Tags: advice, agony aunt, bad advice, blogging, communication, experts, language, psychology, relationships, what
I can’t find an advice columnist I like.
I’ve been searching for the right agony aunt for years. It shouldn’t be too hard, since advice columnists are a staple feature of most major news outlets and magazines. Even smaller media outlets and blogs recruit advice columnists to generate new content.
Besides, sooner or later, just about everyone goes through a period where they believe they are equipped to start giving advice, so some folks take the “Dear so-and-so,” mantle upon themselves, without solicitation.
Perhaps I should put an ad in the paper – “
Single (not really) white female seeks competent sex, relationship and general life advice columnist. Must maintain a predictable schedule, be open minded, patient yet firm, and be knowledgable on every topic addressed… Must never screw up.”
Part of my problem is timing and schedules. I liked the Feministing.com column, Ask Professor Foxy when it was still active, but the eponymous Prof. Foxy hasn’t written a new Q&A column for the site in about a year. Good Vibrations Magazine occasionally answers reader submitted questions in the feature, GV Housecalls, but this feature is irregular. There can be weeks or months between new columns.
I believe that folks gravitate towards the advice they want to hear. So how open-minded your agony aunt is, is likely a function of how open-minded the advice seeker is. In other words, if you value spiritual guidance, you probably wouldn’t reach out to a secular agony aunt for relationship advice. You’d probably look for an advice columnist with a spiritual bent instead. “Dr.” Laura Schlessinger is one such spiritual agony aunt, but for multiple reasons her programs, which include racist rants, repulse me.
With regard to advice columnists in general though, that desire for certain types of advice means different agony aunts will attract certain types of audiences. I’m sure that agony aunts figure out their target demographics. Advice columnists then hone their responses to better meet their readers’ expectations.
Advice columnists specialize in certain areas too. Although one agony aunt responded to every submitted query, I think this is an absolutely terrible idea. The sheer amount of research required to give yourself a crash course before answering curveball questions would draw time away from more relevant queries. I wouldn’t ask a self-described expert on cooking about when it’s appropriate to move out-of-state. (I might ask a financial advice columnist though.)
And so much advice-giving is really permission granting. I notice that the way questions are written offer clues as to what the the submitter already perceives to be true – submitters want confirmation from someone perceived as an authority figure. I remember reading an article about the real Erin Brockovich a number of years ago, in which she described talking to herself when facing dilemmas. (An Amazon review of her book provides backup that Brockovich does indeed describe talking to herself.) I think a lot of advice seekers could similarly find the answer they seek by looking within and confronting themselves.
Frankly I’m not even fond of the direct question-and-answer format of advice columns. With Q&A columns, there’s no way to get all the relevant information required to make an informed decision on behalf of the submitter. Printed letters have to be edited for space, too, which can be even more confusing for readers.
An example of a format I especially want to avoid though, can be found in Wayne & Tamara’s column. The authors usually respond to questions with unrelated stories, with the advice buried in parables. I love it and I hate it all at the same time – the responses can be so cryptic it’s funny.
I prefer blogs, since bloggers frequently follow the “Show, don’t tell” principle – though there’s still some telling involved with blogging. Even then, personal stories & experience work well as examples to illustrate a larger point – the personal is political, after all.
But not all bloggers are agony aunts.
So there’s still plenty of popular advice columnists left to consider, right? Maybe not. My last criteria may be unfair, since everybody makes mistakes sooner or later. And what I view as an error, someone else may perceive as a positive feature. (The social justice blogosphere frequently critiques examples of ignorant “Advice.” Feminist & social justice readers probably recognize the problems in this recent gaffe, but if you’ve been swimming in privilege, you may be all like “I don’t get it.”) But when an advice columnist is recommended and has a strong reputation, I expect more. I’ve been disappointed and disgusted by popular columnists, and once I’m disappointed enough I just stop reading. From that point on I’ll be more reluctant to trust the agony aunt and whatever advice zie have to offer. Sometimes advice-givers apologize after getting called out for obvious screwups, but it may be too little, too late… Doubling down on privilege doesn’t help either. For example:
I stopped reading Dear Abby on June 27, 2007 when I saw this Q&A posted. In her response to a 33-year old virgin woman with anxiety over the prospect of her first gynecological exam, Abby wrote in part:
DEAR SCARED: A woman should be seen by a gynecologist if she is sexually active, or if she has reached the age of 18. She should DEFINITELY see one if her regular doctor tells her to — so please start acting like the 33-year-old adult you are and stop listening to “horror stories” from friends. Pap smears are not painful, and women do not normally bleed after having one.
Sounds spot-on, right? Wrong. Pap smears can be painful for some women – Abby’s response makes it sound like anyone who says otherwise must be a drama queen or a liar – instead of someone who may have a treatable medical problem that any competent gyno could make accommodations for.
Abby doubles down and adds insult to injury with the snide implication that “Scared” is acting like an immature child, just like a childish woman who can’t suck it up and deal with it at the gyno’s.
I never got into Dan Savage’s advice series because by the time I found out about him, it was because his reputation had been recently marred – and not for the first time. I know he’s done good things for the gay & lesbian community in particular, notably the “It gets better” project and comically redefining “Santorum,” but I can’t get over his history.
I’m certainly not going to read Dear Prudence, who recently gave some fucked up “Advice” to a gentleman regarding his wife’s prolonged therapy and the lack of sex after marriage… because she had just started therapy to cope with the abuse her father committed on her.
Do I really need to delve into why Prudence’s advice terrifies me? To make matters worse, Prudence’s answer was heard ’round the tubes, so hundreds of folks saw fit to comment on this couple’s sex life. As always, things got real ugly, real fast.The myriad terrible answers to this particular question, unfortunately, are how I know looking for any better advice is ultimately an exercise in futility.
I used to read Carolyn Hax’s advice column (When it was still called Tell me about it,) until I got bored with it. I decided that much of her romantic relationship advice boiled down to “DTMFA,” because it looked to me like relationship problems, minor or major, could be solved with a breakup. In fairness, that is always an option. But her recent advice is pretty good, so maybe I should give Hax another chance.
