Na-na-na-nananana.
Na-na-na-nananana.
PRESSURE pushing down on me,
Pressing down on you...
Freddie Mercury was onto something when he wrote Under Pressure with David Bowie in the 1980's. Not only is it an absolute banger that must be blasted (and sung) at full volume, but it's also a good reminder that being under too much pressure can be bad for our Vaginas.
It's unlikely that 'Under Pressure' was written about vaginal dilating but I'm going to extrapolate a lesson from it nonetheless. I think Freddie would be down for it.
Prepare yourself. I'm going to impart some wisdom today. I've learned these lessons the hard way so hopefully you can just read this and skip some of the bad stuff yourself. Maybe. Just an advance warning as well that I talk at length about stress, feeling overwhelmed, how this impacts relationships and dilating so maybe save this one for later if you're feeling on edge. The tail section contains some useful tips for managing pressure.
We are all guilty of putting pressure on ourselves. Whether it's your appearance, your career, your parenting style, your education, cake baking or your sex life (or all of the above). We put pressure on ourselves to meet our own internal expectations and we perceive pressure from others, to meet their expectations.
Sometimes pressure can be a good thing. Pressure can motivate us to achieve our goals and ambitions. It's why many of us need the pressure of a deadline to deliver a piece of work. In fact I'm so conditioned to working under high pressure now that unless I have a tight deadline I just can't get anything done. There is a point however where pressure becomes too much and we begin to feel stressed out. Pressure becomes counterproductive at this point and actually prevents us from achieving our goals.
There is a sweet spot somewhere in the middle where we have enough pressure that we are motivated and focused without being overwhelmed. That's what we want to aim for. This is the what's known as the Yerkes-Dodson Law. Sounds very official doesn't it?
We can feel pressure in situations where our expectations of ourselves (or others expectations of us) are out of proportion with reality. Meaning we're aiming for something that's impossible, that we can never hope to actually achieve or that feels too far out of reach compared to where we are now. Even when we are faced with realistic tasks, if we have too many of them to do in the time we are given it can feel overwhelming and impossible. For those of us who are also perfectionists there is also the cherry on top of never quite being content with what you have achieved and always expecting more of yourself.
Feeling under pressure with Vaginismus
It's really common and completely normal to feel HUGE amounts of pressure to recover from Vaginismus as quickly as possible. A lot of this comes from inside ourselves. We might for example feel like we are letting a partner down by not being able to have PIV sex (important: we are not). It's common for women to feel like they are not 'whole' or that they are failing at being a woman, because of what society expects us to be able to do (again, we are not). We might also have a partner who is putting pressure on us to engage in PIV sex or expecting us to do other things to make up for the fact that we can't (this is wrong). There might be pressure on us to date, to get married, to have children (urgh, stop please).
Even with dilating there can be a lot of pressure for each dilating session to be better than the last, to quickly progress to the next size, to dilate for longer periods of time and with more regularity. We just want to skip ahead to the end (guilty).
There isn't enough space to write down all of the different ways we can feel pressure from within ourselves and from others around our Vaginismus condition but I'm sure many of you can relate to some or all of the points above. The point is that we can feel under huge amounts of pressure just living and dealing with Vaginismus, let alone anything else that may be happening in our lives. Unfortunately, being under this pressure whether internal or external makes recovering from Vaginismus that little bit harder. As if it wasn't hard enough already.
Laser focus on the end goal
If we are super focused on our end goal (for example PIV sex) but can't so much as look at a dilator let alone insert it, it can feel incredibly demoralising. You might wonder how on earth you can ever recover from this thing if you can't look at or touch a dilator? It feels impossible because we are comparing where we are today with our ultimate end goal without really thinking about what's in the middle. It can mean that even when we do make small steps towards recovery, we don't recognise them for what they are. Similarly, even the tiniest of set backs or a little additional pressure can make you feel like you have failed or that you're going back to square one. And sometimes that makes us feel like quitting altogether. And sometimes we do quit altogether. And that's bad, because well, Vaginismus does not resolve itself.
Cast your eager minds back to Spring 2019. A brighter time. A time before Covid. A time before social isolation. Everything was well in the world. Kind of.
