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Sensate Focus

Sensate focus is a diagnostic and therapeutic technique for identifying psychological and relationship factors that contribute to sexual difficulties. It can be used to teach new skills to overcome these problems and to foster more meaningful sexual intimacy1. Developed in the 1960’s by Virginia Johnson and William Masters, sensate focus has found a new resurgence thanks to Showtime’s hit Masters of Sex, chronicling the lives of the two cofounders.

Widely used by sexologists worldwide 2, sensate focus can be a great adjunct to treatment by pelvic floor physical therapists to treat pelvic floor dysfunction. With complex cases, it may be necessary to see a sex therapist in conjunction with pelvic floor physical therapy.

Sensate focus involves couples touching each other in a mindful way, focusing on temperature, texture and pressure, not with the purpose to create or receive pleasure. It’s like rubbing your hand against a silk scarf because you like the way it feels. Maybe it’s cool to the touch on a hot summer day. In this same way, you would touch your partner’s skin. If you happen to be aroused, you try to redirect your attention back to the touch.

Why focus on sensations rather than arousal when the goal is arousal? The short answer is, to get out of your own way! Trying to consciously control our pleasure or our partner’s pleasure is a major source of sexual difficulties. Sex is a natural function of the autonomic nervous system3. It’s automatic, like eating or breathing. When we focus on sensation, we become more primal and bypass higher cortical brain pathways responsible for thoughts of anxiety, expectations, past inadequacies. We stay present and reignite our body’s natural sexual response.

So, how exactly does it work? There are two phases, mindful touch and genital sensate focus.

Phase 1 – Mindful Touch

Three rules

1. Touch for one’s own involvement as opposed to partner’s

2. Touch focuses on sensations, especially tactile sensations, rather than on trying to make oneself or their partner aroused

3. Redirect attention back to the sensation when your mind is distracted

Logistics

1. Sessions take place every 48-72 hours, x number of weeks based on comfort of couple

2. Set aside an hour during which partners are least likely to be disturbed

3. No distractions i.e cell phones

4. Comfortable room temperature

5. Some light on, don’t “set the mood”

6. Remove all clothing or as much as you feel comfortable with

7. Open or close eyes depending on which helps you focus

8. Avoid talking or music

9. Do not use lotions or oils for touching

Method

• Assume any physically comfortable position together

• Prior to session decide who goes first (touches first)

• Touch your partner from head to toe, front to back avoiding the breasts, chest, genitals

• Only touch with hands and fingers

• Toucher focuses on tactile sensations (temperature, pressure, texture) and managing
distractions (including pleasure, emotions, the evaluations of emotions as either good
or bad, partner’s responses

• The touchee focuses on the tactile sensations listed above and non-verbally communicating by moving toucher’s hand away if some area is experienced as physically uncomfortable or ticklish

• Toucher touches so long as to become adept at refocusing on sensations but not so long as to get bored or tired

• Initially, no specific time is suggested

• Do not watch the clock, but afterwards reflect on time, slowing down if < 15 minutes
and speeding up if > 15 minutes each

• Once toucher finishes, he or she says “switch”

• Partners exchange positions, after his/her turn says “stop”

• Get up and get dressed and write down what you have experienced in terms of the
sensations and whether you were able to return and focus attention to these sensations and nature of distractions 

*no kissing during Phase 1, masturbation is allowed but not during session, touchee must speak up or redirect hand if something is bothersome 

Progress phase 1 from breasts and genitals off limits to breasts and genitals on limits, mutual touching, lying together, partner astride and insertion as appropriate. Once genitals are touched, orgasm can happen, however, do not force it and the touchee should take an active part in moving the partners hand, adding firmer pressure, etc. Keep in mind, the purpose in phase 1 is still strictly about personal sensation.

Phase 2 – Genital Sensate Focus

Phase 2 is similar to phase 1, except during phase 2, the attitude shifts to emphasize partner, pleasure 

and communication. Partners exchange verbal and non-verbal information about emotional desires and respond to feedback from the partner. One can begin phase 2 with just touching progression eventually insertion as in phase 1, but the focus is now about pleasure for yourself and your partner.

