When sex hurts….

When sex hurts….

There are various medical terms to describe different types of female genital pain – dyspareunia, vaginismus, vulvodynia, vestibulitis, pelvic pain… As a specialist Clinical Psychologist and qualified psycho-sexologist, sometimes the women I work with have one of these diagnoses, and sometimes no diagnosis at all. Often women have had multiple diagnostic labels, which can be even more confusing.

If you are experiencing pain during sex, it is important to first investigate any medical factors that might be causing or contributing to your sexual pain problem.

‘This is not all in my head!’

Some women are disappointed that medical examinations and tests do not show up any physical explanation for their problem. Other times, the biological factors (such as a skin problem, for example) contributing to the pain has been treated but still the problem persists.

One of the questions people often ask me is “Do you think it is all in my mind?”, as if somehow they are imagining their problem or causing it themselves, or that their problem is not ‘real’.  It is important to remember that the body and mind are connected in complex ways, so dividing problems into body versus mind is not a helpful or representative way of looking at problems.  When we look at women’s sexual response cycle as well as the psychology of the pain system, it is clear that sexual pain problems are complex, involving physiological and psychological systems which are inter-related, and feed information back to each other. A specialist psycho-sexology approach, in addition to recommended medical treatment where advised, has been shown to be effective for female sexual pain problems.

Just as specialist Clinical Psychologists play a key role in treating chronic pain problems, clinical psychologists also play a key role in treating sexual pain problems. Everyone’s problem is different and therefore treatment and therapy is tailored to the individual.

I have worked with many clients who thought that they would never have pain-free or even enjoyable sex again, and came along to psychology reluctantly, as a ‘last ditch effort’, only to surprise themselves by how much progress they made in a relatively short space of time, and have been able to reclaim their bodies and resume a pleasurable sex life.

 

Mindsurgery London provides individual sessions, face-to-face and over Skype, for a range of psychosexual issues. See www.mindsurgerylondon.co.uk for more details.

 

 

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Mindfulness and Anxiety: Observing the Storm

Mindfulness and Anxiety: Observing the Storm

The human mind is designed to detect threat. It is primed to be alert to danger so that it can keep us safe and ensure our survival. Our brain developed in a different environment to the one in which we now live. When our ancestors heard a storm coming in on the savanna, worrying about finding shelter quickly and feeling anxiety in the body – racing heart, breathing faster – helped to prioritise survival.  The problem now is that modern threats are very different in nature. In the Western world, most of us are lucky enough not to have to worry about our basic survival needs: food, shelter, water, predators.  But we still have the same brains, the same hardware with which we experience our world.  So instead, we worry about events in the future, what may happen, or things that have no immediate answer, setting ourselves up for chronic worry.

We can get stuck in our heads, worrying about a situation, convincing ourselves that X or Y will happen.  We can feel trapped with the worry, with no escape.  Our attention is completely focused on the worry thoughts, and sometimes it can be immobilising. We can get trapped in our heads trying to fight against worry, or push it away.

We can’t get rid of our capacity for worry, and neither should we want to. We need to understand our brain and its tendency to worry and how we can work with that rather than against it.

Mindfulness techniques can be useful in managing worry as they can teach us to become skilled in focusing our attention. When we worry, our attention is directed internally, we can find it difficult to focus on anything other than the worry. Mindfulness techniques train us to cultivate our attention; if we think of attention like a spotlight, worry hogs the spotlight at the expense of everything else. Mindfulness can teach us to direct that spotlight at other things, thereby using a different part of our brain, switching from thinking mode to perceiving mode. When we worry, we can get caught up in our thinking mode, and get locked into a battle… if this happens, what will I do, how will others react, what will happen then… At times like this, it can be beneficial to switch into perceiving mode and change gear as our thinking mode is not helping us.  Perceiving mode is about turning our attention to moment-by-moment experience.  What is there when we direct our attention away from the worry? There is you – a body, much more than the sum of your thoughts, breathing, existing in this moment, being.

With regular practice, mindfulness techniques can teach us how to relate to our worry differently. We can learn to observe our thoughts by taking a step back and recognising thoughts as just that, thoughts.  Thoughts do not necessarily reflect reality however much our anxious minds try to convince us of it. Our thoughts are not always the storms we think they are; with mindfulness we learn to observe the storm instead of getting swept away by it.

