Psychosexual therapy in an interdisciplinary approach. Case study: patient with anxiety disorders and excessive pelvic floor muscle tension
Marta Rawińska
Academy of Economics and Humanities in Warsawhttps://orcid.org/0000-0002-5797-6886
Małgorzata Starzec-Proserpio
Department of Obstetrics, Medical Center for Postgraduate Education in Warsawhttps://orcid.org/0000-0002-5067-8261
Abstrakt
Aim
This article presents psychosexual conceptualization and methods of therapeutic work with a patient in an interdisciplinary approach. It was based on the techniques of cognitive-behavioral psychotherapy (CBT) and urogynecological physiotherapy.
Methods
The most important elements of the diagnostic interview and work techniques based on the CBT approach and physiotherapy were presented. The therapy was focused on the issues of anxiety, helplessness, and anger. At later stages of the therapy, sexological topics and physiotherapy were introduced. In addition, the patient received treatment from other specialists: a psychiatrist and an endocrinologist.
Results
The patient managed to achieve some of the goals set together with the therapist and eliminate genito-pelvic pain. An additional benefit was the complete medical diagnosis of the patient and commencement of the treatment related of her hormonal imbalance.
Conclusions
Interdisciplinary treatment resulted in beneficial effects. This type of cooperation of many specialists in treating patients reporting emotional, mental, and sexual difficulties seems to give the best results. This indicates the value of teamwork and the need for the cooperation of specialists in various fields.
Słowa kluczowe:
CBT, urogynecological physiotherapy, interdisciplinarity, anxiety disorders, pain syndromesBibliografia
Ariza-Mateos, M. J., Cabrera-Martos, I., Ortiz-Rubio, A., Torres-Sánchez, I., Rodríguez-Torres, J., & Valenza, M. C. (2019). Effects of a patient-centered graded exposure intervention added to manual therapy for women with chronic pelvic pain: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 100(1), 9‒16. DOI: 10.1016/j.apmr.2018.08.188.
Crossref
Google Scholar
Bancroft, J. (2012). Seksualność człowieka [Human sexuality]. Wydawnictwo Medyczne Urban & Partner. Google Scholar
Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported interventions: Controversies and evidence. Annual Review of Psychology, 52, 685‒716. DOI: 10.1146/annurev.psych.52.1.685.
Crossref
Google Scholar
Gentilcore-Saulnier, E., McLean, L., Goldfinger, C., Pukall, C. F., & Chamberlain, S. (2010). Pelvic floor muscle assessment outcomes in women with and without provoked vestibulodynia and the impact of a physical therapy program. Journal of Sexual Medicine, 7(2), 1003‒1022. DOI: 10.1111/j.1743-6109.2009.01642.x.
Crossref
Google Scholar
Haugstad, G. K., Wojniusz, S., Kirschner, R., Kirste, U., Lilleheie, I., & Haugstad, T. S. (2019). Somatocognitive therapy of women with provoked vulvodynia: a pilot study. Scandinavian Journal of Pain, 19(4), 725‒732. DOI: 10.1515/sjpain-2019-0011.
Crossref
Google Scholar
Haugstad, G. K., Wojniusz, S., Kirste, U. M., Kirschner, R. S., Lilleheie, I., & Haugstad, T. S. (2018). Pain, psychological distress and motor pattern in women with provoked vestibulodynia (PVD) ‒ symptom characteristics and therapy suggestions. Scandinavian Journal of Pain, 18(2), 221‒227. DOI: 10.1515/sjpain-2017-0173.
Crossref
Google Scholar
Hoyer, J., Uhmann, S., Rambow, J., & Jacobi, F. (2009). Reduction of sexual dysfunction: by-product of cognitive-behavioural therapy for psychological disorders? Sexual and Relationship Therapy, 24(1), 64–73. DOI: 10.1080/14681990802649938.
Crossref
Google Scholar
King, R., Robinson, V., Ryan, C. G., & Martin, D. J. (2017). A novel interactive diagram to explain pain neurophysiology to patients with chronic musculoskeletal pain (CMP): A practical guide. Pain and Rehabilitation, 42(9), 24‒32. Google Scholar
Lew-Starowicz, Z. (1997). Leczenie zaburzeń seksualnych [Sexual dysfunction treatment]. Warszawa: Wydawnictwo PZWL. Google Scholar
Lowen, A. (2022). Zdrada ciała [Betrayal of the body]. Warszawa: Wydawnictwo Czarna Owca. Google Scholar
Masters, W. H., & Johnson, V. E. (1974). The Pleasure Bond. Toronto, New York: Bantam Books. Google Scholar
Morin, M., Dumoulin, C., Bergeron, S., Mayrand, M. H., Khalifé, S., Waddell, G., Dubois, M. F., & PVD Study Group. (2021). Multimodal physical therapy versus topical lidocaine for provoked vestibulodynia: a multicenter, randomized trial. American Journal of Obstetrics and Gynecology, 224(2), 189.e1‒189.e12. DOI: 10.1016/j.ajog.2020.08.038.
