A discussion has begun on the Hypnosis Technique Exchange on Hypnotic Approaches to Persistent Sexual Arousal Syndrome that is worth exploring here as well.
"Brian (or Brain, as Tom spells it),"
:-)
"Your Erotic Trance seminar has got me to wondering if anyone knows what to do for patients who want to turn it down instead of up."
Good question. The EROTICATRANCE program (http://www.eroticatrance.com) is focused primarily on turning things up in terms of therapeutic intervention as well as for those in intimate relationships for intensified recreational experience.
"I have not had anyone present with this (yet) but many women suffer from a condition known as Persistent Sexual Arousal Syndrome in which constant arousal is a nuisance that gets in the way of their daily activities."
Persistent Sexual Arousal Syndrome (PSAS) - aka, Persistent Genital Arousal Disorder (PGAD) [the name was changed to remove the stigma of it being a sexual disease] - is a rare syndrome, one is not likely to have anyone present . . . however, it is possible. Most folks who suffer from this condition do so silently or are misdiagnosed or hide their condition out of embarrassment. As there is usually no direct physical cause found, women who suffer often feel a stigma or being psychologically week as well as inappropriately "lustful" despite the condition being unwelcome. Hint, just because no physical cause is found, doesn't mean there isn't an undiscovered causal link that may be found at some later date and even if there is no direct physical cause, that doesn't mean that a person should be blamed stigmatized for psychologically or emotionally "bringing upon themselves" such a condition. A woman reported in Boing Boing that her parents pretended that her PSAS didn't exist while others have noted the social stigma they suffer. Naturally, the folks on this list know better but unfortunately women who have this condition go through a lot of emotional turmoil and crap as they wind their way through the system before finding someone who actually understands the issues or has a clue as to how to help them.
I posted a brief bit about this syndrome on my blog back in 2003 http://briandavidphillips.typepad.com/brian/2003/11/persistent_sexu.html and a woman who suffered from the condition posted a comment about it's effect on her life:
"I could tell you if you care to know. It stole my life away. I had to leave school. My social life dwindled. And unless a miracle occurs, even if they cure me, I probably won't have a positive and healthy view of sex and sexuality for the rest of my life."
Certainly a very serious condition for those who suffer from it.
My post from 2003 indicates only 40 or so women having been identified with the condition at that time. As of 2006, there were over 400 who had self-identified in at least one study. Prevalence is touchy to nail down on this beastie because of a number of reasons.
"This is only diagnosed if the patient identifies it as a problem (some women LIKE being turned on all the time.)"
Yes some women do indeed enjoy such things, although I suspect even those who enjoy it would not enjoy it ALL THE TIME and in every context - there are always context considerations. It is only when it interferes with one's quality of life or comfort levels that it becomes a problem. This is also why there is no reliable data on just how prevalent the syndrome is or what the experiential variation levels may be as it's only diagnosed when self-ascribed as a problem.
Keep in mind that many women who experience PSAS also experience conditions such as painful or irritated vulva that can range from mild discomfort to persistent pain. For many, this is similar to the discomfort or pain of blue balls in men. It is usually not as intense as what is experienced by a man with priapism (which is a condition that sucks beyond greatly) or a woman with clitorism (which are usually considered medical emergencies) but it is very much the opposite of a good time and can sometimes require medical intervention.
PSAS doesn't always mean that a person is always aroused all the time, although some poor women do suffer through a condition that is very close to that (before the idjit jokes about "I wish my wife were like that" do consider that being sexually aroused at church or while undergoing a routine medical examination or while conducting air traffic or in a PTA meeting or while performing surgery or while attending the funeral of a very very dear loved one may not be the best conditions - yes, one article discussing a woman with the condition did say that as she went from doctor to doctor looking for a cause she suffered the humiliation of more than a few doctors making that very same "I wish my wife were like that" comment . . . no, you don't . . . yes, you could use the skillsets in Eroticatrance to create something along the lines of an arousal trigger but as I clearly discuss in the course, one is wise to make is context-sensitive so that it operates in appropriate circumstances only.