Both anxiety and mindfulness are huge topics, and this blog is merely the briefest of introductions. To find out more, see our other blogs on mindfulness and try our free guided mindfulness exercise to learn more about the topic.  Mindsurgery London runs mindfulness courses in the workplace and for the public. Contact us for more details.

© Copyright MindSurgeryLondon Ltd. 2016

5 Things Mindfulness Is Not

 

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1. It’s Not Easy

Mindfulness seems to be everywhere these days and yet what it is exactly can seem unclear. Let’s start with what it’s not…

At the heart of mindfulness is a very simple idea; it is about paying attention in the present moment, in a particular way.  It may be a simple idea, but it’s not easy. You might have already noticed this if you have tried even a short Mindfulness exercise and seen how your own mind has a very strong tendency to wander off in all directions and jump from thought to thought.

2. It’s Not About Clearing Your Mind!

This one might surprise you. Mindfulness is not about clearing the mind, or having a blank mind, because that would involve pushing thoughts away, which would get you into a situation where you are wrestling with your mind. Mindfulness is not about striving or struggling at all. It is about observing the full range of present moment experience, including thoughts, bodily sensations, and feelings, holding them all in spacious awareness.

3. It’s Not About Relaxation!

Again, this might surprise you. The goal of mindfulness is not relaxation or helping you get to sleep. Some people find that it does both, but again, these are happy by-products of practising mindfulness rather than the aim itself. Mindfulness is about falling awake, about showing up, with full attention, for the present moment.  This is why it is best to practice Mindfulness at times of the day when you can practice for the amount of time that you want, and not fall asleep after the first 2 minutes of practice.

4. It’s Not Just For When You’re Feeling Stressed!

It’s not just for when you are feeling stressed.  Sometimes people think that they only need to practice Mindfulness when they feel stressed or worried.  This is not the case.  Mindfulness is an on-going practice that has benefits for your entire quality of life.  You wouldn’t only go the the gym the day that you are doing a marathon, you would have put in hours of training before the big day. It’s the same with mindfulness, it is about training your attention, and, in some ways, a bit like taking your mind to the gym, you need to practice regularly to see benefits and also to be able to draw on the skills at difficult time.

5. It’s Not Just For A Particular Type Of Person!

Anyone can practice Mindfulness and see benefits.  You don’t have to have a particular personality type, you don’t have to have an interest in complimentary health, you don’t need to have a particular faith or an interest in the spiritual, you don’t have to be a yogi or a Buddhist,  (and of course if that’s you, that’s great) but the point is, the benefits of Mindfulness can be accessed by anyone who is willing to learn about it and to practice.

If you are interested in trying out a mindfulness practice, listen to the 5 minute breathing space exercise at mindsurgerylondon.co.uk or contact us for details on our mindfulness workshops and courses.

Copyright 2015 © MindSurgery London

Rumination:’Chewing the Mental Cud’

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Have you ever watched a cow chew the cud? The mechanic, circular movement of the jaw; the dead-eyed stare; the seemingly never-ending sameness of the action. The word “ruminate” derives from the Latin word for chewing cud, a process in which some animals grind up, swallow, then regurgitate and rechew their food. Similarly,  as humans, we can all have a tendency to  ruminate or mull over a situation, turning it over and over in our heads.    It becomes rumination and not problem solving when we no longer have any new ideas about solving the problem, but replay the situation in our minds regardless.  When ruminating we tend to focus on causes and consequences rather than solutions; why has this happened to me or what will happen in the future rather than how can I solve this. We all ruminate to a greater or lesser degree; think about a conversation you’ve had with, say, your boss at work, a conversation that didn’t go the way you’d hoped. You turn it over and over in your mind, worrying at it, second-guessing and teasing out meanings that may or may not be real. The gift keeps on giving – we have all had the experience of thinking back on something that irritated or annoyed us, and feeling irritated and annoyed all over again even if the event happened quite a while back.

