TRANSCRIPT: We haven’t consummated our marriage. | ERLC
An interesting point is that the main reasons for this disorder are similar in different countries.
Some of the reasons for occurrence of unconsummated marriage are lack of sufficient sexual information, sexual performance anxiety, vaginismus, lack of privacy, history of sexual abuse, unreal fears, cultural and social factors, strict religious rules, sexual limitations applied by the family and the society and also specific costumes about the first sexual intercourse, premature ejaculation and erectile dysfunction 2611 — Vaginismus is one of the common sexual disorders among women which is also considered one of the main reasons for unconsummated marriage.
The main characteristic of this disorder is involuntary vaginal muscle spasm in women which would make vaginal penetration impossible. This reaction is not just limited to sexual intercourse and the patients would even experience this condition during gynecological examination Also, the history of sexual abuse is associated with Posttraumatic stress disorder PTSDwhich could lead to this disorder.
Unconsummated marriages have different consequences including the sense of guilt, the sense of shame and incompetency, reduced self-esteem, aggression and the sense of frustration, instability in marriage, infertility and divorce 278111216 Life experiences vary in different people and some women's body would react to sexual activity by vaginismus.
Hasty intercourse at the wedding night and its painful experience, unawareness of the anatomy and performance of women's reproductive system and also unawareness of different methods of sexual activity are some of the main reasons for this disorder. Since PTSD should also be considered, narrative exposure therapy was used.
More previous articles are quantitative or prevalence studies. They have used mono-dimensional approach. While recommending the use of multi-dimensional approach in reference books, There is little article detailing this approach it may be useful for young therapists, especially in traditional societies.
Couple's evaluation This case with the sense of guilt, shame and incompetency referred to our clinic. The wife was 23 and the husband was 25 years old and they were married for 6 years.
Male and female each had a diploma and both of them have a normal weight and height. They were in a moderate financial situation and middle social class. Both of them believed a woman must be virgin until marriage. The wife was a housewife and the husband was a freelancer.
Diagnosis and treatment of unconsummated marriage in an Iranian couple
Their marriage was traditional and they were not relatives. Although they had a private bedroom, and nobody living with them, they were not successful in vaginal penetration yet. They were intimate with together. Because they were under pressure of family and local customs, they hid their problem from both families. Man visited a urologist and premature ejaculation and erectile disorder were ruled out.
They denied wanting a baby due to family pressure and had referred to a few persons who were not specialists. Suggested treatments included tying up woman's hands and feet and forceful penetration, using sleeping pills by the woman and then the man tries to penetrate by the man and using narcotics by the woman to reduce pain. Some people had encouraged them to watch pornography videos which decreased woman's sexual desires.
A specialist physician recommended them to perform hymenectomy. Although they were very disappointed, they were introduced from one of the health centers to this clinic. They tired from this incomplete sexual relationship. Hymenectomy was not performed because she referred to our clinic before doing this procedure.
At the first session of counseling, the couple seemed disappointed and exhausted about not getting any results from all the treatment methods. They had no problem in their daily life and had no communicational problems.
The wife's voice was trembling and her sex drive had reduced recently. The husband's sexual response cycle was complete and he would reach orgasm without vaginal penetration. The wife's evaluation showed normal sex drive and having sexual imagination and desire for sexual activity and sometime, due to clitoral stimulation, she had even reached an orgasm.
To havea more comprehensive psychological evaluation of the wife, her history from childhood till now was obtained. After creating an effective communication with the patient, the wife mentioned that during her period of engagement she has witnessed a man raping her sister.
After this incidence she had an unpleasant feeling toward touching her body especially her genitals and starting sexual activity would reminded her of the rape scene. Multi-dimensional approach was used for treating this couple. No pathologic problem was observed in the woman during gynecological examination but she did not allow a full vaginal examination; the primary diagnosis was vaginismus.Sternberg's Theory of Love: Intimacy, Commitment, Passion
Narrative exposure therapy is a method which is used for treating PTSD Usually people, who have had bitter and horrible experiences in their lives, would try to eliminate those experiences from their minds and forget about them as soon as possible.
