My review for the Washington Independent Review of Books.
This honest account of a quest for pain-free intimacy pulls no punches.
Not to mention that this book is more a quest to avoid pain than to find pleasure in the face of dyspareunia, vaginismus, or sexual aversion disorder. As the author puts it, “I have every hooha hangup in the DSM.” Though the condition affects between 10 and 20 percent of women, the author herself didn’t know it had a name — or names — until she was in her 40s.
Lest you’re inclined to think that incredibly painful intercourse is no big deal, people with disorders like vaginismus often cannot even wear tampons. Psychologically, they experience during sex something akin to PTSD. Intercourse is “like being a virgin every single time. Madonna, this is not sexy,” the author explains. And since sex is the lingua franca of our society, you can surmise what a death knell this can be for relationships.
The book — which grew, in part, out of the author’s “Modern Love” essay in the New York Times — starts on a happy note: Zam has met and married her husband, Kurt, but hasn’t told him about her “hooha hangups.”
Insert screeching-halt noise here.
You might be wondering how someone could not know his partner isn’t only not having a particularly good time in bed but is enduring lightning-bolt levels of pain. You might also wonder why the author hasn’t revealed this fact to the love of her life.
This dynamic is less a commentary on Zam’s particular relationship than an indictment of the social norms that drive women to literally grin and bare it. These norms also discourage women from admitting to anything other than a perfect sex life. As Zam puts it, “Privacy has stolen my life force.”
But tell her partner she does, and she goes a step further, undertaking the Sisyphean task of trying to remedy her problem. Like a lot of us “broken” ones, however, as a survivor of childhood trauma, she first must untangle how much of the issue is psychological, how much is physical, and how much is both — a case of “my mind is telling me yes, but my body is screaming a hell no.”
Zam begins a tortuous tour of 15 specialists, exploring EFT (emotional freedom techniques), hypnosis, tantra, trauma therapy, group couples’ workshops, pelvic-floor physical therapy, vaginal weights, and dilators. Unfortunately, vaginismus is poorly understood and difficult to treat, and the situation isn’t helped by various medical professionals’ dismissive stances.
For example, a hypnotist asked Zam pointedly, “You do want to stay married, right?” before doling out the several-hundred-dollar advice to “Just do it.” A sex therapist refuses to see Zam before sending her to a physical therapist first because “she doesn’t deal with vaginal pain.”
(Please, dear reader, don’t start in about how patient Kurt must be for going through this with her. Enough about others. Let’s talk about us, not the long-suffering partners we have a really hard time finding in the first place.)
While Zam’s book is filled with levity — which I interpret as “laughing to keep from crying” — there’s nothing funny about being in so much pain that every attempt at intimacy feels like something to be endured. “Do I love Kurt in these moments? I don’t know. I am too far away to notice,” writes the author. “I strap down my animal sadness so I don’t saturate the bed with the wrong kind of moisture.”
Zam interweaves into The Pleasure Plan stories of her family and growing up as a commentary on trauma and resilience. It makes for engrossing reading and, likely, some vigorous nodding in agreement from people who identify as female and who, like the author, laugh to keep from crying.
Although the clinical term of “vaginismus brought on by fear of penetration” is one way to describe the Hydra she is fighting, “I don’t want anything inside me” captures it more aptly. In its face, Zam perseveres long after most would have given up. At times, the methods of the “healers” she consults are downright hilarious, such as the cringe-worthy approach of “repeating vapid, lascivious language while in a pseudotrance.” (No, it doesn’t work.)
The response to Zam’s book has been overwhelmingly positive, and she has been praised for her bravery in writing it. Of course, a subset of critics harps on Kurt’s patience and understanding. But forget him for a moment. This is about her pain, remember?
The Pleasure Plan isn’t a quest for pleasure. It is an attempt to contend with physical and social pain — the pain of being rejected as a weirdo too broken to repair. Sex is enormously important in our society. If one can’t function sexually, is one doomed to a lifetime of loneliness?
The book is full of questions and exercises to help readers develop their own plan and asks, “Where are you stuck in your sexual healing?” Alas, this presupposes that we all want to become unstuck, when many of us have simply dropped out of the, er, marketplace altogether. Maybe in her next book, Zam could address some alternate forms of relationships where intimacy is not expressed through intercourse alone, open relationships, or even asexuality.
Despite this small cavil, The Pleasure Plan is a must-read not just for people affected by dyspareunia, but for anyone interested in learning more about a complicated condition foreign to most. The book will move you and keep you reading no matter your gender or “hooha hangups” — or lack thereof.