what Sarno hypothesized, pain is not one of the 101). Blackman is a psychiatrist trained in psychoanalysis. We all have defense mechanisms that we habitually use and don’t know it. ISTDP psychotherapist Jon Fredericton wrote a short book about that titled Lies We Tell Ourselves. Perhaps a more descriptive title would have been Lies We Don’t Know We Tell Ourselves. In 1991, Sarno wrote that fewer than 5% of his patients needed analytically-oriented psychotherapy to cut through their defense mechanisms and overcome TMS. In 2013, he wrote that the number was 25%. As for the other 75%, I would expect that self-honesty might have come easy for a some but not for most because as Gordon says, “it’s hard to overcome what we can’t see."