Then there’s the self-described agony aunts of the Internet – they’re not featured in mainstream media, but they’re still popular (On the internet!) Some of these advisors have qualifications that lend credence to their advice – Ph.D. Degrees, M.S.W. degrees, certificates reflecting formal training, etc. Others are bloggers with no formal training, yet have a wealth of experience to reflect upon. And for a lot of readers, I’m sure the advice in Internet agony columns works out well.
The problem is that when the advice I want or need is sexual in nature, I can’t turn to a lot of agony aunts, even the popular ones. I saw some professors and sex educators recommended by commenters in blog posts on places like Jezebel or Feministe, so I read and have since screened out a few recommended agony aunts who write general observation stuff.
Sometimes the posts are great and well-researched. Other times, they’re as airy & fluffy as cotton – and personally, I would rather not post anything, then inflate my post count with fluff. (Everyone reading this now is thinking to themselves, “Yes, K, we’d all prefer it if you didn’t post too.” Haha.) That quality variation is pretty typical of any writing though, so no big deal.
But when it comes to problems most near & dear to my heart, sexual dysfunction specifically, the recommended agony aunts let me down. Some just vomit up yet another uncritical iteration of the New View’s rhetoric: The problem you describe isn’t an actual problem you are experiencing; it’s just part of being a woman. You can’t take medicine for sexual problems today because in the past women didn’t get a choice and you dishonor their memory. Doctors and Big Pharma are in cahoots to fleece potential patients so you can’t trust the sexual health research out there co-authored by medical doctors and certainly you should never visit one for a sex problem. Wait, you have pain with sex? Go see a doctor.
To be fair, I’ve seen this very blog you are reading get plugged by commenters offsite too. I’m flattered. So what’s the difference between me and professional or amateur agony aunts?
The difference is I have never described myself as an agony aunt. I’ve repeatedly stated, I am not here to give you advice. I prefer to be a general nuisance, presenting evidence in contrast to conventional advice, since the usual advice backfires on me anyway. I may on occasion, when pressed directly, offer up some link or sound byte, but ultimately, I believe that individuals are the only ones who know what’s best for themselves when it comes to personal & health decisions.
That said, there are some bloggers I still look to for advice, though they aren’t necessarily in the business of answering questions. Keep in mind even you may find the following bloggers repulsive, for the same reasons I’ve outlined above! They aren’t always perfect, and I’ve seen some of the below make mistakes too.
Readers, have you found a decent agony aunt that might fit the bill for what I’m looking for? Now I want your advice as to who’s good & why.
Tags: experts, female sexual dysfunction, FSD, guest post, health, medicine, pain, pelvic floor dysfunction, relationships, sex, sexual dysfunction, sexual health, vaginismus
[Dear internet, we have a guest poster today! The following was written by Elaine F. Bayless:
Elaine F. Bayless is an author and pastor who lives in Raleigh, NC. She is currently working on a memoir about her experience with pelvic floor dysfunction. After choosing to have surgery to correct her issues, she is happy to report that most of the dysfunction is resolved. She and her husband are expecting their first child in July of this year. For more information about Elaine's published work and her writing process, visit her blog http://elainefbayless.blogspot.com]
I am one of the lucky ones. I only saw three gynecologists who ignored my vaginismus. I only wasted 9 months of my marriage in therapy, convinced that my pain was psychological. My husband never forced me into sex, never punished me for my condition. It only took me six years of treatment to finally find resolution in the form of penetration concomitant with orgasm – MY orgasm.
In November 2010, Discover magazine’s column, Vital Signs, discussed an intern who missed the symptom of painful intercourse. When the doctor asked him about this symptom, he admitted that he thought all women found sex painful. This doctor was shocked to discover this attitude in an “educated” person. I’m not shocked.
Women just don’t enjoy sex that much. That’s the pervasive belief in our society. And women who do enjoy sex are often penalized. We aren’t supposed to enjoy it, after all. We are supposed to be enjoyed. We are objects, not subjects. I still remember vividly an encounter in my recent past, when I had multiple orgasms and my husband had none. I was apologetic! But he had no regrets. He simply smiled and said he was glad I enjoyed myself. He’s a true man, someone who understands that sex is a two-way activity, an encounter between two participants, not between a subject and object. How does this belief play into the diagnosis and treatment of dyspareunia? In every way. My own story serves to illustrate it.
I had my first Pap smear at age 18. I was a virgin, but irregular periods plagued me and so I wanted to go on the Pill. The exam was torture, but every year I went back. My gynecologist was unconcerned, blaming me for not relaxing. She never gave me any tips on how to relax, never suggested anything to try to make things less painful, even when I almost passed out from the pain. My gynecological history post college was sporadic. Still a virgin, I went on and off the Pill, only getting a couple of Pap smears. Each time it was excruciating. I didn’t use tampons – too painful. But I kept that a secret. My doctors assumed that I didn’t enjoy insertion because I wouldn’t relax – that it was my fault, not something beyond my control. After all, women don’t enjoy sex, why would they enjoy an exam?
Prior to my marriage, I went to a friend’s gynecologist, highly recommended. I shared with her my pain issues. I asked her specifically to determine whether there were any reason why sex would hurt (I was still a virgin). This was her chance – her opening to discuss dyspareunia with me, to talk about different causes for pain in the vagina. Surely my medical history, my fear of tampons, and my simple reaction to the exam should have clued her in. She told me to relax because there was nothing wrong with me.
Why did this doctor not even mention the possibility of actual physical conditions that could cause pain during intercourse? Why did she assume that after 11 years of pain during vaginal exams I would be able to relax? I guess she figured I would learn how to grin and bear it, like many women do.
Because of her bad advice, I went to see a therapist immediately after my honeymoon, convinced I was mentally screwed up. After all, physically I was fine, right? When my prescription for the Pill ran out, I went to see a new doctor, a nurse-practitioner who specialized in seeing rape victims. I knew she would be sympathetic. She gave me a tranquilizer to take prior to the exam. It did nothing – my blood pressure was through the roof and I winced at the moment of first contact. And that wonderful woman sat back and told me I needed to see a physical therapist.