Sensate focus allows couples to begin their intimacy in a non-demanding way. There is an increased likelihood of experiencing an intimate connection in a spontaneous and meaningful way, eliciting that erotic closeness they so desire.

References

1. Linda Weiner & Constance Avery-Clark (2014): Sensate Focus: clarifying the Masters and Johnson’s model, Sexual and Relationship Therapy, 14 Mar 2014.

2. Weiner, L., & Stiritz, S.E. (2014). Sensate Focus today. Unpublished manuscript.

3. Masters, W., & Johnson, V.E. (1970). Human sexual inadequacy. New York, NY: Little, Brown
and Company.

Three Big Facts About Chronic Lower Back Pain

If you or anyone you know has chronic low back pain (LBP) lasting several months or recurring multiple times, then this blog is for you. That means most people should read this, since up to 58% of people at any point in time experience LBP.1 Your perception of your pain will shape your recovery. Let’s break this down for you into 3 concrete concepts:

1. Pain is not harm.

“Pain is the perception by the brain of an unpleasant sensation that is due to actual or potential tissue damage.” Actual tissue damage in this sense is acute pain – for example, when you suffer a hard fall on your bum or you deadlift beyond your capacity at the gym. This acute, protective LBP is due to traumatic incidents.

Chronic LBP is typically associated with the brain perceiving potential tissue damage. Long after your fall or your back strain at the gym, you feel this pain 6 months or even 5 years later. Physiologically, the tissue has long passed its phase of healing. But you STILL feel pain. Why is this?

Anytime we actually injure our body (e.g., muscle strain, fracture, etc.), our brain creates a strong memory about this pain. Following the incident, even the smallest discomfort in that area is interpreted as intense pain. The lasting memory of the accident, the location in which the injury was sustained, the position of the body, or the time of the incident can all resurface the feeling of pain. But pain is not always harm!pain in our back is always causing physical damage. Has someone told you that if you cough, sneeze, or bend in a weird way, your disc will slip out of place? Or has someone told you your back looks like a 90-year-old’s? Because of this, have you been fearful of certain movements or avoided moving as much? Well, the spine is a strong and stable structure. It would take a lot more than a cough to cause any serious destruction.

There is enough research out there to show that only a small portion of LBP is due to fracture, tumors, infection, aneurism, or more. For example, less than 1% of patients coming into a primary care office have a tumor, 4% have a spinal fracture, and <.01% have a spinal infection.1,3 Therefore, it is crucial to first understand that, most likely, your back pain is not due to a serious medical condition. When you feel pain, your back is not increasingly being harmed.

Red Flag Disclaimer: This is not to say that your back pain is definitely not a serious problem! If you have unexpected weight loss, pain at night that does not change with altering position, rapid fatigue, fever, reduced appetite, any trauma (accident or fall), bowel or bladder changes, or pain radiating down both legs, please see a medical doctor.1

2. Negative emotions and Pain are Interconnected

 

 

 

 

 

 

 

 

 

Have you ever noticed that if you are really busy at work or school, you “forget” your pain for a little while or you feel it less intensely? Or have you noticed that if you are relaxed and calm, sipping a corona on the beach, you have less LBP? This tells us that much of our pain comes from emotional regulation. This does not mean that your back pain is not real! However, you cannot feel pain without your brain because your emotional state at any moment in time can influence how you perceive pain. Being unhappy, negative, stressed, or anxious can be linked to your pain. In fact, there is a higher occurrence of LBP with reports of decreased job satisfaction and social support and increased workplace demands and stress. 1

If you feel less pain when distracted, then focusing on symptoms may actually increase pain. If you were to shift your focus away from constantly thinking about it and, instead, believe that you are strong and healthy, you may not experience pain as intensely. Similarly, if you feel pain less when you are relaxed, then decreasing your stress can play an important role in your path to pain relief. See our Chronic Pain blogs 1 and 2 (hyperlinks) to understand how this works

In general, while LBP can cause unhappiness, stress, and anxiety, the reverse is also true. With continued negative emotions, pain is perceived more intensely and frequently and this becomes a cyclical process. If you can connect your pain to your emotions, then you are one step closer to controlling your pain. It’s all a matter of shifting your perception of how pain works.