There are usually some periods of non-arousal for those who suffer from PSAS, albeit arousal can last for days or weeks at a time. However, unlike most women for whom orgasm leads to a natural subsistence of arousal, these women find that orgasm does not have that effect and that they remain highly stimulated and may require several orgasms for the condition to subside or it simply remains persistent for a very long period of time.
"For that reason there is no reliable data on prevalence. This is different from hyper-sexuality, which is sometimes a part of Bipolar Disorder. "
The sex-addict may or may not experience persistent arousal as well. There is likely some intersection of the two groups but they are independent conditions.
"There is also a similar condition which is perhaps worse for the sufferer and the name of which escapes my memory at the moment in which the lady climaxes repeatedly during the day without stimulation and in inappropriate contexts."
Many articles on PSAS or PGAD also note spontaneous orgasms (some or these orgasms can last for several minutes, triggered by something as mundane as the vibrations of riding in a car), although PSAS is definitely not always accompanied by orgasms (usually, not). Spontaneous orgasms can be associated with or caused by a number of things. In 2004, a woman in Taiwan was reported in the literature as having spontaneous orgasms while brushing her teeth (she kept her condition secret because of shame until she began having spontaneous orgasms at other random times and would pass out - she was later diagnosed with a form of epilepsy). Some women experience orgasms during pregnancy (I don't mean conception here). Others while nursing. There are women who have spontaneous orgasms during sleep. Some drugs can cause random spontaneous orgasms as a side-effect. Spinal cord injuries can lead to spontaneous orgasms. Sexual tension can be spontaneously release in orgasm through random vibration or touching of a bicycle seat or the like (PSAS sufferers might experience this effect, albeit without complete release). Women who experience spontaneous orgasms develop strategies to hide them while in public . . . usually, just as in many epileptic seizures, one can feel the beginning of an onset to at least some degree. One woman realized there were certain triggers more likely to set them off for her (jazz music, motor vehicle vibrations) and she would avoid those triggers. Another woman developed breathing exercises and a blanking imagery to clear her mind to dampen the experience. At least most physicians would no longer prescribe the treatment or hysterectomy or the protocol TC Erickson used with a woman in 1944 - blasting her ovaries with X-rays (doing her no good, it was not until a small tumor was removed from her brain that the condition ceased).
Of course, while uninvited spontaneous orgasms would be very unwelcome . . . there are contexts where they might be appropriate, however context-sensitivity is key. Those who attended the course or who have seen the Eroticatrance material will remember the "DON'T BREAK THE TOY" adage that I repeated often.
"So for the benefit of all, does anyone know if hypnosis is useful in treating these conditions, and, if so, how it would be done appropriately and effectively."
Just as hypnosis can help those who experience anorgamsmia, it can certainly help with PSAS.
Just as with outside of hypnosis, no single treatment has emerged and I would imagine that multiple approaches is the way to go within hypnosis. Just as with anything and everything else, there really is no one-size fits all approach to trancework.
Sandra Lieblum identified four typical approaches to treating PSAS. I will include them here with a response via my take on a hypnotic twist.
Psycho-education and support.
"Knowing that you are not alone in your experiences, and that it isn't 'all in your head' or something you should be 'thankful' for can go a long way in reducing stress and even symptoms. The support group PSAS-support is an important resource for anyone living with PGAD."