The discovery that there actually was something physically wrong with me – that I was incapable of relaxing – that was a turning point in my entire life. I had never heard of vaginismus, vulvar vestibulitis, dysparaunia, etc. I didn’t know that walking around with a constant Kegel was abnormal. (To this day I still catch myself in “locked and loaded” position). Finally I was able to clear the self-blame and self-doubt that was tormenting me and my marriage. I had a physical problem!
I still listen to women who have bought into the lie that we don’t enjoy sex. They say that their vaginas are too small. They say that they don’t enjoy orgasm. They continue to engage in sex that is unfulfilling. I was teaching a group of high schoolers about sex and counseled them to stop having intercourse if it hurt. They all looked at me blankly and then asked why. I was horrified.
We are not sexual objects. We are sexual subjects. I am currently pregnant with my first child, a little girl. A girl conceived during pretty fantastic, orgasmic sex. (Sure, it took 6 years, 3 physical therapists, and surgery, but it was WORTH it). And one of the most important things I hope to teach her is that sex feels good. And if it doesn’t feel good, she will have to be her own advocate and work tirelessly to find the cause and the solution. I hope that the world will have changed somewhat by then – that the medical establishment will have a better understanding of sex as something that is designed to be enjoyable. For anyone.
Tags: books, communication, experts, female sexual dysfunction, Feminism, FSD, guest post, language, orgasm, relationships, sex, sexual dysfunction, Sexuality
[Dear internet, we have a guest poster today! This is a post by pro-BDSM activist Clarisse Thorn, who blogs at Pro-Sex Outreach, Open-Minded Feminism.]
I’ve been working on a long article about my experiences with sexual dysfunction. It’s a project that’s been in the making for quite a while, but now that I don’t have so many distractions I’m ramping it up.
This is a complicated and difficult subject for me. I have a satisfying sex life now — I’ve gotten pretty good at communicating with partners, setting boundaries, seeking what I want, and masturbating to orgasm. It took me a long, long time to get here, though, and I had to get through a ton of confused feelings. Not just about coming into my S&M identity, though that was certainly a factor, but also dealing with feelings around the orgasmic dysfunction itself — for example, feelings about how my apparent inability to have orgasms meant that I was broken. (I had and still have some vaginal pain, too. Not every time, not even most times, and nothing overwhelming — but enough that I’ve developed coping mechanisms.)
In order to write this article, I’ve been going through a lot of years-old journal entries. One quotation particularly struck me:
[My boyfriend] comforted me the other night when I broke down and cried. I wept and wept and he said it was okay, you’re not broken, there’s nothing wrong with you. It’s okay, he said, not to want sex. But I do want sex, I’m just sickened and terrified and disgusted by it, and I don’t want to be anymore. I want to be able to watch sex scenes and not be enraged and disgusted, to read sensitive ones and not collapse in tears.
I wasn’t entirely sickened and terrified and disgusted by sex, of course: I often liked it. Loved it, really. Sex usually felt good even before I could have orgasms, even before I’d found S&M, even before I’d parsed out my feelings and learned more about sexual media such as porn. And I’ve talked a lot about how awesome and sex-positive my sex education was.
But I knew I was missing something, something crucial and integral to my sexuality. And I hated the way society seemed to always be informing me how to sexually act: I felt crushed into approaches that obviously weren’t working, weren’t meant for someone like me. It was hard to walk the line between craving sex and being unable to stand it.
Here’s another excerpt from my journal, around the same time:
I really hate reading explicit sex scenes. I didn’t used to hate it as much as I do now, and since I broke down in tears during the last one, I guess it’s pretty obvious why. Jealousy and hurt and hatred of the ideals I feel like they’re trying to forge into me, [one ideal being] that love and sex and particularly orgasm are all irrevocably intertwined, and that by missing out on orgasm I’m missing out on not only an aspect of sex but of love.
But mostly I guess the discomfort does come from not wanting to read the intimate details of another’s sex life … and the jealousy for the orgasm, still there, too deep to banish. Christ, it’s fucking ridiculous. I shouldn’t be this miserable about this. It’s so fucking unimportant in the grand scheme of things. — but the tears that startled me in my eyes as I typed tell me just how unimportant it really is to me, I guess.
I started reading some sort of book on having orgasms and wept all through the first chapter because it was so miserably true. And because it was so miserably true I feel as though I ought to read the rest of the book, just give it a chance and go with it, and maybe make it that way, but it hurt so much and I’m so scared that it won’t work, and then I’ll be really unhappy. (A reaction the book even outlined, by the way. Yes, it’s about as true as it gets — the only thing I’ve ever found seems to understand how I really feel about this.)
The book that struck me so much is the monumental For Yourself, by Lonnie Barbach. It’s a famous book. I searched it out at the San Francisco library recently, and spent an afternoon sitting around the Mission branch, trying to locate the passages that once touched me so much. A few quotations:
Do you sometimes feel that you would be happier if sex were eliminated from your intimate relationships altogether? If so, possibly you feel abnormal in this regard, or like a misfit or not whole as a woman. Or, perhaps you just feel that you are missing something everyone else has enjoyed, a part of life that you’d like to have be a part of yours, too. You probably feel as if you are one of only a few women who have this problem. But the truth is that you are far from alone. (page xiii)
A real fear that can keep some women from doing anything to solve their sexual problems is the fear of failure. When Harriet joined the group, she didn’t believe she could become orgasmic. She said, “If I tried, I’d only fail, and then I’d be really miserable.” … Harriet eventually did defy her fears, as did all the other women mentioned. It takes time and effort to counteract these fears. It means saying “I’m afraid” and yet pushing beyond. (page 14)
Is it because you’re embarrassed to ask for what you want at a particular time; afraid your partner will refuse, get angry, or feel emasculated? (page 15)
Empathetic and accurate so far. (As it happens, the only lover I ever directly asked for help during this orgasm-discovery process refused and got angry, which just goes to show that being afraid he might react that way was not all in my head.) Merely confronting so much understanding was hard to face.