3. An aging back is just like your gray hairs. It’s normal.

Spinal degeneration is part of the normal aging process. As we spend more time on this earth, our spine is subject to the same effects of gravity as the wrinkles on our skin.

 It is clear through research that age is a risk factor for LBP, particularly increasing between ages 30 to 60.1,4 Your perception of a naturally aging spine can change how you feel about your lower back.

Just because your MRI says you have a disc herniation or your x-ray shows arthritis in your spine does not mean you will be doomed for life. Join the club – you are getting older! In one study, researchers took MRIs of two groups of patients with sciatica (intense nerve pain in the leg). Firstly, only 68% of those who reported disabling LBP had presence of disc herniation whereas a striking 88% of those who didn’t report disabling LBP had a herniation. This shows that disabling LBP did not correlate to a worse MRI result. Secondly, they found that reports of disabling LBP WITHOUT a disc herniation on MRI caused WORSE perception of recovery 1 year later than an ACTUAL herniation without disabling LBP.

What an interesting finding! Just being preoccupied about your MRI can be linked to more pain later on! It all boils down to perception.

The Take Away…

If you can understand that pain is not harm, that emotions can affect pain, and that an aging back is a normal human phenomenon, then you can gradually alter your perception of your back pain and be one step closer to finding a solution for it. Without the brain, you wouldn’t feel the pain because the mind and the body are not separate entities. Pain IS real… but this real physical pain comes from your brain. The brain can also send pain-relieving signals just as it induces pain-producing signals. Changing your perception of your pain can change the physical

feeling of pain. Understanding this is Step 1. Step 2 is taking massive action! If you continued to live the way you did, if you did not change a thing about your mindset or the way your body moves, then there is little to no chance that you will see improvement.

But there is hope! While back pain has been a massive enigma for centuries, with the advent of modern pain science, we understand it at a higher level. At EMH Physical Therapy, we have devised an evidence-based approach called re.lieve Solutions for Chronic Pain (hyperlink) that treats pain by targeting the brain and the body. If you or your loved one has been suffering from chronic LBP and want solutions NOW, then take a look at what re.lieve Solutions for Chronic Pain (hyperlink) has to offer for you. Visit our website or give us a call to learn more!

References:

  1. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Practice & Research Clinical Rheumatology, 2010; 24:769–781.
  2. Tanenbaum, D.R., & Roistacher, S.L. (2012). Docto, Why Does My Face Still Ache?: Getting Relief from Persistent Jaw, Ear, Tooth, and Headache Pain. New York: Richard Altschuler & Associates, Inc.
  3. Verhagen AP, Downie A, Popali N, Maher C, Koesi BW. Red flags presented in current low back pain guidelines: a review. Eur Spine J, 2016; 25:2788-2802.
  4. Meucci RD, Fassa AG, Faria NMX. Prevalence of Chronic Low Back Pain: Systematic Review. Rev Saúde Pública, 2015; 49:73.

My Jaw Hurts!

Have you ever experienced pain with chewing gum or opening your mouth widely to yawn? Does this sometimes send pain up your temples and give you a headache or even ringing in your ears? Do you sometimes hear popping or clicking in your jaw? There may be many reasons for this but more than likely, you are experiencing some form of Temporomandibular Disorder (TMD).

Let’s break this down. The Temporomandibular joint (TMJ) is the junction between your skull bone (temporal bone) and your jaw bone (mandible). There are several muscles that control the opening, closing, forward, backward, and sideways motions of this joint. There is also a disc inside this joint that acts as a shock absorber. After all, the TMJ is the most used joint in the body! We need it to talk, eat, cough, make facial expressions, sing, and more. So this disc is very important in preventing degenerative joint disease here. Sometimes, this disc can become displaced and cause popping or clicking sounds when we open or close our mouth.

