When the Gate is Shut–A Faithful Response to Vaginismus

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Image Shutterstock

Aleteia posted a deeply heartfelt article about a Catholic woman’s struggle with vaginismus, a disorder in which the muscles of the vagina involuntarily spasm or become rigid which makes intercourse either painful or, in extreme cases, impossible.

I don’t know anything about the author of the blog referenced in the article, except to say that, having read her posts, I can say that  she is a tremendously brave and honest woman who has, with her devoted husband, found ways to allow God’s grace and love to create something beautiful even in the midst of their profound suffering.  I find their courage through adversity to be inspiring and I am grateful for her and her husband’s witness.

How Common Is It?

I wish to be upfront that I am not writing this article as a response to her particular situation. As I say, I know nothing about her circumstances and I don’t presume to be able to offer answers that would address her particular concerns. I invite you to join me in praying that she and her husband will find the grace to continue their struggle in faith and, ultimately, find the healing they seek.

I do, however, want to chime in on the conversation because the issue is both not uncommon (occurring in about 2 of 1000 women in the general population and up to 5% of women who struggle with anxiety or depression) and tremendously sensitive.  For Catholic women, in particular, it can be difficult to find treatment options that are both effective and faithful.  Many Catholic women who suffer from this problem never seek professional help out of either embarrassment or concern that they will be asked to engage in treatment approaches that are inconsistent with their moral values.

Why Does It Happen?

The most common causes are sexual trauma, postpartum trauma, or poor sexual formation, but it can also be caused by issues related to OCD/scrupulosity, alexithymia (a difficulty with identifying or expressing emption), poor interoception (a kind of conscious alienation from one’s bodily senses), avoidant attachment (which can make physical affection of any kind feel overwhelming and intrusive), or other factors.

Can It Be Treated?

Research suggests that self-help approaches to vaginismus (involving self-help reading and dilation/relaxation exercises and other approaches found on the internet) have about a 10% success rate for treating this condition.  With proper treatment, research finds that over 95% of women can experience a full recovery from their symptoms.    For the remaining small percentage of women for whom standard treatment approaches are ineffective, virtually all can be successfully treated through a course of counseling, physical therapy, and the therapeutic use of Botox by a plastic surgeon.  In sum, the recovery rate for vaginismus is virtually 100% once the appropriate course of treatment has been identified.

What is the Process?

There is no cookie cutter approach to treating vaginismus, but effective treatment tends to follow 8 basic steps.

  1. A proper medical evaluation (gynecological/urological) to rule our potential medical/structural problems.
  2. A proper psychological history and review of the various psychological and physical therapy interventions.
  3. Evaluation/Education regarding the nature of sexual pain anatomy.
  4. Mindfulness based approaches to help the client gain conscious control over the automatic spasmodic vaginal response.
  5. Couple-based techniques designed to eliminate phobic responses to (non-sexual) physical intimacy
  6. Communication exercises that prepare the couple for full sexual intimacy
  7. Sexual counseling that help the couple find the least painful positions for successful intercourse
  8. Sexual communication exercises that help the couple overcome any remaining pain and experience the restoration of a fully satisfying sexual relationship.

Because no two women are the same, there are many variations these 8 steps can take.  It is because of the varied nature of treatment that self-help approaches often fail to produce the desired results.  For Catholic women, it can be important to work with a faithful professional who can help them apply these 8 steps in a manner that is respectful of their moral values.

Finding Faithful Help

The Catholic Psychotherapy Association can be a useful place to turn for local assistance in dealing with this sensitive issue.  For those who struggle to find a local provider, or for whom local resources are not adequate for one reason or another, Karin Roach, MSW, LISW-S, a Pastoral Counselor who specializes in women’s issues through the Pastoral Solutions Institute’s Catholic Tele-Counseling Practice can help guide clients down the path to healing.  For more information on living the fullness of the Catholic vision of love, check out Holy Sex!  The Catholic Guide to Toe-Curling, Mind-Blowing, Infallible Loving.