We ruminate because we are trying to come up with a solution, or trying to make sense of something.  Sometimes it can feel as if we are stuck in a rut of rumination that we cannot get out of.  In my experience as a Clinical Psychologist, I regularly see how rumination is linked to anxiety and depression.  This is supported by large scale research which shows that excessive rumination on negative events acts as a mediating factor between a negative life event and stress and is the biggest predictor of depression and anxiety.  In other words, a bad thing can happen in your life, but if you have a tendency to ruminate on this, you are much more likely to experience higher stress and increased risk of developing anxiety and depression. It is not only what happens, but how you process what happened that is important.

It is not just our mental well-being that suffers if we ruminate excessively, it also has a negative impact on the rest of our bodies.  Ruminating on  a stressful event can extend cortisol stress responses and keep the physical stress responses including pounding heart, breathlessness, sweatiness, feeling flushed or light headed going for longer too.   In this way, repeated rumination can have a negative impact on our physical health.

Breaking the habit of rumination

What can we do to break the habit of rumination? Seeing a Clinical Psychologist for a limited number of sessions can help change thinking habits.  Cognitive Behavioural Therapy or CBT is one of the approaches that you are likely to learn in sessions to give you practical strategies for managing your thoughts in a more helpful way.  Mindfulness based therapies can also be a very helpful approach to manage rumination as it teaches us not to attach to thoughts, and helps us to take a step back from the cycle of rumination.

Aside from individual sessions with a Clinical Psychologist, there are also practical first steps that you can take now to reduce rumination:

  1. Become aware of when you are ruminating.  ‘Thought catching’ or identifying that you are ruminating is the first step towards change. Take time to check in with your mind throughout the day and see what it is doing.
  2. Once you catch yourself ruminating, label it as such by saying to yourself ‘I’m engaging in rumination now’ thus creating a distance between you and your thoughts.
  3. Distraction and switching activities can also be a good way to start to break the cycle of rumination.  Beware of passive activities like watching TV or surfing the Internet as these are prime times when our minds can slip into ruminating without us being aware.   If you sit on the couch with the TV on, but really you are ruminating on an argument with a loved one, then you need to do something to focus your attention elsewhere. Get up and engage your attention with another task – plan your day, make a call, do a crossword, decide what to cook for dinner…it can be as mundane or marvellous an activity as you like as long as it involves focusing your attention somewhere else.
  4. Go for a walk – it may be what your granny told you but there is research to show that going for a walk in a nature filled area is correlated with lower levels of rumination. The nature bit is important, just going for a walk around the block won’t do it – research has shown that urban walks did not have the same effect on rumination as a walk in a natural environment. Go walk in your local park, a forest, or a farm – you might even meet those cows, ruminating, while you free yourself from it!

© Copyright MindSurgeryLondon Ltd. 2016

MindSurgery London provides individual therapy sessions and also runs events for well-being and mental health. For further information please contact us at mindsurgerylondon@gmail.com.

References

Kinderman P, Schwannauer M, Pontin E, Tai S (2013) Psychological Processes Mediate the Impact of Familial Risk, Social Circumstances and Life Events on Mental Health. PLoS ONE 8(10): e76564. doi:10.1371/journal.pone.0076564

Zoccola, P. M., Figueroa, W. S., Rabideau, E. M., Woody, A. & Benencia, F. (2014). Differential effects of poststressor rumination and distraction on cortisol and C-reactive protein. Health Psychology, 33, 1606-1609. doi:10.1037/hea0000019

Gianferante, D., Thoma, M. V., Hanlin, L., Chen, X, Breines, J,. Zoccola, P. M., & Rohleder, N. (2014). Post-stress rumination predicts HPA axis responses to repeated stress. Psychoneuroendocrinology, 49, 244-252. doi:10.1016/j.psyneuen.2014.07.021

Zoccola, P. M., Rabideau, E. M., Figueroa, W. S., & Woody, A. (2014). Cardiovascular and affective consequences of ruminating on a performance stressor depend on mode of thought. Stress and Health, 30, 188-197. doi:10.1002/smi.2588

Bratman, G.N. , Hamilton , J.P., Hahn , K.S, Daily, G.C & Gross, J. (2015).  Nature experience reduces rumination and subgenual prefrontal cortex activation. PNAS. 

http://www.pnas.org/content/112/28/8567.full.pdf