Self-stimulation can help survivors through impasses with insertion. Stimulate the clitoris before and during the dilator exercises. Sexual arousal increases natural lubrication and causes vaginal expansion, often making insertion easier. This variation is also useful in helping a survivor associate pleasurable sensations with vaginal fullness. Feeling comfortable with these sensations can eventually facilitate the ability to have orgasms during intercourse.

Once a survivor feels successful with dilator insertion on her own, if she wants she can invite, her partner to join her during some sessions. The survivor can teach the partner how to comfortably insert a dilator and move it around. Active and specific communication is essential.

Ginny, a survivor of sibling incest, worked with her husband, Ron, to overcome her problem with vaginal pain and fear of penetration.

GINNY: Once I became comfortable with the dilators myself, I asked Ron to do the inserting. We got to a point where he was leaving the dilator in and also manipulating it a little bit. His participation showed me that he wasn’t going to do anything that I didn’t want him to do or didn’t ask him to do. His helping became a positive thing with me and with him.

RON: I felt involved. Ginny was actually sharing a part of herself with me. Though I was glad, sometimes it was frustrating: I’d wish it was me and not the piece of plastic. The exercises gave us guidelines. We knew what we were to do, for how long, and that it wouldn’t go any further. I could relax and Ginny could relax.

Vaginal dilators allow survivors to get used to sensations common in intercourse. Women learn that penetration is not always 100 percent comfortable. Little temporary tugs and pressures are often just part of getting started. If some minor discomfort exists, try moving ahead anyway. If obvious pain persists, however, don’t ignore it—stop.

The transition from plastic dilators to a partner’s penis is often an exciting step for a couple. The male partner becomes, in essence, “the human dilator.” A survivor described her transition:

When we finally did the human dilator exercise, I felt shy, nervous, and embarrassed. There was a conflict going on inside me between wanting to turn off the pleasurable sensations and wanting to experience them. I decided it was okay to enjoy it for myself, and I did!

In the human dilator exercise, a male partner has to learn a passive role, letting the survivor control the insertion and then just resting inside the vagina for a while. One partner was concerned about how to maintain his erection and what would happen if he had an orgasm. I explained in counseling that he could move inside his wife only so much as was necessary to maintain his erection. If he had an orgasm, that was fine, but it would be preferable if he didn’t. He said to me, “I think I get the full thrust of what you are saying.” To which I replied, “What you need to get is the half thrust of what I’m saying.” We all had a good laugh.

Over time the human dilator exercise can be expanded to permit insertion by the man of his own penis, clitoral stimulation, some thrusting, and experimentation with different positions. Eventually a couple can apply the skills learned to regular sexual intercourse. A survivor had this to say:

We go really slowly with intercourse. My boyfriend is very careful to take his time, come into me slowly, a little at a time, and come out if it hurts. I’ve become used to it, and as a result I am not afraid of possible pain. I like feeling free to move around and change positions. I let him know my needs openly.

As sexual problems become resolved, don’t forget this: What’s most important is the emotional intimacy, caring, and respect that you and your partner are creating. That is the goal of your healing.

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