Secular Media Finally Admits: “The Pill” Causes Depression & Relationship Problems

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Despite a new Pew survey reporting that only 4% of Americans and 13% of weekly Mass attending Catholics in the US think that contraception is morally wrong,  “the Pill” is getting belated, but well-deserved, bad press from surprising sources.

Harvard psychology professor and Playboy Magazine columnist, Dr. Justin Lehmiller, is reporting on research I mentioned the other day indicating that hormonal contraceptives (HC’s)  influence the type of man that a woman is attracted to and can undermine satisfaction in longterm relationships–especially if a woman who chose a mate while on the Pill subsequently discontinues the use of HC’s.  Of course, one response to this might be, “well, then, don’t go off the Pill!” but such a flippant response denies the reality that, in most longterm relationships, couples eventually want to have children, necessitating that they stop using HC”s.  The real danger here is that just when couples need to draw closer to each other and work better together, the effects of discontinuing contraception can kick in, making partnership that much more difficult.

On top of this, a brand new article by the Guardian is accusing the medical establishment of “pillsplaining” (condescendingly minimizing the risks of HC’s) in light of a new study from the University of Copenhagen that demonstrates that the Pill can both increase the risk of depression and cause a worsening of already-existing depression symptoms in women who use HC’s.

Researchers found that women taking the combined oral contraceptive were 23% more likely to be diagnosed with depression and those using progestin-only pills (also known as “the mini-pill”) were 34% more likely. Teens were at the greatest risk of depression, with an 80% increase when taking the combined pill, and that risk is two-fold with the progestin-only pill. In addition, other hormone-based methods commonly offered to women seeking an alternative to the pill – such as the hormonal IUS/coil, the patch and the ring – were shown to increase depression at a rate much higher than either kind of oral contraceptives.

All of this is to say that despite the challenges that couples using Natural Family Planning can sometimes face, it remains the most safe, effective, and moral approach to family planning.  Once again, we see an example of scientists arriving at the peak of the mountain only to find that the Vatican’s flag has already been planted.  If you would like to learn more about how the Church’s vision of love can help you and your spouse experience a more passionate, joyful, spiritual sexual life together, I invite you to check out Holy Sex!  The Catholic Guide to Toe-Curling, Mind-Blowing, Infallible Loving.

The bottom line?  Don’t believe the lie that opposing HC’s is somehow waging war against women.  In fact, the opposite is true.


Over 500 Scholars Hold Press Conference to Promote Positive Value of Humane Vitae

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Image via Shutterstock

Today, Catholic University of America held a press conference announcing the release of a document drafted by dozens of Catholic scholars and co-signed by over 500 theologians, social scientists, lawyers, physicians and other academics who endorsed the positive impact, value, and continued importance of Humanae Vitae, Pope Paul VI’s letter promoting a consistent, comprehensive, vision of sexual love.
The new document announced today  (click the link to review) is a direct response to about 130 dissident Catholic scholars, including Vatican-censured theologian,  Fr. Charles E. Curran, who sponsored an event at the UN attacking the Church’s teachings.
I was honored to be among the many scholars who contributed sections to the document supporting Humanae Vitae referenced by today’s press conference. Specifically, my efforts focused on the negative psychobehavioral and environmental impact of the hormonal contraceptives, but these were just two small parts of a very thorough and wide-ranging document that addresses both the problems with artificial contraception and the value of living the Church’s vision of love and sex.
Many thanks to Dr. Janet Smith for spearheading this effort and to all those who joined in to make this important event possible, in particular, Mary Hasson of the Ethics and Public Policy Center and Dr. John Grabowski, who is a moral theologian at CUA, and who, with his wife, Claire, is both a member of the Pontifical Council for the Family and a regular contributor to More2Life Radio. This document is a wonderful show of lay support for the incredible beauty and continued relevance of Catholic sexual ethics.  Please check it out!
NOTE: If you want to want the archived version of the press conference, it starts about at about the 12:30 mark.