But, although I read it a long time ago, I think I’ve figured out what it was that made me unable to read further: the way Chapter 1 ends is a bit much. The last page of For Yourself‘s first chapter contains this:
You have to assume responsibility and be somewhat assertive. Our culture has taught us that a woman should depend on a man to take care of her, which means she can blame him for any mistakes. It’s nice to be driven around in a car, but it’s also nice to be able to drive yourself so you can go where you want to, when you want to. But to do that, you’d have to assume some responsibility.
Well, okay. Except that how do you assume responsibility for something if you have no idea where to even begin? If you know something’s missing but you’re not sure what it is? If you’re sure your partner will be frustrated and resentful when you ask for help?
Orgasm involves us surrendering to what we’re feeling, and really rolling with it, even if and when it feels very emotionally precarious. It’s control we’re letting go of, really, and that’s harder for some folks than others.
I’ve been an off-and-on sex & gender geek throughout my life, so I already knew these things intellectually. I’d already absorbed these ideas: that I must both take responsibility for my sexuality, and lose control in order to enjoy it. I think even then I knew that both of these ideas are actually good advice. But the problem is that they’re often put in patronizing and less-than-helpful ways. For example, “It’s nice to be driven around in a car, but it’s also nice to be able to drive yourself so you can go where you want to, when you want to. But to do that, you’d have to assume some responsibility.” Condescending as hell! To me, those words implied that I was making myself into a helpless child. Pulling a wounded-bird act and forcing other people to take care of me. I couldn’t stand the idea that I was doing that!
I am frustrated by the insensitive guilt trips that often happen, even (especially?) in feminist and sex-positive circles, where people will sometimes act as if these things are simple, as if it is oh-so-easy to stand up and take on one’s own sexuality and Just Deal With It. Especially when you’re in a situation where you know for a fact that some men you have sex with will resent you if you’re honest about not having orgasms, and yet you don’t know how to have orgasms and aren’t sure how to start on the journey. What then?
Some women end up faking in those contexts (I didn’t very often, back in the day, but once or twice I did). Of course, some feminists and sex-positive writers are especially unhappy about this:
I’m sure I’ll offend some choice feminist who thinks that it’s unfair to criticize women who make the totally autonomous choice to flatter a man with a fake orgasm instead of working towards a real one, but I’m taking a stand on this one. It’s un-feminist to fake, ladies!
I don’t advocate faking orgasms, and I actually also don’t advocate dating a man who gets angry and resentful when a female partner asks him to pitch in. (Oh my God, sometimes I have nightmares that I’m back in that relationship, and it’s been years.) At the same time, the idea that screaming “It’s un-feminist to fake!” will fix the problem is ridiculous. It’s the kind of idea that will just make feminists (like, say, myself many years ago) feel even worse about trying to figure out our relationships while not having orgasms. I see, so now not only am I failing to be responsible, I’m also un-feminist? Awesome.
This is not easy. It’s actually really hard. I get that people have to want to work on their sexuality, in order to do it — obviously I get that. But telling people that they’re being weak or self-centered or un-feminist because they aren’t sure how to do it? Or are actively pressured out of it?
Tags: books, female sexual dysfunction, FSD, health, language, media, medicine, pain, relationships, sex, sexual dysfunction, sexual health, Sexuality, vaginas, vulvar vestibulitis, vulvas, vulvodynia
[Trigger warning for rape]
The Camera My Mother Gave Me is both one of the easiest and hardest books I have ever read.
Years ago, shortly before I received a tentative diagnosis of vulvodynia by my main gynecologist, I started looking for support and information about what causes vulvar pain. The Camera My Mother Gave Me is one of the earliest books I read about the topic. At the time, it was one of a very few books available that talked about vulvodynia with any amount of detail. Most of my other sources were scientific & peer reviewed medical journal articles or anecdotes from the internet. What sets The Camera My Mother Gave Me (henceforth I shall refer to it as TCMMGM) apart to this day is that unlike informational resources that talk about treatments, it is a memoir. It’s a first-hand personal recollection of author Susanna Kaysen’s life with vulvodynia over about two years.
Yes, you read that right, the author is Susanna Kaysen – this is the same author made famous for her previous memoir, Girl, Interrupted, which was made famous by Hollywood – though I understand the film distorted the facts in the name of artistic license. However, I have not read Girl, Interrupted and will not be talking about that today. Whether Kaysen’s experience with psychiatry in the 1960s has anything to do with her vulvodynia later in life, I cannot say.
So, TCMMGM is both an easy read and a hard read for me. How is this contradiction possible?
It’s easy because it’s short. It’s only about 150 pages with paragraphs double spaced. If you’re interested in reading it, it probably won’t take more than a few hours to finish; maybe a day or two tops. Kaysen uses everyday language instead of heavy academic jargon, so you don’t necessarily need to be a doctor or be familiar with vulvodynia in order to follow along.
But it’s hard because every time I read it, for all the progress I’ve made and improvements I’ve seen over the years, I am instantly transported right back to square one – that daunting, hopeless, barren place where the walls of pain obscure every available path. It’s hard because when I read it, I remember everything… the questions unanswered, the ignorant doctors, the uncertainty …the pain. I’m in my early 20s again and I don’t know what’s going to happen to me.
Another reason this book is so hard for me because no one understands this book unless they have vulvodynia. Perhaps I’m not giving folks enough credit. Perhaps that’s an exaggeration… but not by much. TCMMGM has received mixed reviews, many of them negative. The negative reviews usually contain some variation of gross-out due to TMI or frustration with Kaysen’s lack of progress in treating her pain medically. It’s TMI and gross because vaginas and vulvas are generally considered vulgar and gross – at least outside of feminist circles – sometimes even within feminist circles, because don’t talk about vaginas too much or else you reduce yourself to a big walking vagina – and thus it’s a shock to read such frank language and descriptions about the vagina. Frightening, too, to have to think about an area that’s supposed to be capable pleasure feeling instead only pain. If readers are frustrated with Kaysen’s lack of progress, that may be because Kaysen herself was frustrated and was deliberately trying to convey that feeling – trying treatments she felt comfortable with, avoiding the ones that she didn’t want but that were nonetheless pushed upon her over and over again. When she opened up about her vagina and all its problems, Kaysen also left herself open to invasive personal questions, “Why didn’t she do this, why didn’t she try that.” If the book feels unresolved at the end, that’s probably because vulvodynia is itself a chronic problem, often with no clear resolution. There are still loose ends by the time the book ends, because in Kaysen’s real life the struggle with vulvodynia was ongoing.