I was just coming out of my first round of therapy sessions and feeling pretty good about my Vaginismus treatment plan. I had started to date for the first time in years and I was excited. I also had just started a new job. I thought dating would be a really good motivator for continuing with treatment but I was a little apprehensive of putting too much pressure on myself. The anxiety was warranted. As soon as I started dating someone seriously, I felt a huge increase in expectation to progress to PIV sex. Which meant I needed to move a lot faster with my dilating treatment. I felt under a lot of pressure from myself and from my partner and as a result I perceived the fact that I wasn't able to to have PIV sex as a personal failure and proof that the treatment wasn't working. Everything felt hopeless. The balance tipped too far, from having a reasonable amount of motivation and realistic expectations to being a high pressure situation and it didn't end well. I forgot all about the good stuff that I had achieved and gave up on all of it - the treatment and the relationship. (Don't worry, things get better again, just like in Disney).
Tunnel vision
Maybe you're a little more optimistic and stable than my spring-2019 self. Maybe you're comfortable with your treatment plan, buoyed up by recent achievements. You're zipping through your dilator set and feeling really good. I've also been here too. In fact I'm sort of here right now. It's a great place to be! Its been going so well in fact that I've been constantly challenging myself to diversify and increase my dilating regime. I'm constantly trying new things, pushing myself further and further.
Oh wait. What. That sounds a lot like pressure.
Yep. So I came to the realisation a few days ago that I was putting a huge amount of pressure on myself to dilate-every-single-day-without-skipping-any-sessions-at-all-ever-under-any-circumstances. Its honestly been going pretty well so yeah I can safely say I've been successful at that goal. So I think I've got away with it.
Except I've been so single-mindedly obsessed with dilating EVERY DAY that I've fallen down in other areas. I've been way less focused on properly relaxing, working on breath work and arousal and far more focused on just getting through the session against all odds. As long as I can tick that box that I've dilated today then I feel like that's job done.
Unfortunately despite having double the amount of sessions I was having before, the results have been slowly getting worse. I've freaked myself out a bit that I'm not progressing and potentially going backwards again. ENTER PANIC STAGE. I've forgotten that in addition to dilating regularly there's a TONNE of other stuff that has to be worked on and dilating every day doesn't matter if I'm not doing it in the right way.
Your body's stress response
You won't be surprised to hear that pressure and stress go hand in hand. If you're feeling a lot of pressure to achieve something, particularly if it's an ambitious goal and you've pinned something trivial like oh I don't know, the success of your marriage or your entire future happiness on it, you can feel anxious and stressed out about failing. Your body is likely to have a physical stress response in this situation. This is your sympathetic nervous system kicking in, in other words your fight or flight response. NEWSFLASH - this is the exact opposite of what dilating sessions should be about. You can't painlessly insert a dilator if your engaged in warfare with said dilator, or if you are high tailing it out of the bedroom and down the street in the nudey.
A real world example of this might be starting a dilating session by having the expectation of moving up to the next dilator size. See if you recognise this thought pattern: Tonight is the night. If I don't move up right now I might never make it, I might even go backwards, and then I'll never recover. I will never get a partner and I'll be alone forever. These are some pretty worst-case-scenario thoughts I have from time to time while I'm dilating and you can bet your life they don't help me chill out. When you're anxious and scared you're probably going to be feeling pretty tense, your heart might beat faster, your breathing might become more rapid. You might not even realise it but you might be gritting your teeth, or tensing your thigh and pelvic floor muscles.
Fight or flight is not useful here. We're not outpacing a lion or fighting a bear. We're trying to insert something quite large into our already anxious vaginas and it's really important that we don't spook them. The body's natural stress response lends itself to Vaginismus and stops all the other good stuff that you do want in a dilating session from happening. Such as relaxation, presence of mind, psychological and physiological arousal and pleasure. If you don't have these things then it's not going to be a pleasant experience and you may even do more harm than good.
The psychological processes that underpin Vaginismus are really hard to break down, which is why the treatment is so long and tedious. It's about breaking associations we've made between penetration and pain. There's a hell of a lot of unlearning to be done and a lot of focus on building new positive experiences through the dilating process.
The absolute worst thing you can do with dilating (or any sort of sexual activity really) is grit your teeth and push through it in order to progress your Vaginismus faster. The often quoted "what doesn't kill you makes you stronger" just doesn't fly in Vaginismus World. All it's going to do is reinforce the brain pathways that cause your Vaginismus in the first place.
So chill out, don't be anxious. RELAX.
Ok so me telling you to not be anxious when you are already anxious is probably making you EVEN MORE ANXIOUS and probably quite PISSED OFF. How many times have people told you to JUST RELAX and you'll be able to have sex? Loads I bet. Has it ever worked? No. Will it ever work? Also no. But I do have a point with this.
Relaxing is a really important part of the dilating process and when we're stressed out we are the opposite of relaxed. Therefore it's genuinely important to notice when you are in this dark place of feeling too much pressure so that you can get yourself out of it, rather than trying to push through it.
