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Persistent Genital Arousal Disorder as a Dissociative Trauma Related Condition Treated with Brainspotting – a Successful Case Report

Persistent Genital Arousal Disorder as a Dissociative Trauma Related Condition Treated with Brainspotting – a Successful Case Report

Persistent Genital Arousal Disorder (PGAD) is a condition characterised by excessive genital arousal for long periods of time without sexual desire or associated stimulation, leading to significant functional impairment, embarrassment and suffering to the patient. Little is known about PGAD’s aetiology and pathophysiology, while several treatment strategies have been used including drugs, transcutaneous electrical nerve stimulation, botulinum toxin, electroconvulsive therapy, hypnosis, meditation and even cliterodectomy.

We report, after informed consent, a successful case of PGAD treatment with Brainspotting (BSP), a brain-based psychotherapy intervention that provides access to sensorimotor memories of traumatic activation.

Methods: We considered the symptom of genital hyper-arousal as a conversion dissociative symptom, and the intrusive somatosensory memories trauma originated was the guiding basis for treatment with BSP. The difficulties of verbalization and the patient’s decision not to use psychotropic drugs were also taken into account to choose BSP as a therapy.

Results: After 3 BSP sessions, the patient had full remission of genital hyperarousal symptoms and remained asymptomatic for six months to one year after BSP treatment.

Conclusions: Dissociation could be a key clue to explain the traumatic origin of these symptoms and conversion symptoms can be understood as an intrusive somatic sensory memory. BSP intervention has proved useful for a complete remission of PGAD symptoms. Trauma history and dissociative peritraumatic experiences should be carefully investigated in such PGAD cases.

Speakers: Patricia Mattos