Sexual Problems Say what Words Don’t

1h 05m

Hester Pastoor

Sexologist, Psychotherapist, ECPS
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Content: Which are the signs of poor communication in a couple? Can poor communication affect the sexual symptom, or is it vice-versa? These are the starting questions introducing the case of Mandy and Tim, who have been in a relationship for 2 years. Both work very hard, even during their vacation time. Spare time is also fully booked with social engagements. They ask for help because of sexual pain of Mandy during intercourse. Tim reports no sexual problems and is very understanding. They describe an excellent connection, with no fight. Sometimes they have intercourse despite the pain, and Tim gives cuddles and massages. Mandy experiences superficial dyspareunia due to vulvodynia. No gynaecological causes except for an extremely tense pelvic floor. She presents a negative body image, perfectionism, and a tendency to rationalize her emotions. The treatment process sees two rounds: one with Mandy alone, very short and with scarce improvements, and 6 years later, another one with the couple, as the therapist decided on a different approach. Nevertheless, the outcome is disappointing, both for the couple and the clinician. What went wrong?

Dr. Hester Pastoor analyses the case presented by Francesca Tripodi through the lenses of her experience as a systemic therapist and sexologist, focusing on some key aspects:

  1. What a therapist should have in mind when a couple says that everything is fine except sex
  2. What is likely to happen when the communication (verbal and nonverbal) between the partners is not assessed adequately
  3. What the therapist could manage differently and the meaning of a treatment failure

 

Produced in 2023

Hester Pastoor

Hester Pastoor

Sexologist, Psychotherapist, ECPS
Speaker

Hester Pastoor, MSc, is registered as a sexologist-ECPS, psychotherapist, and systemic therapist. She finished three masters in The Netherlands: Clinical & Health Psychology, Personality Psychology, and Clinical Epidemiology. In Belgium, she completed a Sexology master and a postgraduate in Systemic Psychotherapy.

She is co-director of the Sexology Program in Amsterdam and co-director of the ESSM School and ESSM Advanced Course. Finally, from 2016-2022 she was president of the Dutch Scientific Society of Sexology. 
Since 2000 she works in clinical sexology and sexual medicine as a therapist, teacher, and researcher; she is currently at Erasmus UMC in Rotterdam. 
She states: ‘Sexology is my core business and the love of my life. There is no profession more interesting, challenging, and beautiful than this. It is very rewarding to work with individuals and couples who have questions, struggles, or problems with sexuality. I feel honored that they trust me with these intimate topics. Also, it is a great field to do research in. The biopsychosocial and multidisciplinary aspects make it a challenge every time. It is never boring. And finally, teaching sexology to students and professionals who want to learn about this field or even want to become registered sexologists is a great experience. To teach them what I know, to learn from them too, and to see them develop is always a pleasure.’

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