Affected people believe that the more they run from their experiences and their memories the safer they would be and would have more peace; but this is not true. On the contrary, the more they would escape from their experiences and memories, those memories and experiences would attach to them with more power Psychological researches have shown that one of the effective methods for reducing the symptoms of PTSD is exposure therapy In this case dark and frightening events were assessed in detail; the patient was asked to express all of her feelings, physical reactions, voices and thoughts that she had experienced during that incidence during the therapeutic session to her therapist in detail.
TRANSCRIPT: We haven’t consummated our marriage.
Then she was asked to write down her memories with details on a paper and then tear it. The purpose of this action was to normalize the emotional responses to fear and create an integrated and meaningful storyline of the patient's life, helping her to reevaluate her negative thoughts and cognitive distortions and coordinating her thoughts and beliefs with her current life conditions.
This team included someone with a PhD in sexual and reproductive health, aurologist and a psychologist. Discussion Unconsummated marriage is one of the most important sexual disorder more common in developing countries than developed countries, and cultural factors are effective on intensifying it 2.
If not diagnosed, it could be confused with voluntary non-obedience of women and could lead to court orders that would legally and religiously annul the marriage The presence of the couple together at the counseling center for treatment is necessary and husbands have an essential role in the treatment of this disorder. In most cases husbands are the ones who can help their wives. They should know that, according to the scientific and religious references, this disorder is not a reason for women's non-obedience; these contractions would happen involuntarily and women have no control over them and after a period of treatment, with support from their husbands, women could easily enjoy sexual activities with their husbands We explained that vaginism is the result of an involuntary vaginal muscle spasm and men should never threaten their wives with divorce because of this disorder.
These threats could intensify the muscle spasms and sometimes even lead to sexual desire disorder or sexual aversion in women, which is way more difficult and complicated to treat than vaginismus.
Participation of the man in counseling sessions, non sensate focus and sensate focus which both of them show this problem could treated if both of them are taking part. This disorder is more common among young women, women with negative attitude towards sexual activity and those who had experienced sexual misconduct or abuse.
Barden et al in a study that was conducted on cases of unconsummated marriage in Egypt evaluated its etiologic factors and revealed that the most common factor was psychological disorders, especially performance anxiety, and vaginismus 8. Abraham reported 50 cases that were referred to one of the hospitals of London. Some of them were put under surgery with general anesthesia for vaginal dilation, which was useless. He proposed primary gynecology examination and then psychological evaluation.
Vaginal dilatation was performed under anesthesia, but the problem was not resolved. So you may have somebody who has been exposed to porn since he was nine, ten years old, so he is unable to think of a real-life woman in a way that causes the sort of response to her that God initiated and that God wired within us.
And it also may be that somehow he has been involved in porn for so long, or something, that there is a sense of shame that he is attaching to sex. Maybe there is a sort of guilt that he is attaching, and being in the presence of her, there is that sense that the Bible says is the result of the fall, that the man and the woman were naked and they were ashamed before each other. Another possibility is that there is some sort of trauma that has happened in his life.
It could be that this is someone who was sexually abused. It could be that there was some type of psychological wound that he experienced. Spend some time talking to him. Work him through this to say is there some sort of trauma that is going on.
I refuse to carry out my responsibilities to love and to care for me wife including in the area of sexual intimacy, well, yeah, I think that would constitute an abandonment of her, and that would mean that the leaders of the church should come in and deal with it.
My suspicion is that there is some sort of trauma going on in his life, and you need to help him with that and to provide whatever help that you can give to him. For her, it sounds to me, based again on the very little that you have said to me, that she is wanting to fight this through; she is wanting to be there with her husband and work through this. She has stayed with him for eight months.
So, give her the resources that she is going to need.
That includes keeping her from thinking somehow that she is to blame. I mean, of course she is going to think that this is very unusual, and it is an unusual situation to be married eight months and have no sexual relationship with one another. She is going to feel as though she is somehow unwanted or unattractive, or maybe even freakish.
This is not her problem, I am willing to say right here. This is something that is going on in his life. So help her to see that, and give the ministry to her that she is going to need as you work through this situation.
And just find out what the problem is. Sometimes you have Christians who have been diligent watching their hearts when it comes to sexuality in an unbiblical form.
So there is probably something else going on here. But help him to work through, as you are moving forward, that sexuality is a good thing, a good gift that God has given to us. And just help them to fight through this. That one-flesh union, emotionally, spiritually, psychologically, and physically is really important in a marriage.