Date: October 6, 1998
Interstitial Cystitis Network - Chat Log (© 1998,
Featuring: Oona Mourier, Ph.D. author of "Sexual Archetype: The Theatre of the Bedroom.
Topic: Sexuality & IC

<icnmgrjill> Greetings everyone! Welcome to the ICN Guest Lecture Series. Our speaker tonight is Dr. Oona Mournier (Ph.D.) who is a clinical sexologist in private practice in Sebastopol, California. She is the Executive Director of Sexuality Continuing Education, a company dedicated to teaching sexuality to medical professionals. She is the coauthor of a book to be published next year called "Sexual Archetype: The Theatre of the Bedroom."

<icnmgrjill> OONA... Thank you so much for volunteering your time tonight with the ICN. We have an audience of IC'ers eager to hear your wisdom and insight on Sexuality and IC.

<OonaPhD> Thank you for inviting me here. I'm excited to talk about sex. It is one of my favorite topics, specifically with respect to redefining what sexuality is and what it is that we do in the bedroom and outside of the bedroom that we call sexuality. Part of my life work is to look at sexuality according to a circle or mandala. Each point on the circle is a different place where we are at with our sexuality. So.. it's a model that has an evolution and movement to it.

Practically, we are not always the same in our sexuality. We grow! There is a developmental aspect to our sexual lives. When we are 20, 30, 40, 50, 60... we are at different stages of sexuality. Also, at different times we have different needs in the bedroom. Sometimes I go into the bedroom interacting with my partner...and what I want is to be sexual. Yet, sometimes what I want is to cuddle up and to talk rather than have sex. Sometimes I want depth and sometimes I want an interaction that is light and easy. It is important to understand all of the different ways that we interact in bedroom, young to old, passionate to cuddly, so that we can express who we are clearly.

When we are young and we start to be sexual as young adults, we can only hold a little bit of sexual charge. It is light, playful, connected and not particularly deep and intense. At this early stage, we can see what the body can hold and express in terms of sexual energy.As we continue on in the circle (of sexual maturity), we learn how to hold a little bit more erotic charge. We learn to explore what we like and what we are aroused by.

As we know more about our own sexuality, our ability to hold sexual charge and sexual energy increases. As we grow up and know ourselves more, we bring more of the soul to the sexual realm. We are now more connected we can disclose and get more intimate. We can comfortably show who we are, as well as see our partners more deeply.

The result of this kind of growth is that we open up our soul and our hearts to a deeper level of interaction and erotic connection. Practically, what this means is that even as IC patients we can relearn what sexuality is. In our sexual maturity, we can open doors to redefine sexuality, involving not only the body, but the mind, the spirit and the emotion. This is a version of tantra or spiritual sex.

<icnmgrjill> Fascinating.. Oona...we hadn't thought of it like that before... I think that as IC patients, we often feel that if sex is painful we should stay away from sex and intimacy. In a way, we lose our trust in our sexuality and in our relationships.

<icnmgrjill> Question #1...How do you define sexuality??? and how should we define sexuality as IC patients??

<OonaPhD> The first thing is that there is an exchange that involves mutual pleasure so what does that mean? It means that what I do for you.. and what you do for me.. is pleasurable for both of us. So.. it can be many things, touching, holding, mutual masturbation, penetration... etc. It is a vast realm about what gives us pleasure.

One of the first things that needs to happen is finding what gives us pleasure. One of the ways to do this is to start slowly and to build trust between you and your partner. Another piece that is very important is what I call connection. Usually, when we go back to the model of increasing that sexual charge, we are doing some kissing, holding, touching, massage.. from the bottom of your foot to the top of your head. You slowly build up your sexual energy to let your body become aroused and trusting.

At this point... it is important to have the space to say, "How do I feel now?" "Do I want to go into more intense sexual energy?" or "Do I want to just hold and cuddle." Part of the skill of good sexuality is to learn how to navigate when people have different desires.

One of the things that can happen is when one spouse wants to go fast and the other wants to just cuddle. How the couple effectively negotiates that difference is essential. In the above example, the partner who wants to cuddle can say "How would it be if I hold you... and you masturbate and I stay close to you." That is a win-win solution, where the person who wants an orgasm can do it and the other who wants to snuggle up can do that and stay close. There are many variations on the same theme. This is just one scenario.