A big reason for TMDs is poor posture. Let me lead you through a quick exercise. Assume the worst posture you could ever have: round your shoulders, jut your chin forward and up, and let your trunk slump. Notice where your jaw is sitting. You might find that the bottom row of your teeth is drawn backward towards your ears and the front of your neck is long and stretched out. Now assume the best posture you could ever have: roll your shoulders back, tuck your chin in, and sit up nice and straight. You might now find that the bottom row of teeth is more in line with the upper row. Now imagine that you spend most of your time in bad posture… it makes sense that you might start to chronically stress the ligaments, muscles, and the joint in ways that they weren’t meant to be!

Another large reason for TMDs is stress. Stress can cause an array of body habits. One of them is clenching the jaw, which creates tension and constant compression at the TMJ. With this comes muscle spasm, which can then send pain upward, giving you a splitting headache.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To help alleviate symptoms, it is important to avoid poor posture, chewing gum, eating hard or large pieces of foods, biting your nails, sleeping on your stomach, and grinding your teeth. Try to stifle yawns if this worsens your symptoms. You may need to see a dentist to determine if a mouth guard is appropriate for you if your partner or loved ones have mentioned that you grind your teeth at night. Since the TMJ can be affected by stress, it is also important to relax your mind and body with breathing techniques, exercise, and mindfulness.

Severe forms of TMDs can be quite debilitation. Imagine you can’t even open your mouth or chew down to eat your favorite chocolate chip cookie! Physical Therapists at EMH specialize in the treatment of TMDs. We can help release muscles from both the outside and inside of your mouth, mobilize the jaw to decrease pain and restrictions, guide you through importance exercises to help normalize your jaw movements, and work on strengthening and stretching tissues around your face, neck, and shoulder to improve your posture and jaw control. This will ultimately set you up for success as you eat that favorite cookie of yours! Now check out two great exercises to relax your jaw below.

  1. De Rossi SS, Greenberg MS, Liu F, Steinkeler A. Temporomandibular Disorders Evaluation and Management. Med Clin N Am, 2014; 98:1353-1384.
  2. Furto ES. Move Forward. APTA. Created May27, 2011. http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=0cb5 5ce4-d260-4887-ad29-d8cb18e0b91e. Accessed Jan 31, 2018.
  3. Gauer RL, Semidey MJ. Diagnosis and Treatment of Temporomandibular Disorders. AM Fam Physician, 2015;91(6):378-386.
  4. O’Sullivan & Siegelman. National Physical Therapy Examination Review and Study Guide. TherapyEd. 21st Edition. Illinois: TherapyEd Publishing; 2018.
  5. Wieckiewicz M, Boening K, Wiland P, Shiau Y, and Paradowska-Stolarz A. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. The Journal of Headache and Pain, 2015;16:106.

 

re.lieve Solutions for Chronic Pain Wellness Roundtable

Please join us for a series of 4 online live lectures that can help anyone, family or friend, suffering with chronic migraines, neck pain, back pain, hip pain, abdominal pain, pelvic pain, IC, IBS, fibro myalgia and more.

Learn about the empowering modern science of pain and self help techniques that, with practice and time, can retrain the brain, lower a hypersensitive nervous system resulting in decreased pain.

Lectures take place Sunday evenings, April 15th • April 22nd • April 29th • May 6th @ 8PM EST

Admission: $20 per lecture

Register here ——>www.wellnessroundtable.com/browse-lectures

Let’s talk about sex-things I learned at the ‘International Society for the Study of Women’s Sexual Health’ annual conference

At the recent ISSWSH www.isswsh.org conference in San Diego there was a lot of talk about sex. Psychologists, physical therapists, researchers, sexual medicine doctors and a spine surgeon presented on insights and medical advances to improve women’s sex drive (hypoarousal no more!); reducing pain during/following sex; balancing hormones (estrogen is good!); post menopause in the bedroom (women in their 60-70’s have sex!) transgender information (3% of highschool students in a major US city say they are transgender). Today’s blog is about the big insights in treating vaginal pain.

Many women still think that it’s normal to have vaginal pain during and following intercourse.  Some experience vaginal burning, itching, pain and feel raw in this area 24/7 and sex increases their pain.