As a hypnotist, I would embrace this as well. Too many folks think they have to suffer alone. With sexual issues (whether it be persistent arousal, spontaneous orgasms, erectile dysfunction, low drive, anorgasmia, or anything else there is a tendency for folks to "suffer in silence" and to stoically suck it up as there is so much of a cultural stigma against discussing such issues. Folks feel isolation and shame and guilt for something that is NOT THEIR FAULT and which is far more common than they have been led to believe. So, finding some resources on the subject and helping your client become part of support groups is helpful . . . albeit, I would strongly suggest that you vette the resources first so that they don't get sucked into a victim mentality of being told that they just have to accept their lot in life and suffer with the knowledge that they must endure forever. Rather, focus on support groups that share genuine adaptation strategies, preferably with members who have gone through what your client is going through and have made progress or left the syndrome in their past.
Identifying triggers.
"For some women, certain triggers make the pain or discomfort worse. Discovering what the triggers are can make it easier to avoid them."
If you can identify triggers, then avoiding them is one thing . . . or installing overload triggers or blowout systems that reduce or remove the effect of the trigger might be appropriate. So, if I have an anchor for the experience and set an anchor for a shortcircuiting trigger, run the experience and then fire in the shortcircuit. Practice several times so that the experience is greatly lessened or at least manageable or until it is blown out completely. One might consider doing a modified kinesthetic swish or even a phobia cure type pattern for this. I would discover if my client is more physically responsive to suggestion or more emotionally or visually responsive and adapt the approach to their modalities.
Pelvic massage.
"Stretching and pelvic massage which can relax the pelvic floor muscles and increase awareness of stress and tension, may help in reducing pain. A physiotherapist or other healthcare practitioner with experience in pelvic issues may provide some help in this area."
Certainly, a targeted progressive relaxation visualization would be helpful here. Use whatever hypnotic induction is appropriate for your client and then use the progressive relaxation as a deepener except perhaps with a modification so that one starts with the feet and move up then once one gets to the pelvis go to the head and move down so that you are back at the pelvis and then use an imagery of relaxation of cores going deeper and deeper from the outer to the next level of muscles to the next, as if gently unwrapping the tension or relaxing the layers of muscles to the pelvis, just relax.
Medications.
"Given that some medications may be related to onset of PGAD for some women, it is understandable that they may not want to pursue treatment. On the other hand, the experience can be so distressing that some women will take a 'whatever works' approach. No single medications are recommended, and Lieblum suggests that finding one that works is a process of trial and error to be done with your physician."
On this point, hypnotists are limited by their professional scope of practice and whether or not they are working via referral. If the PSAS seems to be a drug side-effect then I would suggest it is obvious that a licensed physician be in charge of removing or switching prescriptions. Of course, not all PSAS is drug-related.
Certainly, if you are approached by someone with PSAS as a presenting symptom, then a medical consult would be wise before moving forward. Personally, I would strongly suggest insisting upon a medical consult first for this issue or for anorgasmia or the like. Given the association of many cases to drug side-effects, spinal cord injuries, and brain tumors, a neurological examination would be something I would suggest a client insist upon, particularly if they are experiencing spontaneous orgasms as well as persistent arousal.
Of course, as a hypnotist, we are not limited to these four areas.
Certainly, for persistent arousal, I would suggest running a process similar to what we as hypnotists have found to be very effective for pain relief . . . creating an Arousal Dial. I would use this same technique for women who wish to increase arousal as well, albeit with the goal being an opposite effect.
So, when speaking with the client, I would ask her to close her eyes and imagine a dial and for her to go inside herself and just allow herself to experience her level of sexual arousal right now . . . and tell me what number it is on the dial with zero being no arousal and one being very little and each number meaning a far more pronounced effect until ten is the absolute maximum of intense sexual arousal she could possibly experience.
Let's say, she says "six" and I would then respond "great, you're doing perfectly." Now you can either have her continue to keep her eyes close or have her open them between steps to intermittently break state.
My next instruction would be for her close her eyes and to imagine that she can slowly turn the dial up on the dial slowly so that it goes from Six to Seven so that she feels herself becoming EVEN MORE AROUSED so that when she feels herself at level Seven Arousal then she should say the word Seven to let me know that she feels even more sexually aroused.