In some ways when we do this, we have to break a lot of taboos around sexuality.

<icnmgrjill> Oona.. excellent point.. We often see IC patients who, due to their pain, are reluctant to participate in sex and/or to pleasure their spouse. You've just outlined a very good resolution to that situation.... because the IC spouse can get the cuddling that they want... and yet can still express their love and caring to their spouse... Would you agree?

<OonaPhD> In this scenario, one person is keeping the fire of desire.. the fire of sexuality alive and we need to have appreciation for that... and to make sure that no partner is believed "wrong" because of their different desires. Nobody is wrong in the bedroom.

<icnmgrjill> True...Very true

<OonaPhD> In the above scenario, it's very important that participants claim what they want. We are trained to think that our partners can guess what we want in the bedroom. This is not true. We must express what we want. We need to claim what we want. There is no shame in asking for what you want. Your ability to express what you desire is also very revealing and, for most people, we encounter some degree of shame. Successful partnerships communicate clearly about what they want and do not want.

Remember, Step #1 of sexuality is defining physical pleasure and what gives you pleasure and sometimes it might just be having someone suck my big toe. Step #2 is intimacy and a sense of closeness and a place where we can be seen and see another and experience love.

To have intimacy and closeness does not require penetration and sex. Part of being sexual is to find the many ways you can express intimacy and closeness besides through penetration. We must feed the longing of the soul that we all have for a deep connection to our partners. We long for a soul connection with our partners...and we use the body to find that, sometimes with the senses and sometimes by eroticizing the whole body.

 <icnmgrjill> Question #2.. My spouse refuses to masturbate. He says that it's me or nothing. Are there any suggestions for when I just don't feel like it?

<OonaPhD> Hmmmm ... This is where a sex therapist is really useful to look at the types of things that can be done. The question is... when he wants sex... what does he really want?? He might be looking for intimacy but is not able to ask for it directly or he might be just looking for sexual release. The way to go would be different depending upon what he wants.

<icnmgrjill> Let's assume that he wants a quick release.. Any suggestions on how she can handle that??

<OonaPhD> If he is not willing to masturbate and yet can't have vaginal penetration. How about trying penetration between the legs held together. But.. in that particular case... I would also be looking at the connection between the two partners. If you are deeply connected.. then a spouse will not want another spouse to do something that will hurt them. There is, however, a willingness to explore alternatives instead from both partners.

<OonaPhD> Let me ask a few questions...

<OonaPhD> How is the connection between her and her husband at that time???

<OonaPhD> Do you feel connected to your spouse??

<OonaPhD> Do you feel close or apart...

<OonaPhD> If you feel apart.. the work to be done is to focus on helping you both reestablish that intimacy and connection. They are going to need to work together on relearning a sexuality that is not defined by intercourse

<icnmgrjill> Question #3, this ICN participant wants to know how to get over the hesitancy over sex due to IC?

<OonaPhD> One of the first steps is to recreate trust... which is knowing that you both can say yes or no at any time, and that you are safe with each other during sex. Once you have done that, start with a low level of sexual activity that doesn't bring pain. It must feel safe. Try exploring the things that bring you pleasure like touch, massage, erotic massage all over the body. There is good material that exists on video that helps teach erotic massage, very educational tapes that talk about the types of things that you can do.

Very often... what is helpful is to have an agreement that there will not be penetration or whatever else might trigger pain for that patient. By not having penetration, it gives us space to explore the many other things that can happen.

<icnmgrjill> Question #4. How do we handle things when pain begins with arousal? or intensifies with arousal??

<OonaPhD> That's a difficult area. The question is are there any other parts of your body that can be caressed without pain?? Is there a way of diverting your attention.. and/or the sensation of pain by focusing on another part of the body. If you create a strong sensation in another part of the body, it could potentially divert the pain.

Let me ask this question of the group. When you are aroused?? Does that pain get more intense... the more aroused you are???

<eighthpint> the better the sex, the more aroused, means more pain day or days after - not during.