Can Christians Have “Healthy Shame” about the Body? (The Answer Isn’t What You Think).


Lisa Madrid Duffy posted a blog about the new sex ed curriculum published by the Pontifical Council for the Family.  (And to be honest, before you ask,  I haven’t had a chance to thoroughly review it yet. That said, although I understand there are some who have expressed concerns, my cursory view is that it is probably more appropriate than any other off-the-rack sex-ed program that exists, but stay tuned for more when I get a moment).


Regardless, in that post, she mentioned  that the program–whose English translation is….clunky–discusses the need to have a healthy sense of shame about the body and sexuality.  LMD rightly takes issue with this phrase insofar as she understands it to mean that we should somehow be ashamed of our bodies or our sexuality.  She rightly notes that no Christian should ever be ashamed of his or her body or sexuality. In fact, I’ll go one further and point out that being ashamed of either our body or our sexuality is, in large part,  the heresy known as Jansenism.

Even so, there is another sense of “shame” that every Christian should know about and is actually both healthy and appropriate.


In Love and Responsibility, which is the book Pope St. John Paul the Great wrote as a kind-of pre-cursor to the Theology of the Body, he argues that shame, as an emotion, is a gift from God like all the emotions.  In essence, it belongs in a similar category as guilt, or fear.  Each of these feelings, when it is function according to its godly purpose, is a protective emotion in that they protect us from real or possible harm.   Healthy guilt (as opposed to scrupulosity) protects us from threats to our moral or relational self.  Healthy fear (as opposed to anxiety) protects us from threats to our physical well-being.  So, what does “healthy shame” (as opposed to self-hatred) protect us from?

Simply put, healthy shame protects us from being used.  We are created by God to be loved.  That is the fundamental raison d’être of the human person; to love and be loved. To love someone is to work for their good, to help them develop into their best selves, to help them be the best person they can be.  The opposite of love–argues TOB, is not hate, but use.  To use someone is to turn a person into a thing, something that can be employed to some other end and then disposed of.  To be used is to be treated in the exact opposite manner that a person should be treated. Where love always makes us into even better persons if we accept it, use always depersonalizes us even when we allow ourselves to be used.


Shame then, rightly understood and healthily employed, is the emotion that allows us to know if someone is trying to use us or we are allowing ourselves to be used.  It is intended to warn us away from people or situations that are not looking out for our best interest and want to treat us as an object or tool.  Along with healthy fear, and healthy guilt, healthy shame (again, as opposed to the unhealthy alternative, self-hatred) serves as a warning light on the human dashboard that lets us know that either someone or something is threatening an important aspect of our overall well-being.

Having a healthy sense of shame our about our body or our sexuality, then, does not mean that we hate our body or our sexuality or are somehow suspicious of them. It means that we love our body and sexuality so much that we never intentionally place ourselves in situations where will be used by others or allow others to use us.  It means that we treasure ourselves and expect to be treasured by others.

I agree with Lisa Madrid Duffy that this needs to be better explained in the English text of the PCF’s sex ed program, but now, at least, YOU know what the truth is. For more help in living out the Catholic vision of love check out my book, Holy Sex!  Or, to effectively convey the Catholic vision of love to your kids, check out Beyond the Birds and the Bees.

Surprising (Negative) Effects of The Pill on Behavior, Dating, and Marriage

shutterstock--The Pill

I am working on a project about some of the lesser-known effects of the birth control pill on a woman’s psychological, relational, and behavioral well being. I came across some fascinating, high-quality research I thought I’d share a bit of what I found so far.

Although the psychological and behavioral impact of hormonal contraceptives has been a largely understudied area until recently, a review of scholarly research-to-date in the journal, Evolutionary Psychology, found significant cause for concern.  The author states, “Women who use HCs report higher rates of depression, reduced sexual functioning, and higher interest in short-term sexual relationships compared to their naturally-cycling counterparts. Also, HC use may alter women’s ability to attract a mate, as well as the mate retention behaviors in both users and their romantic partners. Some evidence even suggests that HC use alters mate choice and may negatively affect sexual satisfaction in parous women, with potential effects on future offspring” (Welling, 2013, p. 718).