So what’s the book about?
The briefest answer is to say that it’s about Kaysen’s vagina. One day, mysteriously, “Something went wrong with it” (3.) Everything else follows over about a two-year period.
A more comprehensive answer is to say it’s about Kaysen’s experiences during a time when she had to re-evaluate her relationship and sexuality as she navigated the gauntlet of modern medicine in search of answers for her debilitating vulvovaginal pain.
Kaysen began experiencing vaginal pain that “Felt as if somebody had put a cheese grater in it and scraped” (3.) The reasons for this pain are never made 100% clear. We learn that Kaysen had a bartholin’s cyst surgically drained some 20 years earlier, and the pain felt intense at the surgical site – but the pain radiated to other areas of her vulva as well. She was approaching the age at which many women enter menopause (though I could not tell what her age was when the pain started.) Her gynecologist initially misdiagnosed Kaysen with a run-of-the-mill infection and prescribed some treatments that probably didn’t do any help. At some points, Kaysen explores the possibility of psychosomatic causes.
This pain interfered with her everyday activities like “Wearing pants” (8), “Taking a bath” and “Too much driving – it hates that” (146.) She maintains a pain diary, measured on a scale of 0-5, with her pain frequently hovering around a 2 and sometimes spiking above 5. She had good days and bad days.
The pain interfered with her sex life, to the point where her sex life and her relationship with her own body fundamentally changed. Very early on, Kaysen tells her gynecolgist,“Listen, I said, everything’s getting worse. I’m really having trouble with sex. My vagina hurts all the time now. If I have sex it hurts more, but it never doesn’t hurt” (9). Unfortunately an expanded definition of “Sex” did not adequately address Kaysen’s problems:
“I tried a lubricant named Astroglide that was more glue than glide. My boyfriend and I tried all sorts of varities of sexual activity: very quickly, so it wouldn’t have time to hurt; without moving, just in there; only fingers in there; nothing at all in there, only outside. Whatever we did, it hurt” (10).
She was not even able to enjoy arousal in and of itself, because “Just getting aroused hurts” (55).
When her pain first manifested, Kaysen visited multiple doctors specializing in different fields. She lived in Boston at the time, which is home to some real-life vulvovaginal specialists. She visited her gynecologist, an alternative medicine practitioner, an internist, a vulvovaginal specialist, and a physical therapist. Some of these doctors pass her off to other doctors – notably, when her primary gynecologist was stumped, Kaysen felt that he was “Washing his hands of me! After twenty years” (9). She was tentatively diagnosed with vulvar vestibulitis and tried multiple treatments – conventional western style and alternative – but none of them were right for her. Kaysen was acutely sensitive to side effects, and in some cases the side effects just made things worse. Even physical therapy, a treatment that I had very good luck with, only set her back farther. (Having a crummy physical therapist who ignored her wishes probably didn’t help.) Other treatments, notably surgery, she did not want to try, though the doctors and her boyfriend pushed and pushed.
The doctors left Kaysen with a lot of unanswered questions about vulvar pain…
With her gynecologist:
So what is it? I asked him.
I don’t know, he said
But what is it? I asked him. What’s wrong with me?
I don’t know, he said. (9).
With the internist:
But why does it hurt all the time? I asked. Why does it hurt when I’m not having sex? When I’m sitting on the sofa?
I don’t know, said Doctor Matthew (21).
With the vulvar specialist:
Why did this happen? I asked him.
Eh, he said. He shrugged.
What is it, anyhow?
Eh, he said. He returned to the stool and resumed his Q-tip (28).
What’s the matter with me?
You have a sore spot, he said (30).
WELL THANK YOU, CAPTAIN OBVIOUS!!! A sore spot! Of course! Why didn’t Kaysen think of that?! That explains everything!!!
It goes on like that in some fashion over the whole book. Just as it continues to go on day after day in real life for still all too many women.
[Trigger warning for rape]
Kaysen’s nameless boyfriend was not sympathetic to her situation or open minded about the kind of sex he wanted. For two years prior to the events described in TCMMGM, Kaysen and her boyfriend had enjoyed a sexual relationship. Her partner had a strong interest in sex - “It was one of the things I had loved most about him” (95), though they never say “I love you” to each other. But when sex hurt, Kaysen began to lose interest in sex. While they stayed together for the first year that she looked for treatment, the boyfriend nagged and coerced Kaysen to have sex with him – even if it meant she was performing against her will. Readers of this blog would probably recognize what Kaysen describes as rape. She didn’t say no, she acquiesced under pressure, but certainly she stopped giving any kind of enthusiastic consent. She spends days after sexual activity coping with the painful after effects. Kaysen herself never uses the word rape to describe what she went through with her boyfriend, even when it caused her to disassociate during the act and left her in physical pain for days afterward. When asked by a biofeedback specialist if she had ever been sexually assaulted, she answers “No,” but when the question is rephrased to “Have you ever had sexual relations against your will,” Kaysen says “Yes” (82). When she recounts the last straw to her friend, Kaysen questions herself, her boyfriend’s actions, her own fear at the time, and what actually happened.
Even after evicting her boyfriend, Kaysen continues to feel pain long-term. It wears her down over an extended period of time. “Low-grade pain is debilitating in a subtle way” (121.) Eventually she loses interest in sex, and this is a painful experience for her, but in a different way. When Kaysen talks about sex and eros, it’s clear to me that prior to these events, she really did enjoy sexuality in her life. For her, it was a source of unpredictability. At one point, after throwing her boyfriend out of the house and struggling to rediscover pleasure from what once felt only plain, she tells a friend, “When eros goes away, life gets dull. It’s as if I’m colorblind. The world is gray” (125.) She eventually decides that the best course of treatment is to stop treatment. Eventually she makes a limited, partial recovery… But by then her relationship with her vagina, vulva and her own sexuality are fundamentally changed. Maybe forever.