Crossref
Google Scholar
Nijs, J., Wijma, A. J., Willaert, W., Huysmans, E., Mintken, P., Smeets, R., … Donaldson, M. (2020). Integrating motivational interviewing in pain neuroscience education for people with chronic pain: A practical guide for clinicians. Physical Therapy, 100(5), 846‒859. DOI: 10.1093/ptj/pzaa021.
Crossref
Google Scholar
Nobre, P. (2009). Determinants of sexual desire problems in women: Testing a cognitive-emotional model. Journal of Sex & Marital Therapy, 35(5), 360‒377. DOI: 10.1080/00926230903065716.
Crossref
Google Scholar
Nobre, P., & Pinto-Gouveia, J. (2006). Emotions during sexual activity: Differences between sexually functional and dysfunctional men and women. Archives of Sex Behavior, 35, 8‒15. DOI: 10.1007/s10508-006-9047-1.
Crossref
Google Scholar
O’Sullivan, P. B., Caneiro, J. P., O’Keeffe, M., Smith, A., Dankaerts, W., Fersum, K., & O’Sullivan, K. (2018). Cognitive functional therapy: An integrated behavioral approach for the targeted management of disabling low back pain. Physical Therapy, 98(5), 408‒423. DOI: 10.1093/ptj/pzy022.
Crossref
Google Scholar
Rawińska, M. (2017). Badanie seksuologiczne [A sexological study]. In M. Lew-Starowicz, Z. Lew-Starowicz, & V. Skrzypulec-Plinta (Eds.), Seksuologia [Sexology] (pp. 199‒208). Warszawa: Wydawnictwo PZWL. Google Scholar
Rawińska, M. (Ed.). (2019). Zaburzenia seksualne a psychoterapia poznawczo-behawioralna [Sexual dysfunction and cognitive-behavioral psychotherapy]. Warszawa: Wydawnictwo PZWL. Google Scholar
Rosenbaum, T. (2011). Addressing anxiety in vivo in physiotherapy treatment of women with severe vaginismus: a clinical approach. Journal of Sex & Marital Therapy, 37(2), 89‒93. DOI: 10.1080/0092623X.2011.547340.
Crossref
Google Scholar
Ruscio, A., Brown, T., Chiu, W., Sareen, J., Stein, M., & Kessler, R. (2008). Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychological Medicine, 38(1), 15‒28. DOI: 10.1017/S0033291707001699.
Crossref
Google Scholar
Sapolsky, R. M. (2010). Dlaczego zebry nie mają wrzodów. Warszawa: PWN. Google Scholar
Schnyder, U., Schnyder-Lüthi, C., Ballinari, P., & Blaser, A. (1998). Therapy for vaginismus: in vivo versus in vitro desensitization. Canadian Journal of Psychiatry, 43(9), 941‒944. DOI: 10.1177/070674379804300910.
Crossref
Google Scholar
Rosenbaum, T. Y. (2013). An integrated mindfulness-based approach to the treatment of women with sexual pain and anxiety: promoting autonomy and mind/body connection, Sexual and Relationship Therapy, 28(1‒2), 20‒28. DOI: 10.1080/14681994.2013.764981.
Crossref
Google Scholar
Ter Kuile, M. M., Melles, R., de Groot, H. E., Tuijnman-Raasveld, C. C., & van Lankveld, J. J. D. M. (2013). Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy. Journal of Consulting and Clinical Psychology, 81(6), 1127‒1136. DOI: 10.1037/a0034292.
Crossref
Google Scholar
Wells, A. (2010). Terapia poznawcza zaburzeń lękowych [Cognitive therapy of anxiety disorders]. Kraków: Wydawnictwo UJ. Google Scholar
Department of Obstetrics, Medical Center for Postgraduate Education in Warsaw
https://orcid.org/0000-0002-5067-8261
Licencja
Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne – Bez utworów zależnych 4.0 Międzynarodowe.