Relaxation isn't going to cure your problem. You won't miraculously not have Vaginismus anymore if you meditate for 30 minutes. What it will do is give you a better chance at a successful dilating session and slowly this will help you work towards recovery.
This is the low point of the article (don't worry, it gets better!) and I feel like it's really important to shout out to anyone who is already recognising that they are in a super negative thought spiral and struggling with their dilating regime. In this situation sometimes the best thing you can do is take a break from your dilating. I know it feels counterproductive but if you skip a few days, maybe a week, and focus on self-care and mindfulness you'll be in a better place when you come back. Just make sure you do come back to it! Slow and steady wins the race.
OK PLEASE STOP TALKING ABOUT BAD STUFF.
Alright. DEEP BREATHS EVERYONE. And we're back in the room. I'm very sorry I took you to some really dark in places. Lets lift ourselves out of the hell hole that I just painted and come into the light. Here are some therapeutic dolphins. Please allow the dolphins to wash away all the dark stuff. Happy place. (If you are afraid of dolphins then I'm extremely sorry).
Getting the balance right
So too much pressure is bad. Psychologically and physically. But also sometimes pressure is good in the right amounts. Cool. How do we know how much is enough? Well it's like most things in life. You need to find the right balance for you. (Sigh, okay yes but HOW?)
It will come as no surprise to you that dilating generally isn't that much fun. Even when pleasure is involved I'd still rather be doing something else. I need something to motivate me to keep going otherwise I would just avoid it altogether (and yes, I have been there many many times!).
If you've read some of my previous posts you'll be aware that I've only recently starting dilating again. I've had two previous attempts at dilating, with some pretty hefty 'breaks' in-between. I'm talking months and even years, not days. I'm not sure I'm even allowed to call it a break when it gets to that length. Just like Ross and Rachel in 1997. Anyway, my point in saying this is that I have a habit of swinging from having zero motivation/zero pressure (and zero dilating) to lots of motivation/too much pressure (and also zero dilating). I'm either giving all I've got, or I'm giving nothing at all. Neither is particularly useful and it's only when I'm briefly in that middle zone that I actually make any progress.
If I really thought about it I could probably quite accurately predict the peaks and troughs of my dilating journey by tracking the amount of pressure I'm feeling at a given time.
So, like all things in life, it's about moderation. Having just enough pressure and having realistic expectations and goals to give us that motivation. SOUNDS EASY.
How to recognise when you're under too much pressure
Possibly the most important aspect of trying to hit that sweet spot is recognising when you're under too much pressure (or not enough pressure) so that you can actually do something about it. Historically I've not been good at this and the 'flight' response is a particular favourite of mine: running away from dilating by burying them in the bottom of the wardrobe and forgetting they exist. It's also true that when I relocated to the other side of the world I left my dilators behind. Oops. We have been reunited now.
During Vaginismus dilator treatment, if you have a CBT therapist or even perhaps a Physiotherapist on your side they can usually spot when you're under too much pressure and help you to find a pace that suits you. My therapist was ace at doing this. She recognised that after my first few successes I started tackling my dilator set like a bull at a gate. She slowed me down, thankfully. I'm getting better at spotting the signs myself now. It takes a little while but there's usually a lightbulb moment soon enough.
If you aren't in therapy then you should seriously consider it. If it's not for you, then I can recommend at least keeping a dilator diary for yourself so that you can keep tabs on how you are feeling about your progress, what actually happens in each session, and take stock every now and then.
So spotting when you're feeling under pressure. Probably fairly easy. Often presents as stress so it's going to be something that you are feeling, either physically or psychologically.
Check in with how you are physically feeling generally and also when you dilate - is your heart beating faster? Does your chest feel tight? Are you sweating? Are you holding tension in your muscles?
Listen to your thoughts - are you hearing a lot of "I should do this", "I must do that", "If I don't do this then that will/won't happen"?
Think about your expectations of yourself and the expectations that others have of you. What are they? Are they realistic and achievable? If you're not sure, bounce them off someone that you trust to be objective and kind.
Keep a dilating diary and check in with yourself from time to time. Are you still taking as much care in your dilating sessions today as you were 6 weeks ago? (general patterns, not every session!). Has your mindset shifted in a negative way without you noticing?