Women may be embarrassed, think this experience is normal, some even feel guilty so they don’t tell their doctors. Unfortunately, many doctors do not ask 3 important questions:

  1. Do you feel pain during/after intercourse?
  2. Are you happy with your sex drive?
  3. Can you achieve orgasm and if yes, are you satisfied with the quality?

 

 

Women with persistent pain can get stuck in a cycle of pain. Vaginal pain causes tension of the pelvic floor/abdominal muscles which can lead to depression, anxiety and catastrophizing behavior. If not treated effectively, they can develop a hypersensitive central nervous system and overprotective brain which worsens pain.  To break this cycle, it’s crucial to find out what type of vaginal pain she has, as each requires a completely different medical approach.

 

The following is a general information guide – see your doctor to get your specific diagnosis!

 

After taking a good history and listening to your symptoms, your doctor that specializes in sexual medicine will do a physical exam, using a Q-tip to gently press against each point of the Vestibule (see image below)

The vestibule is divided like a clock, the top portion, 9 to 3 o’clock is considered the “anterior vestibule” and contains Skenes glands.  The lower 4 to 8 o’clock are considered the “posterior vestibule” contains Bartholin glands and reflect how tense or relaxed are the pelvic floor muscles. Redness of the vestibule is not always an easy way to determine pain because it’s naturally red due to lots of blood vessels.

Complete Vestibulodynia

The whole vestibule, anterior and posterior portions are super sensitive to the Q-tip touch.

This is due to a dominance of estrogen (the pill, acne medicine, facial hair medicine all contains estrogen). These women are not getting enough androgen and testosterone, male hormones that the vestibule needs to be balanced.  Treating this type of vaginal pain is challenging because the woman on the pill has to discontinue and find alternate birth control methods. Teenagers being treated for acne will have it return, so coming off estrogen is a challenge yet once done, this type of vaginal pain will completely heal.  The time it takes to heal – in 6 months she is 50% better and in a year, she is  100% better.  While waiting for the body to balance, doing some healthy mental and physical exercises from the relieve program (link) can also help.

Inflammatory Vestibulitis.

If a woman has a history of chronic infections or if she is one of the 3-4% of American woman who is allergic to propylene glycol which is found in all vaginal gels, yeast creams, steroid creams such as the over the counter Monistat.  Woman may have been incorrectly diagnosed with a yeast infection and given creams (that contains propylene glycol) which causes more sensation of rawness, burning and cutting. What’s happening is that the inflammatory cells, called Mast cells, actually signal nerve endings to grow into the vaginal tissue which makes women feel more pain.

How to treat? If women can be seen within 6 months of symptom onset, they’ll be started on Interferon, a medicine which stops the production of mast cells.

If the woman is seen after 6 months, then treatment is more challenging. Either they use of a capsaicin crème (hot pepper component which removes “Substance P” of the nerve ending or desensitizes the nerve). Treatment is for 12 weeks of use of nightly cream – doable, but painful. Other option is surgery (vestibulectomy) to remove the affected tissue.

Congenital Neuroproliferation.

There is an increased amount of nerve fibers in the vestibule since birth.  These women could never use a tampon. A quick test is to touch your inner belly button and gently press inward. If you feel increase pain/sensitivity in your vagina, then this may be the cause for your pain. How can this be? The umbilicus shares the same embryonic tissue as the vestibule – so they are connected and have the same increased nerve fiber growth.

Treatment is surgical removal of the vestibular tissue (which healthily heals without the extra dense nerve fibers) resulting in no pain.

Overactive Pelvic Floor

Women who experience vaginal pain and have pain with the Q-tip test at the 4-8o’clock region, the posterior vestibule, with no sensitivity in the anterior vestibule. These women have overly tense pelvic floor muscles and this is the most common cause for vaginal pain.  Women can also experience symptoms of urinary frequency, urgency, sensation of incomplete emptying, constipation, rectal fissures, hemorrhoids.