Regarding the issue of mate attraction and retention, a subsequent study in the Proceedings of the National Academy of Sciences supported Welling’s (2013) earlier observations, finding that women are attracted to different types of men depending upon whether they are on or off hormonal contraceptives and that marital stability can be negatively impacted when a woman who was on HC’s at the beginning of their relationship subsequently discontinues HC use (Russell, McNulty, Baker, 2014).

For more about the truth about God’s plan for sexuality, check out Holy Sex!  The Catholic Guide to Toe-Curling, Mind-Blowing, Infallible Loving.


Russel, V.M., McNulty, J., Baker, L. et al. (2014). The association between discontinuing hormonal contraceptives and wives’ marital satisfaction depends on husbands’ facial attractiveness.  Proceedings of the National Academy of Sciences of the United States of America. vol. 111 no. 48. 17081–17086  Retrieved September 11, 2016 at http://www.pnas.org/content/111/48/17081.full

Welling, L. (2013). Psychobehavioral effects of hormonal contraceptive use.  Evolutionary Psychology, 11(3): 718-742

What’s Up With All Those Catholic “Rules” About Marriage?

My latest for OSV Newsweekly…



I recently received the following question about the Church’s requirements for weddings and marriages:

“My girlfriend is a Protestant, and her mother recently asked her a question that I haven’t been able to find much information on. She asked, ‘Why can’t a Protestant and a Catholic have a Protestant marriage recognized by the Catholic Church?’ My understanding is with the proper dispensation, it is possible. I couldn’t really explain, though, why a dispensation is required or what that entails. Can you enlighten me on how to explain what the rule is and why it is that way?”

The most common way to answer this is in terms of the canonical rules or sacramental requirements, but I think these sorts of answers, while being technically correct, miss the point. What does it really mean to say to a person that a “dispensation from form” is required for a Catholic to get married in a non-Catholic church? That often ends up sounding like this: “Catholics have a bunch of rules that have to be followed by everyone regardless of whether or not they’re Catholic … so there!” It doesn’t really move the conversation forward in any personally meaningful way.

I would like to suggest a more pastoral and practical answer. READ MORE

Twice As Much Sex Makes Relationships About Half As Good.

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Image shutterstock.

Sorry, guys.


By Shilo Rea

Countless research and self-help books claim that having more sex will lead to increased happiness, based on the common finding that those having more sex are also happier. However, there are many reasons why one might observe this positive relationship between sex and happiness. Being happy in the first place, for example, might lead someone to have more sex (what researchers call ‘reverse causality’), or being healthy might result in being both happier and having more sex.

In the first study to examine the causal connection between sexual frequency and happiness, Carnegie Mellon University researchers experimentally assigned some couples to have more sex than others, and observed both group’s happiness over a three month period. In a paper published in the Journal of Economic Behavior & Organization, they report that simply having more sex did not make couples happier, in part because the increased frequency led to a decline in wanting for and enjoyment of sex.

One hundred and twenty eight healthy individuals between the ages of 35–65 who were in married male-female couples participated in the research. The researchers randomly assigned the couples to one of two groups. The first group received no instructions on sexual frequency. The second group was asked to double their weekly sexual intercourse frequency.

Each member of the participating couples completed three different types of surveys. At the beginning of the study, they answered questions to establish baselines. Daily during the experimental period, the participants answered questions online to measure health behaviors, happiness levels and the occurrence, type and enjoyableness of sex. The exit survey analyzed whether baseline levels changed over the three-month period.

The couples instructed to increase sexual frequency did have more sex. However, it did not lead to increased, but instead to a small decrease, in happiness. Looking further, the researchers found that couples instructed to have more sex reported lower sexual desire and a decrease in sexual enjoyment.