Be patient and let her do her thing and let her take as much time as she likes. Please be aware of her state and do NOT set any unintentional anchors for increased arousal through a touch or gesture or vocal change at this time.
When she says Seven to indicate arousal, praise her and let her know she's doing a great job and follow this with a statement to the effect that "You're doing GREAT. Now, you know you can increase your arousal, so you also know you can also decrease your arousal so I'd like you to close your eyes and to imagine that you can slowly move that dial back down to Six and when you have felt your arousal shift down and your dial shift down to six, let me know by saying Six" and wait.
When she has Six, then followthrough with suggestions for bringing it down even further . . . don't have a specific number in mind, just let her imagine she can bring it down even further and to notice how she can really feel the sensations of her arousal going down and dampening even further down and when she's moved it down, she can say the number and open her eyes.
You can then continue until she is able to bring it down to a background noise of one or even zero, depending upon her imaginative involvement and success. Many will be able to bring it down to a manageable level if not complete relief.
Instead of a dial, you can also install a sliding anchor so that as she moves her finger from the center of the back of one hand to the end of the middle finger of that hand, she can feel the arousal diminish and then just slide away and gone as she slides the finger completely off the hand (I've used a similar approach with migraines and other pain relief with success).
Honestly, I would think a variation of Scott Sandland's quirky and highly effective "Row Row Your Boat" pattern would work for this as well.
Other hypnotic approaches that I would most likely include in my toolbox for possible use for a client presenting with PSAS . . .
- Hypnoanalsysis (Regression to Cause plus Gestalt Chair)
- Higher Self
- Core Transformation
- Parts Therapy
- Submodality Work
- Anything else, including the proverbial hypnotic kitchen sink
Pretty much the same things I would consider for most therapeutic hypnotic interventions, just remembering to stay very focused on issues and careful to maintain appropriateness and context-sensitivity. Obviously, keeping touch limited and context-appropriate. I would say that a male hypnotist working with a female client for this issue should be particularly careful of transference or professionalism but I won't as a female hypnotist should be careful of the same things. Certainly, you should also be very willing and ready to refer to a colleague if a client is uncomfortable running processes with you due to gender (this would also be true of the more typical Eroticatrance material as well).
I am certain that I've skimped a bit on this response . . . the subject is one I've an interest in and could make a seminar in its own right, but I need to go get some actual work done.
I hope this has been helpful.
BTW, for those of you reading this elsewhere, I have posted the clip from Grey's Anatomy with the PSAS patient on the Life of Brian version of this post http://briandavidphillips.typepad.com/brian as well as a few other video clips.
Another BTW, folks interested in the EROTICATRANCE material should go to http://www.eroticatrance.com for more information (the package deal is very very good for those wishing extremely comprehensive distance training in becoming an Ultimate Ecstasy Pleasure Hypnosis Specialist).
Yet another BTW, while not specifically related to sexual arousal one way or another, our LOVE TRANCEFORMATION EXPERIENCE seminar is set for Jan. 16-17. See http://www.lovetranceformation.org for complete details (the Chinese information page is at http://www.lovetranceformation.org/love.html for those preferring it). If you register before Dec. 25, you will receive a FREE DVD. The Early Bird Discount price expires on Jan. 1 so register NOW!
All the best, (If you are reading this blog post via a stream, go to http://briandavidphillips.typepad.com/brian/ to access the full post with any videos or photos included.) Brian David Phillips, PhD, CH [brian@briandavidphillips.com]
Brian
http://www.briandavidphillips.com/products/shop.html
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Hypnotist, Hypnotherapist, Intuitionist, Trance Wizard
President, Society of Experiential Trance
Associate Professor, NCCU, Taipei, Taiwan
The question for today comes in from a message sent to me via facebook . . .
This question and answer post is a response to an email query I received in regard to my work with Hypnosis (specifically, my work with Past Life Hypnosis, such as my current 
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