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Yıl:1998; Cilt: 35; Sayı: 1>> Özet
Nöropsikiyatri Arşivi; 1998;35(1):55-60
Vajinismus olguları ile bir grup psikoterapi süreci
D Şahin, A Kayır
İ.Ü. İstanbul Tıp Fakültesi Psikiyatri Anabilim Dalı
Gerekçe: Ülkemizde cinsel terapilere başvu­ran kadınların büyük bölümünü vajinismus olguları oluşturmaktadır. Bu olguların birçok ortak özelliği olmasma karşın, her olgunun terapi sürecinde önem kazanan farklı özellik­leri de bulunmaktadır. Yöntem: Çalışmaya, İstanbul Tıp Fakültesi Psikoterapi-Psikonevroz Birimi'ne yakın tarih­lerde başvurmuş olmaları dolayısıyla bir ara­ya gelen 7 vajinismus olgusu alındı. Olgularla grup öncesi iki veya üç kez ön gö­rüşme yapıldı. Grup terapistleri (bir kadın, bir erkek) eşlerle grup psikoterapisi başlamadan önce bir kez, grubun 4. ve 6. haftalarında bi­rer kez olmak üzere üç kez bireysel görüşme yaptılar. Haftada bir sıklıkla 10 haftalık grup psikoterapisi boyunca ve terapinin bitiminden bir ay sonra yapılan değerlendirmede olgula­rın bireysel özellikleri, gösterdikleri tepkiler, dirençler izlendi. Grup psikoterapisi; cinsel bilgilendirme, davranışçı alıştırmalar, bilişsel terapi ve öçgörü kazandırmaya yönelik dina­mik terapinin eklektik olarak kullanılması bi­çimindeydi. Tüm kadınlara, soyo-demografik özellikler; cinsel gelişim öyküsü ve cinsel işlev aksamasından oluşan yan-yapılandınlmış bir öykü formu; cinsel öykü formu; cinsel mitler formu; T.A.T, Bir İnsan Çiz Testi uygulandı. Sonuçlar; Vajinismus olguları benzer özellik­ler gösterdikleri kadar nedenleri ve tedaviye yanıt açısından farklılıklar da göstermektedir­ler. Çoğunun 8-10 seanslık çift veya grup te­davisinden yararlanmasına karşın dirençli güç vakaların varlığı da bir gerçektir. Değerlendirme: Vajinismusun tedavisinde bi­reysel özellikleri dikkate alan eklektik tedavi­ler uygun olacaktır.
A Group Psychotherapy Process With Vaginismus Cases
Objectives: Women referring for sex therapy in our country are mostly the cases of vaginis­mus. Although they have many common cha­racteristics, different aspects gain importance in each case during the psychotherapy process. Method: Seven vaginismus cases, referring to the Istanbul University, Faculty of Medicine, Psychiatry Department The Outpatient Clinic of Psychoterapy and Psychoneurosis, were included in our study.
The cases were interviewed for 2-3 sessions, both individually and with their partners pri­or to the onset of the group therapy. The partners also were interviewed individually prior to the group psychoterapy and during the 4th and 6th group session. Assessments were made by: Structured socio-demographic history form including sexual development and sexual dysfunction, sexual myths form, TAT and Draw a Person Test. Two therapists conducted the group which consisted of 10 session meeting once weekly. The group psychotherapy was in a context using sexual information, behavioral home­work, cognitif psychotherapy, and gaining in­sight by dynamic psychotherapy. During and 1 [month] after termination of the group sessions, the cases were evaluated from the point of individual characteristics, their responses and resistances. Results: As much as they have common cha­racteristics, the vaginismic women show indi­vidual differences.
Evaluations: An eclectic approach of psychotherapy, taking into account of indivi­dual differences, will be the best for the treat­ment of vaginismus.

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