Kaysen’s language may be plain and easy to understand, but it’s not without criticism. She uses frequently the word “Vagina” even though a more accurate word is “vulva.” Or maybe it is accurate for her to describe her pain as vaginal, since with vulvodynia the pain can radiate and spread beyond the vulva. In practice, when the pain feels like it’s everywhere, it can be very hard to pinpoint. One social construction argument against female sexual dysfunction as a valid diagnosis is that women with sexual problems may not be educated enough to understand their own anatomy; however Kaysen demonstrates that she is aware of her own anatomical structures and function.
Overall though, I would hope that readers accept Kaysen’s idiosyncrasies and simplified language. She uses other inaccurate terms, most likely as deliberately as she chooses to forgo with quotation marks when recalling conversations. She refers to her doctors as the “Vulvologist” and the “Biofeedbackologist” instead of as “The vulvar specialist” and “the physical therapist.” But when you’re encountering these specialists for the first time, perhaps not knowing such fields even existed before, what else are you supposed to call them??? The title of the book itself is an error. The title is based on Kaysen’s memory of a scene in a movie, with some artistic license exercised. (According to this interview with Kaysen about TCMMGM, technically the title of the book should be The Camera My Father Gave Me.) She receives materials from the “National Vulvodynia and Vestibulitis Association” instead of National Vulvodynia Association. And so on…
But this is her story in her words. I hope we can forgive her for taking liberties with some of the language – though it does have some disableist moments that are questionable and perhaps not so flexible.
I don’t know if Kaysen ever found relief for her pain in the years since TCMMGM came out, though it seems unlikely. Around 2003, the following was written about her on Salon.com:
Though she lives in the Boston area, the doctor capital of the world, Kaysen never found a workable medical treatment. Today, Kaysen hasn’t so much lost or won her battle; rather, she’s signed a treaty, with massive concessions. “Celibacy is a great cure!” she said wryly in a recent phone conversation. “I wasn’t interested in having sex again. The only thing I was interested in was not having pain. Pain eclipses desire.”
So who might be interested in reading TCMMGM? Who might benefit from exposure to such a taboo subject and who should approach the book with caution?
If the reviews online are any indication, many readers will be disappointed and frustrated with the book, but a few will strongly emphasize with what Kaysen went through. I am one of those people, and would like to see more people read and attempt to understand Kaysen’s situation. The frustration that so many reviewers are left with may be exactly what readers most need to feel, to better understand the frustration that still too many patients with vulvodynia have to deal with when running the gauntlet of modern medicine in search of adequate treatment.
The book is a memoir of one woman’s experiences with what is probably vulvodynia, and therefore it should not be taken as an advice or how-to book. This is all stuff that happened to Kaysen. It’s not necessarily going to happen to you. Some readers with a history of vulvar pain may find the book depressing because at so many points, things appear hopeless. Others take comfort knowing that they are not alone. It’s been a few years since the TCMMGM came out too, so there have been some advances in treatment since Kaysen conducted her own research and treatments. Your mileage may vary.
TCMMGM is short and small, but it’s not light fare. Although it has moments of dark self-deprecating humor, it’s not something to read if you want to feel good (except perhaps through schadenfreude.) It’s kind of a downer, to be honest. Because Kaysen describes a rape and post-rape scene with frank language, the book may be triggering to those with a history of sexual assault.
TCMMGM is available online from several retailers and it is available in E-Book format for Kindle. If you’re still interested after reading all this, then may I suggest that you make a purchase through the NVA’s book list, since they have a referral program set up for financial support.
As with all reviews conducted at Feminists with Female Sexual Dysfunction so far, I had to pay for TCMMGM with my own money, and I receive no compensation for posting a review of it.
Tags: archetypes, books, experts, female sexual dysfunction, Feminism, FSD, myths, pain, psychology, relationships, sex, sexism, sexology, sexual dysfunction, Sexuality, Sleeping Beauty, stereotypes, vaginismus, what
While browsing for interesting (and often outrageous) coverage of sexual dysfunction via Google Books, I’ve occasionally stumbled across experts (doctors, sexologists, laypersons, etc.) interpretations of vaginismus and the women who live with it. I’d like to present some of my findings to you now. Full disclosure: I haven’t been able to finish every book I’d like you to look at today. But on the other hand, I’m not doing a full book review today either and I am not certain what context, if any, could redeem the following passages.
One of the points Dr. Leonore Tiefer made in Sex is Not a Natural Act (yes we’re returning to this title again) is that we need to look at sex symbolically. Sex has meaning beyond the obvious that we can see and feel, and to understand sex and sexual problems, we need to figure out the meaning behind it. Consider some of the following quotes with emphasis added by me (thanks to Kindle’s word search feature:)
“It’s the symbolic investment that makes sex ecstatic” (location 1215).
“The first [story about doing the 'Viagra tango,' as she puts it] is about how Viagra the pill, but more importantly, Viagra the symbol, may affect the sexual conduct and experience of women and men in many parts of the world” (location 1315).
“[Orgasm is] just a reflex. It’s the symbolism that makes it feel so good” (location 1195; available online.)
And it goes on like that at a few more points throughout the book. We need to look at the symbolism of sex, phalluses, the Viagra family of sexual medicine, etc. We need to pull the curtain back and understand the why behind a woman’s libido crash. Some contemporary examples of where understanding sex and symbolism would be helpful are with the very expression “Sex symbol” and with sexual imagery used in advertisements.
There’s just one potential problem: Some so-called experts on women’s sexuality have already done that – looked at sex, women, women’s sexuality and sexual problems symbolically – and the results haven’t been pretty. Sometimes the ugly things people say about FSD and the women who have it doesn’t come from hack journalists and misogynist comments on message boards. Sometimes – often times – it comes from the professional sphere and trickles down.