If you are feeling under pressure from someone else's expectations of you (e.g. a partner), do a reality check. Is your perception of their expectations actually what they are expecting? If it is, are their expectations realistic or unfair? (I have history of assuming what my partner was expecting of me. Shocker - I was frequently wrong)
Breakdown what you have set for your treatment in terms of a plan, goals, and how you conduct dilating sessions. Go granular. Does anything seem off balance? Are you neglecting some things in favour of speed? Have you set unrealistic timelines?
What can you do about it?
If you have noticed that you are feeling a bit too much pressure then you need to make some sort of change before it gets overwhelming. I'm speaking from experience in this area and I'm genuinely writing this today because this is literally where I am right now in my treatment. It took me a couple of weeks to notice it. Pressure is sneaky like that.
Firstly, be proud of yourself for getting to whatever point you are at today. For seeking help and for trying to work through your treatment. IT'S A HUGE DEAL! AND YOU'RE DOING IT! High five. Big hugs
Secondly, don't panic and run away from whatever pressure you are under. It's super tempting but there are lots of small things you can do to rebalance yourself and get to a place where you feel like you can cope.
Take a step back and assess what's on your plate. Is your plate too full? Are you trying to do too much? Can you take something off, to lighten the load? You are not a superhero (are you..?). Take a few days away from dilating if you are already feeling overwhelmed. Just make sure you set a date to come back!
Get some support - a therapist, a friend, a fellow Vaginismus sufferer. Someone for you to check in with and bring you back down to earth every now and then. And of course a sympathetic ear.
Revisit your expectations and your goals. Make sure they are realistic and achievable. If they are not, break them down so that they are. Don't worry about the big end picture so much as what you can achieve today, or tomorrow, or next week to give yourself a happy juice boost (yum).
Keep a dilation diary. Be proud of your achievements. Celebrate them at every opportunity. This can be anything you want, from holding a dilator in your hand without feeling nauseous, to moving up a size. Treat yourself! Cake, alcohol, fancy dinner, a massage. Balloons. Go wild.
Try to accept your progress and each session for what it is, not what you want it to be. I do not say this lightly. This is SUPER DUPER HARD and takes conscious effort and lots of practice to achieve. And even then, sometimes it doesn't happen. Mindfulness exercises may help you here.
If you are feeling external pressure from a partner, it really depends on the scenario but I think communication is king here. I've made the mistake of (incorrectly) assuming what my partners expectations were and not opening up about how much pressure that put me under. Ultimately you need to include them but they also need to respect that this thing goes at YOUR speed. You need control of the situation. I personally find it useful to completely take PIV off the table, at least until such a time that I want to put it back on (I could go on forever about Partner Pressure but I think it deserves its own post!).
Try not to compare yourself to anyone else's progress - be that with dilators, transitioning to sex, dating, or wearing tampons. Check your internal dialogue, is it being helpful or self critical?
Try to neutralise any situation that is causing a road block E.g. if you just can't crack tampons, then be open to taking a break from trying by exploring other options. Tampons aren't for everyone and you can always try again with a fresh brain when you feel up to it.
Be nice to yourself! Don't beat yourself up.
Taking my own advice:
I practice what I preach. As I said earlier in the post, I've been putting too much pressure on myself lately. Here's an outline of what this looks like for me, now that I've recognised it:
I've been hell bent on dilating EVERY SINGLE DAY. I even just set myself an arbitrary goal of dilating for 30 days consecutively. Publicly! To you guys!
I want my sessions to be QUICKER so they take up less time in my day. That's resulted in sometimes rushing through a session and not focusing on taking it slowly like I had been doing.
I've been focusing on including arousal in my routine quite a lot, which is a good thing, but actually it has always been as a means to an end. Rather than focusing on the whole dilating session being pleasurable, I've only been using arousal to get the dilating over and done with easier.
I've been using some mindfulness techniques to prep for dilating, but I haven't really used them throughout the session. Again, its just been a tick box exercise so I can start the dilating.
All in all. When I look at these points, it's a bit of a DOH moment. It would be a miracle if my pain scores hadn't increased (they have). When I first started dilating a month or two ago I paid SO much attention to myself, gave myself so much time and actually enjoyed my sessions (as much as it's possible to enjoy). Lately I've just wanted to get through it and finish so I could go to sleep.
So I'm going to take my own advice above and give myself a break. I've taken a couple of days off, I'm noticing where I'm putting too much pressure on and I'm learning to let go a bit. Let's face it. This journey is going to be a long one, so is it really going to make a difference if I skip a day or two here or there? Probably not. If I skip 6 weeks, maybe a little. If I skip a year, well, I'll still get there in the end. So I just need to be realistic about what to expect of myself and not be so hard on myself. I encourage you guys to do the same!
YOU GOT THIS!
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