The more one delves into the pathology, the more one realizes how complex the picture of vulvodinia is and how addressing it requires a treatment plan that moves on several fronts. Indeed, it is only a fruitful collaboration between different dimensions of intervention that makes it possible to arrive at the improvement and resolution of an issue that greatly impacts the lives of women affected by it.
What is mindfulness
In a treatment setting where physical and psychological therapies often work side by side, mindfulness also finds its place of intervention in the treatment of vulvodinia. Before going into specifics, however, it is first necessary to clarify what we are talking about. “Mindfulness is a method that is based on mindfulness meditation: it aims to lead to self-awareness so as to improve the quality of life by providing the tools to deal from a different perspective with events, even negative and suffering-bearing ones, that one may encounter on one’s path.”
This is explained by Maria Beatrice Toro, psychologist and psychotherapist, Director of the School of Specialization in Cognitive Interpersonal Psychotherapy SCINT aut miur 2008 in Rome, lecturer at Lateran University, President of the Italian Institute of Interpersonal Mindfulness, member of the Federmindfulness board as well as author of numerous scientific and popular publications on mindfulness. “Mindfulness practices thus help to stay connected with the present moment by easing stress and amplifying well-being.”
The benefits of mindfulness practice
It is the very benefits attributed to mindfulness, and proven by now forty years of studies, that delineate a relationship between mindfulness practices and intervention in cases of vulvodinia. “In addition to the positive impact in terms of stress reduction due to the presence of a severely disabling situation, the neurological effects of mindfulness must be taken into account, which, in addition to changing thoughts and behaviors, is able to create new synaptic pathways in the brain at specific points affecting, for example, the perception of pain, which is constantly present in women suffering from vulvodinia,” comments the expert.
“Further help in this direction comes from the anti-inflammatory power related to the regular practice of mindfulness as well as from the positive reflexes on sexuality, which is often impaired if not denied in the presence of vulvodinia.”
Analysis of a recent study
Confirmation of the effectiveness of mindfulness practices in the presence of vulvodinia comes from a recent study involving the coordinated efforts of the Department of Neurorehabilitation at the Danube University Krems in Austria, the Department of Obstetrics and Gynecology at the Medical University of Graz also in Austria, and the Department of Biological and Medical Psychology at the University of Bergen in Norway.
While many studies had previously been done on the role of mindfulness in reducing chronic pain and on the intervention of mindfulness meditation in vestibulodynia, this study is the first to have investigated the possibility of direct intervention of mindfulness practices on women suffering from vulvodinia.
The practice of body scan
The objective of the research in question was to verify the effectiveness in the treatment of vulvodinia of a coordinated protocol of pelvic floor physiotherapy and mindfulness practices, specifically the one named body scan. “It is about the basic exercise where you meet the body,” explains Professor Toro.
“According to Kabat-Zinn, founder of the mindfulness method, the experience of physical awareness that is gained through this exercise has healing power in itself because it teaches us to come to terms with whatever is there, even if it is pain: carefully observed, the discomfort shows itself to be less intense than we imagine. If we pay attention to the body’s reality, the body, in its own way, responds to us: sensations change and even pain, sooner or later, becomes less intense. To stop struggling with sensations is, in some way, to stop struggling with oneself.”
The fruitful relationship between physical therapy and mindfulness
Participants in the study received ten sessions of fisioterapia del pavimento pelvico, considered one of the basic therapies in the treatment of vulvodinia, which is often accompanied precisely by pelvic floor hypertonus. They were also invited to follow the practice of body scan at home under the guidance of an audio file, five times a week. The researchers assumed that pelvic floor therapy is not just a rehabilitative practice but represents a path toward recognizing pain and the limitations it imposes.
A bodily awareness, then, that mindfulness practice only supports by raising the threshold of pain acceptance also through desensitizing the nervous systems that generate it and reducing sympathetic nervous system activity. The practice of audio-guided body scanning has the advantage that it can be done where and when one prefers and, like physical therapy sessions, is helpful in improving control over oneself. The researchers verified that many of the women involved in the study continued with the activity even after treatment ended.
Conclusions
The integration of a protocol of fisioterapia del pavimento pelvico with mindfulness practices was well accepted by the study participants and resulted in recording a reduction in the pain condition and an improvement in sexual function.
This is even though the body scan practice included only a few specific references to the genitals and pelvic floor: according to the researchers, future studies could explore the effects of practice focused on the pelvic region to record whether it may be even more effective in reducing pain symptoms in the presence of vulvodinia.