Let’s focus on vaginismus as an example. Vaginismus, if you didn’t already know, can be described as an uncontrollable spasm of the pelvic floor and vaginal muscles, usually during sexual activity. It’s most obvious when attempting penetrative activity, like sexual intercourse, but it may also occur with a dildo, tampon use, or during gynecological exams. The spasm may be strong enough to completely prevent an object from entering the vagina, or it may be possible to insert something, but with pain. As such, it can be the cause of dyspareunia (painful sex.) Vaginismus is often recognized as a sexual dysfunction, however, some sexologists question the validity of sexual dysfunction broadly as a diagnosis at all and vaginismus in particular. For some folks like me, vaginismus a chronic problem connected to medical issues, other times it’s situational. Some folks say it’s purely psychological and can be treated without physical intervention, others say there’s a physical component and that it can be addressed physically.
Vaginismus does not necessarily require any treatment at all, but when folks with vaginismus do seek assistance to address it, that assistance may come in the form of talk therapy with a counselor or sex therapist, dilator use, learning how to kegel, or more extreme medical intervention such as botox injections (not for cosmetic purposes) or physical therapy.
And some sexologists have described vaginismus symbolically.
One of the first, if not the first, books to deal with vaginismus exclusively is 1962′s Virgin Wives: A Study of Unconsummated Marriages, by Leonard J. Friedman. It’s out of print now, but you may still be able to find a used copy online or through your library. I first came across this title while slogging through Linda Valin’s When a Woman’s Body Says No to Sex: Understanding and Overcoming Vaginismus, a book about vaginismus, from the perspective of someone who has personal experience with it. Valins acknowledged Friedman’s contributions to her own book, but alas Google Books does not offer me the complete text of Virgin Wives or a preview version to pursue at my leisure.
However, because authors like Valins have referenced Friedman’s work, we can get a pretty good feel for what he thought about women with vaginismus. Valins is a big fan of his, so it probably isn’t all bad – but I found the following disturbing.
Last week, I tweeted one of my findings regarding symbolism and vaginismus, from Google’s preview of 1987′s Sexuality and Birth Control in Community Work, by Elphis Christopher. Based on what I can see in Sexuality and Birth Control in Community Work, Friedman described three archetypes of women who tend toward developing vaginismus:
(1) ‘The Sleeping Beauty’: this occurs where the woman denies her own sexuality and waits for the man to awaken her sexually. Unfortunately, she often chooses a ‘safe’ partner, i.e. a man who is uncertain of his own sexuality and may suffer from impotence. He is often praised as a ‘good,’ nice boyfriend because he did not attempt pre-marital intercourse.
(2) ‘Brunhilde’: this refers to the woman who is always looking for a man strong enough to conquer her. She usually chooses as sexual partners men whom she despises.
(3) ‘Queen Bee’: this refers to the woman who manages to get pregnant without allowing penetration so that she can claim the pregnancy for herself.
What… the… fuck…?
I have no reasoned, rational response to this. Do I need to explain the multiple layers of Wrong with this picture to you?
We got here, above all, the assumption of heterosexuality, and according to these personality types, if you have vaginismus you are likely to be:
1. a woman who refuses to own her own sexuality and instead waits for some guy to come along and give it to her. But for some reason the author decides that a man with basic human decency who did not coerce his partner into sex simply must be sexually insecure and possibly “Impotent” (as if there’s anything wrong with having erectile dysfunction.)
2. I don’t know wtf this is – Some kind of Viking archetype I think where a woman who doesn’t settle down with any ol’ jerk and who doesn’t take shit is asking too much. Or else if she’s got vaginismus, it means she must hate her partner.
3. I don’t know wtf this is either. I think term is dated because I had to look it up. I think this archetype is supposed to conjure up images of a bossy lady who, frustrated with vaginismus, gets pregnant the “Wrong” way – minus the ejaculation of a penis inside of her.
So, what the fuck, which one of these archtypes am I then? Anybody here identify with one of these three archetypes? Does anybody here appreciate being described like this? Does anybody here in a relationship appreciate having your partner described like this?
“Now wait, K,” you may be saying. “That paragraph starts out talking about non-consummation generally, and then the next paragraph is about vaginismus.” Fair enough, so let’s make an effort to double-check and make sure that we’re talking about the same thing. Here’s a website that mentions the three archetypes of women who are prone to vaginismus, and it says:
Friedman (1962) describes three types of women inclined to vaginismus:
* the sleeping beauty (father-type relationship with partner and various feelings of guilt)
* the Brunhilde (the woman perceives sex as a battle between the sexes, and the male dominance has to be opposed)
* the queen bee (the woman perceives sex as dirty and sinful, she is afraid of pain in coitus and, in principle, she wants to get pregnant)
Again, what… the… fuck…?
Still don’t believe your eyes? I’ve got one more piece of evidence I can present, from the Science/Fiction of Sex: Feminist deconstruction and the vocabularies of heterosex. I’ve been picking it up and putting it down every once in awhile, browsing random passages – because every passage is so cerebral. This book is hard. Alas, unless you’ve got a copy of the book you won’t be able to read page 210 so let me fill you in. This is, as the title says, a feminist deconstruction of sex, so the author does not necessarily endorse what I’m about to show you.
Annie Potts references the work of Eve Adler, who submitted an article to the British Journal of Sexual Medicine in 1989. I have tried to access the journal article myself but have not yet been successful through my usual means. Adler described several archetypes of women with vaginismus, including one of particular interest to Potts:
Less commonly seen today is the primary vaginismic patient, Sleeping Beauty; an emotionally immature woman awaiting a sexual awakening without taking responsibility for it. These ‘good girls’ have often been brought up to believe that sex is bad or dirty; she had to save herself for marriage! This type can appear quite ‘little-girl-like,’ pristine, clean an tidy and very controlled generally; or she may look quite sexy, enjoy sex play and experience orgasm with clitoral stimulation. Her partner is often ‘a gentleman’ in every sense: an unassertive, gentle, literally non-pushy man who may well have hidden anxieties about his own sexual abilities (Adler 1989 in Potts 2002)
What… the… fuck… What is the meaning of this bullshit?!
