The final step in therapy is dissolving blocks in the pelvic floor so that its spontaneous pulsatory movement becomes integrated into movements of the pelvis, and with the breathing; this happens involuntarily, if the work has been successful. In couples work, the most important step is probably to become aware of the discussed later, in chapter 7. Meanwhile here is a brief description of what can be done on a mechanical level.

"Kegel exercises" i.e. alternately tightening and relaxing the muscles of the perineum and vagina, are often recommended to women preparing for childbirth or as a routine to promote sexual response. Women in some primitive tribes (e.g. the Xhosa of Africa) are deliberately taught these maneuvers as part of learning to please men, and women in Western society also may do this, to please themselves or men by a movement of "pumping" the penis with the vagina. This may be beneficial by drawing attention to any sensation to the vagina, as long as it is allowed eventually to become involuntary. To pump the pelvic floor consciously is merely mechanical but with practice it may become spontaneous as a response to sensation.

Men too may have done pelvic floor exercises: one which is sometimes recommended as a way of avoiding future prostate trouble is to stop and start the flow of urine, thus gaining control over the sphincters and pelvic floor and increasing muscle tonus in the area.

In therapy the same movements are encouraged as part of a mechanical preliminary to a hoped-for spontaneous pulsation, but they are integrated with movement and breathing.

10:1 Ask the explorer if they can sense without moving whether their pelvic floor is relaxed or contracted. Bringing attention to the area may in itself provoke either a contraction or a relaxation.

10:2 Ask the explorer to tighten the pelvic floor for a few seconds. Watch them carefully. Can you see any movement? Does the abdomen conspicuously tighten? Are the buttocks clamped tight? Visible tightening of surrounding musculature in order to tighten the pelvic floor is a sign of blocking.

Lowen has argued convincingly that if toilet training is too early, the child must hold back excretion or urination by using surrounding musculature because the sphincter muscles are insufficiently developed.

Tell the explorer what you see, and ask them to tighten and release the pelvic floor without tightening abdomen or buttocks. This may be possible. If it is not, the only solution is intensive work to loosen the surrounding musculature, as suggested earlier in general work on abdomen and pelvis. However, encourage as much exploration as possible of the pelvic floor sensations. With some practice, the anus can be felt tightening independently of the buttocks. Women may be able to work on tightening the vagina, perhaps in private while inserting a finger. Men can explore the equivalent tightening by deliberately trying to get their penis to twitch (tightening the pelvic floor pulls the penis upward).

10:3 Now ask the explorer to breathe out as fully as possible, and to tighten the pelvic floor just before the end of the out-breath, hold it for a second or so until the end of the breath, then release it on breathing in. If they find the timing hard to grasp, hold your hand up and tighten it into a fist as they reach the end of the out-breath, letting go as they breathe in. They can be encouraged to match the pelvic floor tightening to the tightening of your fist. Or you can hold their arm lightly and tighten your grip for a second or so toward the end of the out-breath.

Continue this for several minutes, although not to the point of fatigue. Some people may feel fatigued after only a few breaths; if so, take a break, and come back to it. This process may cause a marked increase in sensation, or provoke involuntary movements involving the pelvis or even the entire body.

By now, after doing these explorations, you probably have some sense of the difference between an involuntary movement and a voluntary one: the tightening of abdomen and pelvis which may accompany the voluntary tightening of the pelvic floor, and which should be discouraged, it not the same as a convulsive tilting upward of the pelvic area as the pelvic floor is tightened.

Much of the exploratory work you have been doing is mechanical, deliberate, "pushed." Work on the pelvis may seem especially so. To repeat, this mechanical induction of movement is to prepare the ground for spontaneous, involuntary movements which have more the quality of pulling than of pushing. When an unarmored person breathes fully out, the pelvis tilts spontaneously.

Some specific problems may emerge during work on the pelvis, since it may cause anxiety. The most common are:

Displacement

Instead of movement being allowed into the pelvis, it is displaced upwards or sideways. Many people will wriggle the pelvis from side to side, and it may mistakenly appear sexy. This is not absolute displacement, but it discharges excitation which might otherwise build and become a spontaneous forward movement of the pelvis. It is as if the pelvis is saying "no" rather than "yes."

More often the pelvis will be held still and something more or less dramatic will happen up above. At first, do not discourage upward displacement, it may lead to some unblocking of upper segments. The explorer might break into tears or strike out with the arms, entering into a genuine emotional expression as they begin to feel something unusual in the pelvis. In some cases, this upward expression of emotion is appropriate, linked to the repression of genitality in childhood. For example, I have seen women cry deeply as they begin to feel new sensations in the thighs and remember humiliating experiences of being bullied into holding their legs together like little ladies. Or I have seen rage emerge as someone becomes aware that they have been deprived of the full enjoyment of their own genitals.

However, if the upward displacement is repetitious, this is a kind of flight. You can verbally encourage them to hold back the expression and to stay with the feeling in the pelvis as far as possible.

Cutting Contact

Some people "go off" in the eyes, or into a cerebral fantasy, as soon as pelvic sensations increase to a threatening level. If you have a sense that they are out of contact, have them breathe out fully while keeping eye contact with you. In particular, see if the explorer can work on pelvic floor movement while looking and not "going away" in the eyes. Or ask them to keep breathing low into the belly and move their legs slowly open and shut while eye tracking your finger. Sometimes sensations are overwhelming and the explorer may become lost in them. This is not the same as cutting contact as a way of avoiding sensation.

Sexual Advances

It is paradoxical, but many people will make sexual advances in order to avoid the build up of genital sensation—to discharge it immediately it is felt. In couples work it is especially hard not to fall into responding to the explorer's sexual advances: you already have a permitted sexual relationship which you know can be pleasurable, and it may be sexually exciting to you to watch your partner's body move spontaneously. This is fine but I think a clear line should be held between couples work and making love. Let the excitation build so that the explorer becomes fully aware of the sexual tension in the pelvis. Of course if the result of the session is to produce a strong genital tension which demands release, this can be done in lovemaking. But I suggest you take a break between the session and lovemaking.

Some therapists may criticize couples work for "opening a can of worms" which the couple may not be able to handle, particularly in work on the pelvic segment. To this I would reply that, 1) If you already have a sexual relationship and there are sexual issues which are buried like a can of worms, this is hardly a healthy situation. 2) A precondition of doing this work is that your relationship is fairly strong. 3) A professional therapist may be less able to work through a sexual problem with you than your partner. In fact he or she must sometimes resort to a kind of therapy by third party in discussing various ways in which your partner can help. 4) Finally remember that the goal of this couples work is not to have the perfect textbook orgasm or develop the perfect relationship, or even to dissolve major blocks: it is to open up what is already near the point of opening.

If you do feel you need outside advice on any of the work suggested in this book, you can always seek it from a therapist who is experienced in emotional work, but, as I suggest in chapter 9, you can maintain your independence and privacy as a couple by always insisting that outside help be on a consultation basis.