The Pleasure Prescription: A Path to Healing with Physical Therapist Dee Hartmann

The Power of Pelvic Floor Physical Therapy

For years, I've been hearing about how pelvic floor physical therapists are the gold standard of pelvic floor care. Dee, with over 30 years of experience, is a shining example of why this is true. She emphasizes the importance of getting a baseline of your pelvic floor health, especially in midlife:

"Just like we go for our annual mammogram, or PAP smear or colonoscopy, we have to go to that pelvic floor PT and have them be part of our care team just to get that checkup."

Understanding Sexual Pain: More Common Than You Think

One of the most striking revelations from our conversation was the prevalence of chronic vulvar pain. Dee shared a startling statistic:

"We know up to 6% of women in the United States have chronic vulvar pain for more than three months."

This underscores the importance of seeking help rather than suffering in silence. Dee explained that women often wait years before seeking treatment, sometimes seeing up to 10 doctors before getting the help they need.

Key takeaways about sexual pain:

• It's more common than most people realize

• Women often wait too long to seek help

• Multiple factors can contribute to sexual pain, including physical, emotional, and relational aspects

The Pleasure Prescription: A Unique Approach to Healing

Dee's approach to treating sexual pain is refreshingly holistic. Instead of focusing solely on eliminating pain, she emphasizes the importance of cultivating pleasure. This is the core concept behind her book, "The Pleasure Prescription: A Surprising Approach to Healing Sexual Pain."

"Pleasure is not just sexual pleasure, we have to start with sensual pleasure. We have to be happy, we have to feel good, inside and out. Before we can really be there sexually," Dee explains.

The book offers over 22 pleasure prescriptions, many of which are non-sexual in nature. These prescriptions are designed to help women:

• Understand their anatomy

• Explore their bodies without judgment

• Cultivate sensual awareness in everyday life

• Gradually build arousal and desire

Genital Self-Esteem: A New Perspective on Body Image

One concept that particularly resonated with me was the idea of "genital self-esteem." Dee explains that this term, rooted in psychological research, refers to how women feel about their own genital anatomy.

"It really is about how you're feeling... from a psychological perspective, about your own anatomy," Dee clarifies.

This concept is crucial because negative feelings about one's genitals can contribute to sexual pain and dissatisfaction. Dee's approach encourages women to befriend their vulvas and appreciate the diversity of vulvar appearance.

Action steps to improve genital self-esteem:

• Take time to look at and appreciate your vulva

• Learn about the natural diversity of vulvar appearance

• Practice self-touch without judgment

• Focus on sensations rather than appearance

The Importance of Full Arousal

Another key insight from our conversation was the significance of full arousal for pleasurable sexual experiences. Dee contrasts the experience of "quickie" sex with fully aroused sex:

"The whole clitoris is only there for pleasure... a quickie when you don't include your clitoris is very different than... a fully aroused, fully engorged, fully open vaginal canal. This includes sensing for increased temperature, increased blood flow, increased mucus production, that sense of expansion at top of the vagina."

This underscores the importance of taking time for arousal and not rushing the process. It's a reminder that pleasure is not just about the destination but the journey.

Tips for enhancing arousal:

• Explore different types of touch and stimulation

• Practice mindfulness during sexual activities

• Communicate with your partner about what feels good

• Consider using tools like vibrators to enhance stimulation

Inviting Partners into the Exploration

Dee emphasizes that healing sexual pain and enhancing pleasure isn't just an individual journey – it often involves partners as well. She recommends techniques like Sensate Focus to help couples explore pleasure together:

"It really is about getting to know each other... explore each other's body through consensual touch."

Sensate focus involves a series of touch exercises that progressively become more intimate, allowing couples to explore pleasure without the pressure of sexual performance.

Steps for incorporating partners in pleasure exploration:

• Open communication about desires and boundaries

• Practice non-sexual touch exercises together

• Gradually incorporate more intimate touch

• Focus on giving and receiving pleasure without specific goals

The Broader Definition of Pleasure

Perhaps the most impactful takeaway from my conversation with Dee was her expansive definition of pleasure. She views pleasure not just as a sexual experience, but as a fundamental aspect of well-being:

"Pleasure is the opposite of pain and hurt... it is like this incredible, magnificent, psychological and physiological high, where everything feels good way inside and out and all over again... we have to bring it there and we have to let ourselves experience it."

This perspective invites us to seek and cultivate pleasure in all aspects of our lives, not just in the bedroom. It's a powerful reminder that pleasure is our birthright and a crucial component of overall health and happiness.

Ways to incorporate more pleasure in daily life:

• Practice mindfulness to fully experience sensory pleasures

• Engage in activities that bring you joy regularly

• Prioritize self-care and relaxation

• Cultivate gratitude for small pleasures

Conclusion: Embracing Pleasure as a Path to Healing

My conversation with Dee Hartmann reinforced my belief in the transformative power of pleasure. Her approach offers hope and practical strategies for women dealing with sexual pain, while also providing valuable insights for anyone looking to enhance their experience of pleasure.

Remember, healing is possible, and pleasure is not just a luxury – it's an essential component of our well-being. Whether you're dealing with sexual pain or simply want to enrich your life with more joy, consider exploring Dee's pleasure prescriptions. Your body, mind, and spirit will thank you.

For more resources and information, visit Dee's websites at PleasureMovement.com and VulvaLove.com. And don't forget to check out her book, "The Pleasure Prescription: A Surprising Approach to Healing Sexual Pain" for a deeper dive into these concepts.