If I asked 100 women what their goal is for Vaginismus treatment, it might be something like "To be able to have sex with my partner". I think I'd probably say the same thing.
I'm a very goal oriented person. I like to have a goal in mind to give me something to aim for. This is generally speaking a good thing. Goals gives you motivation and you can see your progression. The problem is I don't always set good goals, and sometimes I find them counterproductive.
I'm often over ambitious - I get far too excited, make the goals too big and I expect too much too soon. When I don't get the results I'm after it feels like I've failed, I lose motivation and give up on the goal.
When I first started having therapy sessions, my therapist would ask me what I wanted to achieve from the sessions. It seemed like an obvious question. To get rid of my Vaginismus, OBVIOUSLY. What else was I here for? But that was (and still is) quite a big goal. I'd had that goal for 11 years before that therapy session and I'd made absolutely no progress whatsoever. So the goal was useless. It was too big and I didn't have a plan on how to achieve it. It was just me on the one end, figuring out how to cross the grand canyon of my condition (as yet undiagnosed), without any real strategy other than running towards the edge and hoping for the best. The only thing the goal did was make me feel bad about my lack of progress.
I do this with pretty much every goal I've ever set in my life. The goal is either too ambitious so it makes any progress look insignificant (even if it's not) or I don't have a plan on how to get to the end goal. Lots of us do this, particularly at the start of the New Year. How many people actually stick to their resolutions? We're so bad at setting goals it has become a cliché.
So how do you achieve your Vaginismus goals? What even is a good Vaginismus goal?
VERY GOOD QUESTIONS MADAME. And no I'm not just going to list what makes a SMART goal you hear about at work for your appraisals 'cause I don't want you to fall asleep. I'm also not here to tell you what goals to set, because that's an individual decision. I'm just going to outline how I think about it.
Let's pretend I want to swim across the Atlantic ocean from the UK to America because I have something wrong with my brain*. That's a bloody massive goal. My normal goal methodology would be to nip down to Dover hop into my swimming costume, run across the beach at great speed, dive blindly into the water, and expect to reach the USA, I don't know, maybe like next week? In reality, I'd experience shock from the cold, and if I didn't drown in the first 15 minutes I'd probably be struck by a P&O ferry shortly after. Goal well and truly NOT accomplished.
The PROPER way to achieve this goal would be by realising there's a bunch of stuff you have to achieve before you can do the big swim. For a start I'd have to have some sort of training plan, learn how to do proper outdoor swimming, I'd have to work through a route with someone who knows about navigation and shipping lanes, I'd maybe speak to some people who do this kind of thing, perhaps assemble a support crew, then there's the equipment, nutrition, psychological considerations, acclimatising to the cold... Basically there's a whole bunch of stuff to give you the best shot at being successful.
All of those things in the middle are like a string of smaller goals that you need to work through, in order to achieve your final goal.
It's exactly the same with Vaginismus treatment goals. I still have the Big End Goal (to have p in v sex with a partner) but I don't think about it too much. I don't find it helpful. I've broken down my recovery goals into smaller more achievable pieces. I haven't worked everything out like some grand planner extraordinaire, I just made a few goals to get started, and I focus on them and only them.
It feels more achievable. It feels realistic. It also allows you to recognise your progress. If for example I succeed in getting to dilator 3, but my Big End Goal is p in v sex, its easy to get despondent and feel hopeless. But if your mini goal was to just get to dilator 3 comfortably, then you absolutely smashed it! And you can feel good about yourself. Then move on to set the next goal. You can see that you are progressing, and that gives you motivation and carries momentum, and that keeps you on track. And even if you do have a set back occasionally, it doesn't seem like such a disaster.
What should you set as a smaller goal?
Well that depends on what YOU want. It's going to be different for everyone. Some people need to work on self esteem, others need to focus on dilating.
After some intensely uncomfortable initial sessions with my therapist I put together some initial goals in early 2019. They do break most of the classic SMART rules so I sincerely apologise to the Goal Police.
Reducing some of my negative emotions/feelings around Vaginismus/Sex
Be able to discuss my Vaginismus with other people (calmly)
Dating (yikes)
Being able to use tampons
Make progress with my dilators (very vague..)
Kegels (do some?)
You can see that NONE of these goals had anything to do with "MUST MASTER THE FINAL DILATOR AND HAVE SEX WITH MAN". Because what is the point in setting that goal, when I have 6 dilators to get through and a whole load of work on self worth, my sexuality, and even dating?
