The following history exemplifies onset of vaginismus subsequent to episodes of psychosexual trauma. There have been three women referred to therapy so physically and emotionally traumatized by unwelcome sexual attack that vaginismus developed subsequent to their traumatic experiences.
When first seen, couple C had been married for 18 months, with repeated attempts to consummate the marriage reported as unsuccessful. The husband, age 31, reported effective sexual function with several other women prior to marriage. The wife, age 28, described successful sexual connection with four men over a five-year period before the specific episode of sexual trauma.
One of these relationships included coitus two or three times a week over a 10 month time span. She had been readily orgasmic in this association. The traumatic episode in her history was a well authenticated episode of gang rape with resultant physical trauma to the victim requiring two weeks' hospitalization.
Extensive surgical reconstruction of the vaginal canal was necessary for basic physical rehabilitation. No psycho-therapeutic support was sought by or suggested for the girl following this experience.
Mr. and Mrs. C met one year after the rape episode and were married a year after their introduction. Prior to the marriage the husband-to-be was in full possession of the factual history of the gang raping and of the resultant physical distress.
During the latter stages of their engagement period, several attempts at intercourse proved unsuccessful in that despite full erection, penetration could not be accomplished. It was mutually agreed that in all probability the security of the marital state would release her presumed hysterical inhibitions. This did not happen.
After the marriage ceremony, attempts at consummation continued unsuccessful despite an unusually high degree of finesse, kindness, and discretion in the husband's sexual approaches to his traumatized partner. Severe vaginismus was demonstrated during physical examination of the wife after referral to the Foundation.
The remaining two rape experiences were family-oriented and almost identical in history. In both instances young girls were physically forced by male members of their immediate family to provide sexual release, on numerous occasions, for men they did not know.
In one instance:
A father, and in another, an older brother, forced sexual partners upon teenage girls, 15 and 17 years of age and repeatedly stood by to insure the girls' physical cooperation. Sexually exploited, emotionally traumatized, and occasionally physically punished, these girls became conditioned to the concept that all men were like that.
When released from family sexual servitude each girl avoided any possibility of sexual contact during the late teens and well into the twenties, until married at 25 and 29 years of age. Even then, they could not make themselves physically available to consummate their marriages, regardless of how strongly they willed sexual cooperation. Severe vaginismus was present in both eases.
The husbands' physical and psychosexual examinations were within expected limits of normal variability. Neither husband had been made aware of the family-oriented episodes of controlled rape that had occurred years before their association with their wives-to-be.
Once apprised of the etiology of their wives' psychosomatic illness, both men offered limitless cooperation in the therapeutic program. There are various etiological orientations to vaginismus. As evidenced previously, trauma initiating involuntary vaginal spasm can be either physiological or psychological, or both, in origin.
Of course there are factors of psychosomatic influence that predispose to vaginismus other than those frequently noted categories of channelized religious orthodoxy, male sexual dysfunction, and episodes of sexual trauma.