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Sex Therapy for Vaginismus: A Review, Critique, and Humanistic Alternative

Vaginismus has typically been treated using behaviorally oriented sex therapy. The treatment of choice has been systematic desensitization with the use of graded vaginal dilators. The prevailing model is described, and its underlying assumptions and implications are explored and evaluated. A critique of the conventional treatment paradigm is offered. An alternative way of understanding sexual problems and how to deal with them in therapy originates in existential-experiential psychotherapy. Although this model has been applied to the study and treatment of sexual concerns infrequently, this approach may be of particular value to sex therapists. The conception of the problem, the goals of therapy, and therapy process are described from this perspective. Therapists working with such a model attempt to promote awareness, choice, embodiment, sexual potential, and integration. A case illustration of therapy with a client presenting with vaginismus is presented. The advantages of using an experientially oriented approach are discussed.