This condition can be effectively treated by pelvic physical therapy. Pelvic PT includes releasing tension in the muscles of the lower back, sacrum, inner thighs, pelvic floor, teaching breathing techniques to relax the pelvic floor muscle, biofeedback, use of dilators and bladder and bowel retraining exercises.

Biopsychosocial Approach for Chronic Pain

Over the last 10 years, we also are now understanding why people stay in chronic pain for months, years, even decades.  Once an injured or chronically inflamed tissue has healed, why is there pain?

 

The answer is that they have developed an overprotective brain and hypersensitive nervous system. Without being aware of their habits developed due to social norms, family history, past experiences with pain, some people learn to be in a pattern of pain. Once the tissue issue has been healed, yet there is still pain, pain is the brain’s way to protect your body.   Ongoing negative experiences like a fight with your partner, stress at work, abuse at home, loss of a pet, saying non-loving, fear-based statements to yourself all day, not having or doing something that gives you joy  (even for a few minutes) can make the brain feel you are always in danger and send pain to protect you.

 

The Doctors of Physical Therapy at EMH are well versed in helping women heal from chronic pain using the biopsychosocial approach as well as our pelvic floor physical therapy for vaginal tissue based pain.  Our e-Book, re.lieve Solutions for Chronic Pain can help you learn self-help techniques to lower chronic pain.  Here’s the link: http://emhphysicaltherapy.com/product/re-lieve-solutions/

 

In summary, women can have a healthy fulfilling sex life – to find a provider, go to isswsh.org.

 

Painful sex? Check out our helpful tips about what you can do to help!

If you’re having pain during sex, try the following tips:

You should have a consult with a pelvic floor physical therapist for training on positioning and how to use a set of vaginal dilators:

They are used to stretch the vaginal tissue, facilitate pelvic muscle relaxation and prepare for intercourse.

If you are able to have penetrative sex:

  • Practice breathing techniques or stretching prior to intercourse
  • You may want to begin with clitoral stimulation to increase natural lubrication and vaginal expansion prior to insertion
  • You can use the dilator with your partner if you feel comfortable as a way to transition from medical to sexual use of dilator. This practice can help prepare you for engaging in sexual intercourse and help you both come to understand the challenge of the healing process and develop skills for working together as a team
  • The transition from plastic dilators to a partner’s penis is often an exciting step for a couple. To make the transition, your partner has to learn a passive role, letting you control the insertion and then just resting inside the vagina for a while. In time you can expand this exercise to permit insertion by the male of his own penis, clitoral stimulation, some thrusting and experimentation with different positions.
  • Use plenty of lubricant and use one that is water soluble
  • Apply ice or frozen blue gel pack wrapped in one layer of a hand towel to relieve burning after intercourse. Frozen peas or corn in a small sealed plastic bag mold comfortably to vulvar anatomy.

Keep in mind that intercourse isn’t always 100% comfortable. Temporary tugs and pressures are often just part of getting started. If some minor discomfort exists, try moving ahead anyway – but if obvious pain persists, don’t ignore it, stop. If you encounter unexpected difficulty, you may want to practice with the dilators some more before attempting intercourse again. Continued dilator use may be necessary from time to time, to keep the vaginal area relaxed and comfortable.

Don’t miss your chance to listen to Evelyn Hecht, PT, ATC speak about modern pain science and how she’s been using it to help heal chronic pain

 

Follow this link to listen to Evelyn’s episode of the Healing Pain Podcast: listen to podcast here

Online Educational & Empowerment Course for Women Suffering with PGAD &/or Vulvodynia

therapy

A unique program designed for a small group of women (15) who suffer with PGAD and chronic vulvar pain.  From the comfort of your home, you’ll have the opportunity to connect with each other in a safe environment, using private encrypted meeting platform (Zoom.us) while learning evidence-based therapeutic solutions for both your physical and emotional healing process. Each class is 2 hours held every 2 weeks for a total of eight(8) classes over a four month time period.

Health care experts from the fields of physical therapy and social work will be teaching this one of a kind program: Evelyn Hecht, PT, ATC and Eva Margot Kant LCSW-R . Their combined 35 years of experience will help you learn effective self-help tools for your mind and body while connecting and supporting each other on your journey to health.