Yes having p in v sex is still my end goal, but I've attached less importance to it by diluting it into smaller more achievable goals. I've also realised that I can let go of p in v sex as being that holy grail. I can enjoy sex without it, so, actually I don't feel like this huge goal is hanging over me all the time.
Some ground rules that I use when working towards my Vaginismus goals:
Make it achievable
This means making it something that you are confident you can achieve. It's a balance between challenging yourself enough, but not too much.
For the love of God, write it down
Otherwise you won't remember what on earth you are working towards or be able to measure your progress.
If you are struggling, move the goalposts
Challenge yourself but not too much. And don't beat yourself up if you're struggling. Maybe your goal was too big, maybe you don't have as much free time as you thought. Cheat! Change your goal! It doesn't matter, you can make the rules up here. The important thing is that you accept where you are and focus on moving forward. You won't do that by beating yourself up, so do it by making a better goal.
Reward yourself (no punishments!)
For achieving major milestones but also just for being strong and sticking at it. Don't punish yourself if you have to take a step back.
Accept that there will be set backs
Like anything in life, it isn't going to be a lovely smooth journey from diagnosis to recovery. Sometimes you go forwards, sometimes you go backwards, sometimes you end up 50 miles in the wrong direction (especially if I'm driving). But the important thing is you get back on track when you can.
Have some perspective
Remember to zoom out on your goal 'map' every now and then, to check where you are. Not for the purpose of seeing how close you are to your Big End Goal but to recognise the progress you have made so far.
What happens if you're still paralysed by your smaller goals?
Sometimes even these smaller goals seem too big and daunting and you avoid doing anything. We have all been there. Well, what I've found works is just focussing on what is the smallest, easiest, quickest way to get yourself into action. Maybe you're not ready for any sort of goal yet. I remember when I first got my dilators I HATED looking at them so much. I'd feel dread if I so much as thought about them. So a goal like 'getting comfortable with dilator X' was just way too big and scary and I hid my dilators at the back of my wardrobe. In more recent times I've broken those big goals down again and again, smaller and smaller. Finding the smallest most insignificant thing that I can do first. You could just take 5 minutes to look at and contemplate the smallest dilator, just noticing how you feel about it. Or you could take 15 minutes each day to chill out on your bed. Time that in future you'll use for dilating but for now you just sit and chill.
If you're feeling like this, then I strongly recommend seeing a therapist alongside your dilation. My experiences on here are just my own, I'm not a professional and these posts aren't intended to replace a proper treatment programme. Therapists can help you work through these feelings much better than you can do on your own and they can help you get into a better mindset first before you start dilating. Even if you hate the idea (like I did) you might come round to it, if you give it a chance.
My 2020 Vaginismus goals!
All this talk about goal setting has made me realise I need to revisit some of my own goals so here is my Autumn/Winter 2020 collection. My goals for the next 'phase', however long that may be:
1. Continue to get more comfortable discussing my Vaginismus
I will continue writing about it on this blog and in personal journals (so you guys don't have to read alllllll of the blabbering nonsense, just some of it)
2. Find someone that I can talk to privately about it
This scares me to write this so its probably a good goal for me
3. Continue to invest in my own self esteem & self worth
This is my biggest blocker FOR SURE. I'll achieve this by continuing to build up other parts of my life outside of Vaginismus, e.g. My work, interests, hobbies, sports etc. It has the delightful bonus that I care less about my Vaginismus and also gives me some other positives in my life, so a set back in one area doesn't send me reeling
4. Get comfortable with dilator #4
We're pretty well acquainted but need to get to know each other better
5. Get comfortable removing dilators
This is a sticking point for me, more practice needed
And before you say it! I knoooow I'm breaking some of the classic SMART goal rules here again. Pipe down Goal Police. I'm not always super specific, and I haven't necessarily set timeframes. But I don't want to set rigid timeframes, that's too much pressure and I don't find it helpful. I'd rather commit to a regular dilating schedule e.g. 3 days of every week. There is no point saying I want to achieve higher self esteem in 6 months, or I want to be on dilator 5 next week. It takes as long as it takes, honestly. And these are measurable, I can measure these goals through my journaling, and that's the important thing. I think.
What are your goals?!
*All joking aside Sarah Thomas has actually swum the whole journey and back again. So much respect.
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