“Emotionally immature?” “Little-girl-like?” “Unassertive?” This is in print, people! This is how women with vaginismus and their partners have been described. In books and journal articles. What about descriptions like “Creative and resourceful?” Or “Resilient?” How about some of that?
Don’t be too angry with Annie Potts for re-printing that passage above though; she analyzes it, though you may not agree with her analysis either… It gets far out there when she starts talking about vaginismus as a form of political resistance against a phallocracy, and hey did you ever notice how phallic your fingers and a newborn baby are.
Let’s go a little deeper and focus on Sleeping Beauty since she keeps popping up re: vaginismus. The myth of Sleeping Beauty has been reinterpreted by various authors. According to one interpretation by Joan Gould, when Sleeping Beauty pricked her hand and fell into an enchanted sleep, the spindle that cut her represented a phallus and sexual maturity; the blood that came out of the injury represents menstruation. Sleeping Beauty was protected from spindles (sex and puberty) by her royal family up her 15th birthday – the age by which many girls reach menarche. The sudden appearance of sex and adulthood upon her (and Snow White, too, for that matter) was too much to bear all at once. The sleep she fell into was not necessarily a passive time; she spent the century mulling over impending adulthood and all the responsibilities that came with it. At a predetermined time, a prince came to wake her up and she was transformed into a woman ready to act as an adult. Usually we think of the awakening as romantic, stemming from a kiss but some versions have her shocked out of her sleep by rape or nursing her babies – conceived in sleep during rape, the perpetrator long gone (Gould, 86-126). Gould’s explanation of the myth of Sleeping Beauty, coincidentally, also addresses the myth of Brunhilde. However we cannot ignore the well-known 1959 Walt Disney version of Sleeping Beauty, in which Aurora was at last rescued from an evil witch’s spell by an active, handsome prince – who she was scheduled to be married to anyway. We need to think about that version too, especially since Disney’s Sleeping Beauty was released by the time Virgin Wives was printed.
Edit 7/22/10 – The boyfriend suggested I add more pictures to the blog. Here’s a picture of Disney’s Princess Aurora, Disney’s Sleeping Beauty.
[Image description: A picture of Disney's Princess Aurora wearing an iconographic pink dress.]
Is this the true face of Vaginismus? What the hell does she have to do with vaginismus? You think of vaginismus, what’s the first thing you think of, Disney, right? No. (Via.)
But wait, there’s more! Last week, when I Tweeted a link to my findings about archetypes of women with vaginismus, @NevillePark responded back with a very good question:
Wow. Uh, dykes, genderqueers, masculine folk, trans guys, etc., can’t have vaginismus? NEWS TO ME #youreadthisstuffsowedonthaveto
Indeed, good point! Because Friedman was looking at unconsummated marriages back in the 1960s, the most likely scenario is that he wasn’t interested in anyone who wasn’t cis- and heterosexual. After all, marriage was then (and remains to this day in the US on a federal level) defined as a legal union between man and woman. I would love to get my hands on a copy of Virgin Wives just to confirm that he had no interest in queer sexuality and vaginismus.
Alas, I cannot offer a complete answer to the question @NevillePark raises. However, we can turn to another body of work for partial credit.
Last week on Google Books I found Sexual Salvation: Affirming Women’s Sexual Rights and Pleasures, a book about women and sex, with an interest in often marginalized groups of women. I’m surprised to report that it does have a Kindle e-book edition (though the Kindle version is out of my price range right now! $63?! For a sex therapy textbook!? That’s not on the budget!) Overall it sounds interesting and potentially valuable – the Amazon summary says the author spends time talking about feminism and marginalized groups of women, including seniors, disabled women, and sex workers. And I can see from looking at the indexes to Sexual Salvation and (once again for the millionth time,) Sex is not a Natural Act that the authors, Naomi B. McCormick and Dr. Leonore Tiefer, respectively, reference each others’ work. Hmm…
The discussion of vaginismus starts on about page 190, preceded by a discussion of dyspareunia (painful sex) and followed by a discussion of sexual dysfunction, especially in men, and then sex therapy.
There’s a lot we could talk about with this one section of the book, but for now let’s focus on the following:
Taught that the only “real sex” is sexual intercourse, heterosexual women are susceptible to two sexual problems that are largely unknown to lesbians, dyspareunia, painful coitus, and vaginismus, involuntary spasms of the vaginal musculature which prevent penetration. (McCormick, 190).
Well there’s an answer. This leaves room for the possibility of lesbians to experience painful sex and vaginismus, but according to McCormick, that’s almost unheard of. (An unfortunate side effect of establishing profiles of ‘typical’ patients for diagnosis of problems though, is that if you don’t fit the profile, you may have to work even harder to get a caretaker to take your complaints seriously.) She does, however, go on to describe situations in which a lesbian may find herself in a heterosexual relationship and experiencing vaginismus, and some pages later, she describes a lesbian couple coping with cancer and sexual problems including genital pain. Meanwhile, the Vaginismus Awareness Network goes on to address two myths about vaginismus and sexual orientation (Emphasis mine):
A woman MAY be a lesbian if she has vaginismus, just like she may be a lesbian even if she was able to have painfree intercourse with a man.
This myth seems to spread from the belief that lesbians won’t have penetrative sex. Though that may be true for some of them, others will use strap-ons etc and have ‘intercourse’ too. So clearly vaginismus has little to do with one’s sexual orientation since so many heterosexual women in love with their partners have it. It has more to do with lack of knowledge of one’s private parts, lack of information on their PC muscles, lack of sexual education and lack of kindness…
You know, I don’t always agree with the VAN. I have the sexual education I need to understand my own anatomy and how to do a kegel, and my partner is kind to me, yet somehow I still have vaginismus. Maybe we shouldn’t paint all women with vaginismus as one big homogeneous group. But compared to the other Freudian analyses described above, even I prefer this. I’m very uncomfortable by the way women with vaginismus have been described in literature like what I’ve shown you today. For how long were these archetypes and stereotypes repeated and used in clinical settings? To what extent do the myths and stereotypes about women with vaginismus still exist, and what effect do they have now?