Mindfulness based approach to the treatment of women with sexual pain

There is an excellent new article in the Sexual and Relationship Therapy Journal (footnote 1), titled “An integrated mindfulness-based approach to the treatment of women with sexual pain and anxiety: promoting autonomy and mind/body connection”. The author, Talli Y. Rosenbaum, is an AASECT certified sex therapist who is also a pelvic floor physical therapist and is an internationally recognized expert on the role of combined physiotherapy and sex therapy in the treatment of sexual pain disorders.

Key points, mindfulness principles, and excerpts of the article are highlighted, as follows:

1. Reconsider your response to pain The mindfulness approach encourages the client to reconsider her response to pain. Rather than consider pain as the enemy (i.e. “I hate you pain, I am afraid of you”), the patient is asked to attribute a number to her pain and stay with it, paying attention to how the pain feels as she allows her body to relax. She then notes how allowing herself to accept the pain as part of her experience reduces the actual perception of pain. In addition, she is encouraged to remember that each moment in time will be replaced by another one.

2. Experience each session with patience and a beginner’s mind Rather than emphasize a need to “do better” than the prior session and demonstrate objective progress each time, clients are encouraged to experience each session with a beginner’s mind … experience the activity as if for the first time, without any preconceived notions or expectations based on prior experiences.

3. Mindfulness Principles in relation to dilating

  • Create a space for the activity. Turn off communication devices, put on soft music and candles, and begin with several minutes of deep breathing.
  • Always begin with the smallest dilator and work up gradually to the next size.
  • Allow, rather than push the insert inside.
  • Consider fantasy and self-pleasure while using the inserts in order to best stimulate arousal, which is the circumstance under which vaginal penetration is most comfortable

4. Mindful couples interventions Mindfulness-based couples interventions change the script from the male partner playing the supportive and patient role to that of the couple taking a journey together. The couple is encouraged to engage in and experience physical intimacy for its own sake and not as foreplay to intercourse. The couple is further instructed to focus on the sensation of breathing together, touching each other, and ascribing new meanings to their sexual connection.


1. Talli Y. Rosenbaum (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, DOI:10.1080/14681994.2013.764981

Contact Us

If you have any questions about our Botox treatment for vaginismus and progressive dilation under anesthesia, please contact us via our contact us form.



Avatar photo

About Dr. Pacik

Peter Pacik, MD, FACS is a recognized pioneer in treating patients with Botox for vaginismus and the author of When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy. He has been in practice for over thirty years and belongs to a small group of prestigious surgeons who are double board certified by both the American Board of Surgery and the American Board of Plastic Surgery. In 2010, Dr. Pacik received FDA approval to continue his study to treat vaginismus using intravaginal injections of Botox together with progressive dilation under anesthesia.
This entry was posted in Botox Treatment and tagged , , , , , , . Bookmark the permalink.