The following steps explain the exercise:
1. Conduct the exercise (initially by oneself) lying down naked in a comfortable, safe, distraction-free setting (e.g., bedroom). Begin by gently touching the top of the head with the fingertips, noticing the sensations. Systematically move down the face and head, and then the body, slowly touching as much of oneself as is comfortable. Take notice of all sensations, and vary the pace and pressure of the movements with the goal of learning what feels pleasurable and what does not. Do not be overly concerned about feeling sexual, and do not attempt to reach orgasm. The purpose is to explore yourself and to develop an enhanced sensual awareness of pleasurable touch.
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| Multiple Sclerosis Sexual Dysfunction |
Many people may initially experience sadness or irritability when they conduct the exercise, as they process the sense of emotional loss associated with libido changes, particularly when they stroke their genitals. Some find it helpful to conduct the exercise in front of a mirror in order to provide additional visual feedback. Conduct the exercise for 15 to 20 minutes approximately twice a week.
2. Include the partner after the first few sessions of self exploration. When libido diminishes or is absent, the sequence of communications around sexual behaviors for partners almost always needs to change as well. Conducting the body mapping exercise for the purpose of improving communication (rather than for immediate sexual gratification) allows the parthers to develop new sequences of touch that are mutually pleasing. It also allows for communicating about the emotions associated with this process. Partners should be instructed verbally (e.g., "stroke me lightly on my neck with just your fingertips") and non-verbally (e.g., taking the partner's hand and guiding it to a pleasurable place, demonstrating the pace and pressure of the desirable touch). For the first two or three times the partner is included, touching the genitals should be avoided.
3. Expand the body mapping exercise with the partner to include stimulating the genitals. The focus should remain on communication and the restoration of pleasure, without the goal of having intercourse or achieving orgasm.
4. If he or she is physically able, the person with MS should reciprocate by conducting a body mapping exercise on the partner. This introduces mutual communication and sensual pleasure during the process of relearning cues associated with sexual pleasure. Partners can take turns, spending 15 to 20 minutes each, as "givers" and then "receivers" of pleasure. In the role of receiver, the goal is to suspend the usual concern for the partner's pleasure and focus on communicating to the partner how he or she can provide maximal pleasure.
Similarly, in the role of giver, the goal is to be maximally attentive and completely devoted to following the cues and feedback offered by the partner. Changing one's sexual signals or cues to initiate sexual activity can be assisted by conducting a body mapping exercise. Body mapping is typically used to help compensate for primary (genital) or secondary (nongenital) sensory changes, but it can be a useful first step in the enhancement of physical pleasure and emotional closeness, as well as sexual communication and intimacy.
5. If the exercise elicits significant emotional distress or couples find that they have a great deal of difficulty communicating during the exercise, professional counseling can often assist in resolving the interfering issues.
Women and men report that diminished libido is frequently associated with a decrease in sexual fantasies. Diminished libido on sometimes be stimulated by increasing sexual imagery and fantasy. Historically, most sexual literature, videos, and magazines have been developed to appeal to a male rather than female audience. Recently, however, some sexual videos are being marketed to appeal to couples and women. They typically include fewer close-ups of genitals during orgasm and have more emotional and romantic content and imagery.
When libido is partially intact but difficulty sustaining arousal and/or having orgasms occurs, sharing sexual fantasies or watching sexually-oriented videos together may help sustain arousal. Similarly, introducing new kinds of sexual play into sexual behavior can help maintain arousal and trigger orgasms. To find out more, you can check out Multiple Sclerosis Sexual Dysfunction.