To learn more about what it REALLY takes to have a more joyful, passionate, and fulfilling sexual and marital life, check out Holy Sex! The Catholic Guide to Toe-Curling, Mind-Blowing, Infallible Loving


New Study Finds, “More Church = Less Porn”

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Image Shutterstock

From PsychCentral.

A new study finds that attendance of religious services by young people is associated with a reduction in viewing pornography over time.

The study findings appear in the Journal of Adolescence.

“We were able to determine that there is a barrier effect at play wherein religious social control encourages adolescents to view less pornography over time,” said Kyler Rasmussen, lead author of the study and a Ph.D. student in the University of Calgary’s Department of Psychology.

“This increase in pornography consumption as adolescents get older isn’t as drastic among those who attend religious services. We can see that religious attendance is a factor in shaping the trajectories of pornography viewing in adolescents.”

Rasmussen added, “Some might see it as a vindication of the role of religion, in that it can shape the behavior of young adolescents in a positive way.”

…So what is it about attending religious services that would help steer adolescents away from viewing pornography? “People in religious communities learn that there are expected patterns of behavior,” says Bierman.

“It may be the notion of a divine significant other who watches over them and there may also be a social support component. When you become integrated within a moral community where pornography is used less often and is, in fact, discouraged, this may shape and deter pornography usage. There’s a kind of social control function at play.”  Read the full article here.

To discover more faithful ideas for raising loving, moral, godly, porn-resistant kids, check out Beyond the Birds and the Bees:  Raising Sexually Whole and Holy Kids.

Condom Distribution Shown to Increase Teen Pregnancy Rates




A new study finds that schools with condom distribution programs in the 1990s seem to have actually increased the rate of teenage pregnancies. “We find that access to condoms in schools increases teen fertility by about 10 percent,” the researchers concluded.

According to National Review, the study by two Notre Dame economists fills a gap in research on school contraceptive programs since there was little previous work on condom distribution programs in high schools.

Researchers Kasey Buckles and Daniel Hungerman used 22 school districts in 12 states, districts that began using condom distribution programs in the ‘90s. The study spanned 19 years and studied teen fertility data from 396 high-population counties.  READ MORE

For more information on how you can raise teens to joyfully live out the Catholic vision of love in their life and relationships check out Beyond the Birds and Bees: Raising Whole and Holy Kids.




Lisa and I are honored and grateful to have been chosen to be the 2016 recipients of the Fr. Richard M. Hogan Award from the Couple to Couple League International (CCLI).  CCLI is internationally recognized for their tireless work in promoting the Catholic vision of love, in particular by educating and supporting couples in the effective use of Natural Family Planning (NFP).

According to CCLI, the Fr. Richard M. Hogan Award is given to those who have excelled in the promotion of NFP in the fields of theology, psychology, sociology, or related social science!

Below is the text of the email that informed us of our award….
Dear Dr. Greg and Lisa Popcak,

I’m very happy to let you know that you and Lisa are the latest recipients of CCL’s Fr. Richard M. Hogan Award, which is given to those who have excelled in the promotion of NFP in the fields of theology, psychology, sociology, or related social science!

We are so grateful for all of the ways you have not only promoted the beauty of the Church’s teachings on marital love and NFP, but also the countless ways you have supported and guided couples in living out this sometimes difficult teaching. 

Your first “The Marriage Counselor” column in Family Foundations was published in the January/February 2001 issue (!), and you have continued that now for over 15 years, and our readers consistently rank your column as one of their favorite parts of the magazine. And that column is just a small part of what you do to promote NFP. Between your professional practice, your many books (often co-authored by Lisa), and your husband-wife radio team (most recently with More2Life), both you and Lisa are tireless supporters, defenders and advocates for living out marriage according to God’s amazing design. Praise God for all of your good work!

Ann Gundlach
Director of Communications
Couple to Couple League International