Dergi Ara >>
Yıl:2010; Cilt: 21; Sayı: 3>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2010;21(3):243-248
Vajinismusun EMDR Yöntemi İle Tedavisi: İki Olgu Sunumu
F Torun
Ümraniye Eğitim ve Araştırma Hastanesi, Psikiyatri Kl., İstanbul
Vajinismus kadının vajina kaslarındaki istemsiz kasılmalar nedeniyle hiçbir şekilde cinsel ilişkinin gerçekleşemediği
bir cinsel işlev bozukluğudur. Vajinismus için temel tanı kriteri vajinanın dış üçte birindeki kaslarda koitusu
engelleyecek, yineleyici bir biçimde ya da istem dışı spazmın olması olarak tanımlanmıştır. Birçok olguda ağrı ya da
ağrının olabileceğine ilişkin korku vajinismusun ortaya çıkması ve sürmesine neden olmaktadır.
Bu yazıda, çocukluk çağında geçirilmiş cinsel travmaya bağlı olarak ortaya çıkan iki vajinismus olgusunun Göz
Hareketleri ile Duyarsızlaştırma ve Yeniden İşleme (Eye Movement Desensitization & Reprocessing-EMDR) tekniği
ile tedavisi sunulacaktır. EMDR ağırlıklı olarak ruhsal travma tedavisinde kullanılan bir tedavi tekniğidir. EMDR
tekniğinin etkinliği, travma sonrası stres bozukluğu, cinsel travma mağdurları gibi birçok grupta yapılan randomize
kontrollü çalışmalarla gösterilmiştir. Her iki olguda da standart olarak sekiz aşamalı EMDR protokolü uygulanmıştır.
3 seanslık EMDR seansı sonrasında her iki olguda da hem kaygı düzeylerinde azalma, hem de cinsel ilişkiye
yönelik işlevsel olmayan düşüncelerin ortadan kalktığı görüldü ve vajinismus sorunu ortadan kalktı. Bu çalışmada
sunulan iki olgudan hareketle, travmanın neden olduğu vajinismus olgularında EMDR�nin alternatif bir tedavi
tekniği olarak etkili olabileceği söylenebilir.
Treatment of Vaginismus with EMDR: A Report of Two Cases
Vaginismus is a type of sexual dysfunction in which spasm of the vaginal musculature prevents penetrative intercourse.
The main diagnostic criterion is the presence of recurrent or persistent involuntary spasm of the musculature
of the outer third of the vagina that interferes with sexual intercourse. In many cases associated pain or the
fear of pain may contribute to its persistence. Herein we report 2 patients that presented with vaginismus that
developed secondary to childhood sexual trauma, which was treated with the Eye Movement Desensitization and
Reprocessing (EMDR) technique.
EMDR is a non-pharmacologic treatment for psychological trauma. Randomized controlled trials with posttraumatic
stress disorder patients and with victims of sexual abuse have shown that EMDR is effective. The standard
8-phase EMDR protocol was used in both of the presented cases. Following 3 sessions of EMDR, the patients
exhibited a substantial reduction in self-reported and clinician-rated anxiety, and a reduction in the credibility of
dysfunctional beliefs concerning sexual intercourse. These findings support the notion that EMDR could be an effective
treatment alternative for patients with vaginismus of traumatic etiology.

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