Evelyn Hecht, PT, ATC owner of EMH Physical Therapy has been treating women with pelvic pain and sexual dysfunction for 20 years. She and her team of Doctor of Physical Therapists will be teaching self-care techniques and exercises that can be easily implemented into your healing routine.   The DPT’s will will answer questions about physical symptoms and exercises to the best of their virtual ability.

Physical therapy topics will include

  • Breathing and Meditation
  • Symptom Tracking to identify triggers and solutions
  • Pelvic Floor stretching exercises
  • Neuroplasticity – break the pain cycle

Eva Margot Kant, LCSW-R is a compassionate sex/psychotherapist in private practice with 15 years counseling patients with chronic and sexual pain. She helps clients navigate life’s transitions, address fears and questions about chronic illness/pain.  As a group therapy facilitator, she has worked with organizations including the American Cancer Society and National Multiple Sclerosis Society. Eva teaches courses on sexuality at Columbia University Graduate School of Social Work.

Talk therapy topics will include:

  • Fear
  • Avoidance
  • Mindfulness Based Stress Reduction (MBSR)
  • Educating the Clinician
  • Sharing Information to Loved Ones
  • Dating/Love Relationships

Additional Experts may be incorporated into the separate groups to share information and resources.

Course Details

Length of Online Group Class: 7PM to 9PM Eastern Standard Time

Start Date: Thursday January 19, 2017

2017 Class schedule:  1/19, 2/2, 2/16, 3/2, 3/16, 3/30, 4/13, 4/27

Number of Classes:  Eight (8) classes over a 4 month period January thru April 2017

Cost: Each two hour class is $40.00 per person.  You must register and pre pay for  all 8 classes, at a cost of $320 per person one week prior to the first class.  The price of attending one personal session with a counselor or physical therapist can range between $80 to $250 per hour, depending on where you live. This program offers you access to speak to and learn from a pelvic physical therapy professional with experience treating PGAD, vulvodynia and a clinical social worker seasoned in treating sexual issues and chronic pain for a total of 16 hours at a reduced rate of $320.

While Online Educational & Empowerment Course for Women with PGAD &/or Vulvodynia  does not substitute for individualized therapy, the evidence-based strategies, techniques and support you will gain without leaving the comfort of your home is a one of kind opportunity.

Online Educational & Empowerment Course for Women with PGAD &/or Vulvodynia welcomes a maximum of 15 attendees.

To Register: contact Cindy or Star at (212) 288-2242. Payment is accepted by check, no credit cards. Write check to “Evelyn Hecht, PT” in the amount of $320 and mail to following address:

Evelyn Hecht, PT,1317 Third Avenue,9th Floor, New York, NY 10021

Payment in full is due by January 12, 2017.

Space is limited, so please Sign Up Today

This course will only be conducted with a registration of 15 women.  If the course is cancelled, all monies will be refunded.

For additional questions, please email: info@emhphysicaltherapy.com or call  (212) 288-2242

 

 

A Pregnant Physical Therapist’s Top Tips for Your Healthy Pregnancy

Navigating the pregnancy literature on proper posture, exercise and sleeping alignment can be overwhelming and the guidelines presented are often not a “one size fits all”. Afterall, everyone’s pregnancy is unique. Below you will find some quick and easy tips that I utilized and found helpful throughout my pregnancy that kept me fit, aligned and pain free throughout my work day as a physical therapist at EMH.

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“Rewire Me” The Source for Your Healing Journey

screen-shot-2016-11-07-at-10-31-55-pmrose-and-evelynjpg

I am fascinated by how the body and mind work together to heal from pain and injury.  To learn more about healing and how physical therapists can help patients be committed to their healing process, I interviewed my good friend Rose Caiola, founder of Rewire Me, a company with a wealth of resources, writings and teachers in fields of physical, spiritual and emotional health, all thoroughly researched and curated by Rose and her team at Rewire Me.

Here are some of the gems I gleaned from our interview:

Evelyn: Why did you start Rewire Me?

