Sexology of the Vaginal Orgasm (10 page)

A full session consisted of three segments each with six phases, hence 18 sequences. Each phase began after a visual and audio signal with a 10-second contraction. The women were instruct- ed to attempt to contract their PC muscles so that the purple indicator on the monitor reached and maintained a red zone microvolt level of tension for 10 seconds. The minimum level of the upper field was 65% of the maximum value measured before the first session. A ten-second relaxation phase immedi- ately followed the ten-second contraction phase. This phase was also initiated by visual and audio signals during which the ten- sion in the PC muscle was to remain in the green zone on the

Fig. 31

Fig. 32

1 of 18 EMG curves from the 1
^st
session 1 of 18 EMG curves from the 3
^rd
session

monitor. The maximum level of this lower field was ten percent of the maximum value measured before the first session (fig. 31). There was a 20-second pause between the three segments. Fig-

Fig. 33

ure 32 shows one of the 18 EMG curves from the third session which took place 29 days after the first session. If all 18 se- quences from the last session are placed one on top of the other, then a significant training effect

All 18 EMG curves from the 3rd session

becomes evident (fig. 33).

The role which lack of awareness plays in coital anorgasmy is demonstrated by the following curves (fig. 34):

Fig. 34

1
^st
phase 2
^nd
phase 3
^rd
phase 4
^th
phase 5
^th
phase 6
^th
phase

1
^st
segment

2
^nd
segment

3
^rd
segment

Maximum value: 20.1 volts

All 18 phases demonstrate complete lack of control

The individual phases show that the pelvic floor muscles take on a life of their own. The curves measured indicated that many patients were not the least bit capable of ordering the curves to conform with a specified scheme distinguishing ten- sion from relaxation. This is even more apparent in figure 35, where all 18 phases are placed on top of one another. The sub- jective experience did not at all reflect the actual movement of the muscles. The patient believed that they she been able to easily contract her “vaginal muscle” for ten seconds and then again completely relax it for the same period. This supports

the claim that this is obviously uncharted territory.

Fig. 35

Fig. 36

Unconscious chaos Increasing control

It is not surprising in the light of this prominent absence of control that a six-week pelvic floor exercise program pre- scribed by a gynecologist failed to produce the desired effect. But after only five weekly sessions the patient succeeded in transforming the originally uncontrollable microvolt curve chaos, which was first experienced as completely separate from the self, into the intentional and distinguished states of tension and relaxation (figure 37).

In the course of this study, profound changes were observed not only in between two sessions, but sometimes even with- in a single biofeedback session. How even one short and simple action can bring about this spontaneous and sudden shift in awareness is nicely illustrated by the EMG curves from the fourth session of a 32-year-old patient who sought treat- ment due to coital anorgasmia and level one incontinence:

Fig. 37

1
^st
phase 2
^nd
phase 3
^rd
phase 4
^th
phase 5
^th
phase 6
^th
phase

Paradoxical intervention

Maximum value 49.2 volts

Paradoxical learning of awareness

It is striking that the first segment’s curves are paradoxi- cally the exact opposite of the patient’s subjective expe- rience. It seems that she perceived a permanent state of con- traction as relaxation. Consequently, after the 20-second segment break, she was simply instructed to switch the order of the contraction and relaxation sequences – as a sort of paradoxical intervention – in the four first phases of the second segment. Thus, as an exception, the patient was instructed to first relax for ten seconds and then contract the muscles for ten seconds. Without a break in between, the fifth phase was again conducted in the original order. It is apparent that already in the following phase a normal coherent curve profile is produced. From this point on the curve never reversed again – not even during an examina- tion three months after concluding the study. The inter- vention – limited to only four sessions for the purpose of enacting a “be spontaneous” paradox – apparently provoked just the right expansion of awareness that ultimately made the desired behavior change possible.

In the following weeks the average values for contractions significantly increased. Continence was reestablished after a total of seven perineometry sessions. The patient, who is a professional singer, reported that she also experienced an unintentional, yet extremely beneficial side effect in that her voice had improved. Her voice was no longer restricted to the upper part of her body; her voice then resonated from the bottom of her pelvic floor. With particular regard to over-control, relevant systemic and hypnotherapeutic ele- ments taken from the theories of Milton Erickson were also integrated into a concomitant and ultimately successful sexual therapy.

8.

Female Ejaculation