Abstract Introduction Body-mind dissociation and sexual dysfunctions are frequently observed in individuals with histories of attachment trauma due to unsafe early caregiving environments. Integrating practices of embodiment into psychotherapy may help cultivate somatic awareness to support long-term self-agency and sexual health recovery. Objective The objective of this study was to explore the potential benefits of a combined dynamic psychotherapeutic and trauma-informed, somatic yoga-based approach in enhancing body ownership and embodied safety in two female patients with sexual dysfunctions. All sessions were based on a common clinical construct centered on embodiment, i.e., reconnecting with the body and using bodily signals to guide experience and choices in life. Methods Two clinical case studies were conducted with female patients presenting sexual dysfunctions. Both had a history of attachment trauma and physically abusive parents. Case 1: a 41-year-old woman with a history of vaginismus recently diagnosed with BRCA2 mutation and breast cancer, presented with strong body-mind dissociation, difficulty in accessing sensations in the pelvic area and relational sexual discomfort. She also had a history of depression. Case 2: a 24-year-old woman presented with frequent somatizations, genito-pelvic pain, alexithymia, dissociative episodes and panic attacks. Her background included endometriosis, suspected childhood sexual abuse and dissociation in intimate relationships. The adopted underlying clinical construct is defined as the ability to maintain a mental state that monitors bodily sensations in order to manage stressors and regulate somato-emotional responses. In both clinical cases, a joint intervention was carried out by two professionals trained on the described clinical model: a psychotherapist and a trauma-informed yoga teacher certified in sex education. The multidisciplinary program included online weekly dynamic psychotherapy and somatic yoga sessions focused on building interoceptive awareness and self-regulation strategies. The therapist’s somatic countertransference was intentionally leveraged as a clinical compass for the attuned exploration of the patient’s somatic states and the integration of traumatic memories. Results Case 1: After 18 months of treatment, the patient showed increased body awareness and the emergence of basic self-care skills such as personal hygiene, physical activity and health-oriented behaviors. While she remained not sexually active, she expressed a novel sense of comfort in her body, sensuality and empowerment. Case 2: Following 9 months of treatment, the patient reported a reduction in the intensity and frequency of anxiety and panic attack episodes. Even if sexual topics were not directly addressed, pelvic somatizations drastically decreased. She showed increased ability to anticipate and recognize emerging triggers and manage them through enhanced bodily awareness, thus preventing dissociation. Despite the sessions being online, the practitioner’s embodied awareness and presence in interacting with the patient was deemed a key factor in re-establishing the patient’s capacity to inhabit her body and experience relational safety. Conclusions Even when sexual topics are unspeakable, interoceptive awareness and embodiment training can indirectly enhance well-being through trauma-informed somatic and psychological interventions, where the therapeutic embodied relationship can address primary deficits rooted in early attachment trauma. Although more extensive evaluation is needed, this approach could be a valuable indirect yet foundational health support for individuals with complex trauma histories. Disclosure No
Baretta et al. (Mon,) studied this question.