Rose: Rewire Me evolved from life lessons I’ve learned from age 13 onward, meeting various teachers and mentors who helped me on my life’s healing journey. Connecting with these teachers proved more beneficial than trying to “fix things on my own.”

Many people feel alone when dealing with life’s challenges and don’t know how to ask for help or even where to look for guidance. One method or teacher may not resonate for every person, so I thought “Wouldn’t it be wonderful to have a site with a range of authentic experts, teachers, and healers?” People can seek and access these teachers’ wisdom through writings, books and classes to help them on their healing journey”.

Rewire Me’s website includes a range of experts on topics such as relationships, parenting, physical health, spiritual growth,  dealing with illness and loss –  incorporating all aspects of life.

E: How can people with physical pain start their healing process?

R: The first step is to acknowledge that there is something wrong. Many people don’t want to acknowledge that they are feeling pain, so they bury it or pretend it is not there. Once you acknowledge there is a problem, then you can reach out to a friend, call a medical professional, research on professional medical websites like WebMD and go on to Rewire Me to find teachers who may inspire them.
People may reject acknowledging pain or injury due to fear of the unknown.  Others may feel that asking for help is a sign of weakness, especially if they are used to being in charge or control.  Pain can make a person feel out of control. In essence what this really translates into is, ‘I don’t feel worthy enough to have somebody help me. I don’t love myself enough to get the help I need.’

E: How can one rewire fear-based thinking that stumps taking positive action?

R: Set a little time in the morning before you have to start your day. Sit up, feet on the floor to ground yourself and spend 5 minutes focusing on your breath, feeling and focusing your attention to the breath moving in and out, at whatever pace. This centers you to the present.

After the 5 minutes of quiet breath, ask “What do I want to happen today so I can achieve good health, or be successful as a parent or attain a work goal”

Envision your hero, or person of history who inspires you, for example, Amelia Earhart. What would it feel to be like her? Envision and embody the emotion of Amelia‘s courage, risk taking, forward thinking. How do you think she felt when she was flying solo in the starry night sky?

E: How can we help patients stay motivated and the course of treatment; to understand that their home program as physical therapy is not a “quick fix?”

R: Well, one I think is to have faith in the healing process. So that might become their mantra. ‘Today I’m going to do what I can to heal myself.’ ‘Today I’m going to take that first step.’ ‘Today I’m going to do my physical therapy exercises.’ Not worrying about tomorrow, not thinking about anything else, but having faith that they can overcome. When and if they come up to a crossroad or a flare up, don’t give up. Tell yourself “It’s okay.” Acknowledge that it’s painful and that you’ve hit a rock or a wall. Figure out how you can go around the wall instead of letting yourself get stuck. Avoid the “Oh poor me.’ ‘This always happens to me.’ ‘This is my life.’ If you keep repeating that story, you’re never going to get anywhere. Replace them with positive statements. The brain and body are listening!

The second thing to do is Practice. Practice your home exercises, self care techniques, say your positive affirmations out loud.  With practice different parts of our brain light up and those neural networks become bonded over time, overriding faulty pain patterns. If you play a sport you have to practice to compete well.  But, if you don’t practice, you won’t play as well. My kids are on sports teams and if they don’t practice, they get benched. They’ll say: “Why did the coach do that? I’m so angry…the coach hasn’t put me in play for the last 3 games!” Well, if you don’t practice, why would that coach put you in the game? It’s the same with committing and doing your home program, practice allows your body to change for the better.

Third, Schedule the 2-3 times a day in your calendar where you know you can do your physical therapy exercises. They don’t take long, right?

E: No. People wouldn’t do them otherwise, so we keep them short and manageable.

R: That’s great, so patients start to feel better, get stronger and over time they’ll see the many benefits of committing to their treatment.

E: Yes!  You’ve used the term “healing journey.” What does that means to you?

R: A healing journey means learning to love myself. Learning to forgive myself, including what happened in my past.  Incorporating growth and love from others and building this Rewire Me community is all about healing. Healing your heart. Healing your physical, emotional and spiritual well-being

Check out Rewireme.com to be inspired and continue on your healing journey!

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