<IC_Elfie> I get pain from sexual tension...not from arousal.

<icndiane> me too

<OonaPhD> What is sexual tension??

<eighthpint> muscle tension

<eighthpint> ?

<IC_Elfie> Being so worried that my whole body tightens up.

<ICN_KEN> yes we do get more pain on arousal.

<icnmgrjill> Let's move on... because we've got more questions and time is flitting by Question #6 is an excellent question.... It is from an icer.. who wants to have sex but doesn't want to define their sexuality via IC. While intimacy and penetration isn't required... We want to have it... How do you tell your body "no" when your heart says Yes.. I want to have penetration.

<OonaPhD> Well, that's a good question. We can't ignore our body. So, is there anyway that penetration is perhaps less painful or is the payoff of having pain after a willing sacrifice. The passion and desire when we want sex has both a physical and emotional aspect to it. There is a physical aspect to it, but there is also a desire to touch and caress someone closely.. to merge with them. They have a hunger for closeness. If penetration isn't possible, how can that hunger be fed?? Perhaps anal penetration or mutual masturbation.

In penetration, the experience is magical because the two partners are being pleasured at the same time. It's like "I feel this intense feeling.. do you feel it to?" So your challenge is to figure out how you can recreate that feeling without penetration for those moments when intercourse isn't possible.

<icnmgrjill> Question #7.. Do you have any suggestion on how to stop the pain of arousal??

<OonaPhD> The best suggestion that I have is to create a sensation more intense somewhere else

<icnmgrjill> Question #8... A lot of ic patients are on antidepressants which minimize their sex drives. Any suggestions on how to get past this??

<OonaPhD> Thats a hard one. There are some antidepressants that aren't in conflict with sexual function that can be explored, Wellbutrin(sp?) and a few more of the newer antidepressants that do not depress the sexual function. And the world of alternative remedies such as St. Johns Wort seems to be effective for some patients.

<icnmgrjill> Question #8 is about Oral Sex... Any comments?

<OonaPhD> It's good! From the IC point of view.. if I understand it well... it allows physical stimulation that doesn't allow penetration and the pain appears to be less... so this is an option to explore. The difficulty, however, is that couples don't feel as connected with each other.. so it is important to communicate that you are still together by looking at each others eyes... using voice and body language. Oral sex can also stimulate other parts of the body which can dramatically increase arousal.

<icnmgrjill> We have a few more questions...Question #9... Sex is scary for me. It hurts. I don't feel like I can try it without having more pain.

<OonaPhD> I think it is important to have a partner that is willing to work with you and to give each partner permission to go slowly and to rebuild that trust. Sex therapy can really help people who are struggling with this. It is not long term therapy and there is so much information available that can help couples reenergize their sex lives. Very often just a few sessions can make a big difference

<icnmgrjill> Last question... #10.. Do you have any resources or educational materials that you can suggest??

<OonaPhD> Yes.. I'll send Jill a list and she can post it on the web. I have a good list of materials available... and we will get that information to you shortly.

<icnmgrjill> Oona...Thank you so much for your wisdom and your insight into this often unspoken world of IC. We, as patients, do not give up our sexuality when we are diagnosed with any disease. We do, however, face some challenges as we seek to relearn, including new ways to express love, caring, support and eroticism to our partners. Thank you so much for your insights and wisdoms tonight!

<OonaPhD> I want to honor the determination that you all show with this challenge!

1998, The IC Network, All rights reserved. This transcript may be reproduced for personal use only. If you do so reproduce, we ask only that you give credit to the source, the IC Network, and speakers, Oona Mourier & Jill Osborne. For additional use, please contact the ICN at (707)538-9442.

<icnmgrjill> :::as she stands and applauds:::

<eighthpint> clap, clap, clap, clap......thank you!

* chelsea8673 claps loudly

<Carol_noWhisper> Thank you so much Oona

<icSueC> Thank You........Oona!

<IC_Elfie> _4Yes, Thank you Dr. Oona!

<Derbylamb> Thankyou

<Kester> Thanks for answering our questions.

<OonaPhD> Your welcome!

<eighthpint> ((((((Dr. Oona))))))