Alexandra Milspaw can trace her career path to high school, when she discovered that someone close to her had been sexually abused. It was even more firmly established when Milspaw, herself, was drugged and sexually abused in college, which prompted her to become a passionate activist for others like herself. “There were no resources available to help people like me, so I created one,” says Milspaw, PhD. M.Ed., L.P.C., who founded Break the Silence – a student group dedicated to peer education about gender violence - while still a student at Lehigh University.

Now a nationally recognized counselor and educator, Milspaw is the founder of 4Directions Counseling in Bethlehem, where she employs a synergistic mix of mindfulness-based cognitive therapy, neuro-linguistic programming, and hypnosis techniques to help both women and men heal from sexual pain and trauma. She also hosts an international radio show called Pelvic Messenger, where she shares upto- date research related to the treatment of chronic pelvic pain disorders. “Often when patients go to their doctors seeking help for pelvic pain, they are told it’s all in their heads, or that it’s sometimes ‘normal’ for sex to hurt,” says Milspaw. “Neither is true, and hearing that only contributes further to the depression that these patients can experience. I enjoy collaborating with Lehigh Valley’s top pelvic floor physical therapists, nutritionists, and pelvic health physicians to offer clients the support, understanding, and pain relief they deserve.”

Milspaw’s career took a quantum leap when she attended a guest lecture by Gina Ogden, Ph.D., L.M.F.T – a renowned therapist, researcher and author – while pursuing her Master’s degree in counseling psychology at Lehigh University. Ogden’s presentation “blew my mind,” says Milspaw, making her aware that she could earn a Ph.D. in human sexuality, which she subsequently received from Widener University. Ogden developed the 4-D Wheel of Sexual Experience, which takes a multi-dimensional approach sexuality, integrating the heart, mind, spirit and body in healing. Milspaw has been working with Ogden ever since and, as her practice name suggests, incorporates the 4-D approach into her therapy.

As she neared completion of her Master’s degree, Milspaw met another influential figure when she attended a presentation by Robert Echenberg, M.D., an OB/GYN in Bethlehem. Echenberg “connected everything I was passionate about: neuroscience, mental health, pain, and trauma,” she notes. At the time, Milspaw was beginning an 18- month program combining neurolinguistic programming, mindfulness meditation, and energy work, and she approached Echenberg about practicing these new skills on his patients. The first two patients experienced such positive results that he invited her to continue her work as an adjunct to his medical practice. It was then that Milspaw says “the world opened up.” Unbeknownst to her, she had collaborated with one of the foremost practitioners in sexual health. As a result, she received additional training on the neuroscience of pain, and attended conferences hosted by professional networks including the International Pelvic Pain Society (IPPS).

Milspaw noted that she was the only mental health therapist at the first IPPS conference she attended, and says even now there are very few. Most attendees are physicians and physical therapists. Still, Milspaw says that most doctors don’t know how to address the issue of sexual pain. “When patients see their doctors with sexual/pelvic issues, they are not asked about relative pain. It’s not being taught in medical school.”

To help spread awareness through education, Milspaw subsequently founded the Alliance for Pelvic Pain (focused on “Connecting the Dots of Your Experience”), which hosts biannual educational and experiential retreats. The organization’s first retreat in 2012 drew over 100 participants from 18 countries. “That’s when I knew there was this huge need not being met,” she says.

Milspaw says that by the time clients discover her, they will often have seen several medical doctors of different specialties, without having been offered any real solutions. Still, she always recommends a medical evaluation, as gastrointestinal issues like leaky gut and irritable bowel syndrome can play a role by allowing toxins from gut to leak into body, causing inflammation of the bladder and pelvic region. “All those nerves are connected,” says Milspaw. “Interstitial cystitis is often gut-related.” Often, clients will also be referred to a pelvic floor physical therapist for evaluation and treatment, if warranted. And Milspaw provides counseling for the depression which often accompanies long-term chronic pain.

Because of these and other factors, clients’ first one or two sessions are always educational, which Milspaw says is often enough to provide them some initial relief. “They realize the problem isn’t all in their heads, that there are real physical, physiological and emotional reasons for their pain.” She notes that unaddressed sexual pain can filter into other areas of life, causing pain with any movement, or even merely upon sitting. Untreated, it can become chronic, with what clients describe as nearly intolerable burning and/or spasms that greatly diminish overall quality of life. Milspaw practices what she calls “very action-oriented” therapy, including mindfulness training designed to relax the body and heal the areas of brain linked to chronic pain and trauma. Also integral to the process are exercises designed to help clients restore intimacy with their partners, noting that “intimacy involves much more than sex, which is not even an option in the earlier exercises.”

Milspaw is expanding her practice in May, 2017, when Tim Silvestri, Ph.D., Ashley Matz, Psy.D., M.Ed., Sara Edwards, M.Ed., and two highly-skilled interns with an interest in multi-cultural populations, children and adolescents will join her. Silvestri is a licensed psychologist and expert in neuro-biomechanics. Matz has a Master’s degree in human sexuality, and is completing her doctoral degree in psychology at Widener University. Edwards is completing her second Master’s degree in human sexuality at Widener University and has a special interest in working with individuals and couples seeking a healthier relationship and sex life. Matz and Edwards will be training with Dr. Milspaw on the treatment of chronic pelvic and sexual pain disorders and associated dysfunctions. Neuromuscular massage therapist April Pilz will offer massage services for pain and stress relief.

Milspaw and Silvestri will also offer weekly group supervision for those seeking licensure in counseling and psychology. World-renowned Master NLP practitioner and hypnotherapist Charlie Curtis will lead a certification course in mindfulness-based stress reduction, neuro-linguistic programming and consulting hypnosis (available via Skype), with a free introductory session on Thursday, May 25, 2017. And Milspaw will lead a couples retreat weekend July 7-8, 2017.

“We all deserve intimacy without pain,” Milspaw says. “Sexual traumas can have long-lasting effects and manifest in seemingly disconnected ways, so my therapy focuses on addressing causes of pain, exploring a deeper sense of the present moment and integrating practices that restore healthy sexuality. We offer a safe supportive environment for all clients, within a culture of acceptance, compassion, and authenticity.”

4Directions Counseling is located on West Union Blvd. in Bethlehem. For more information, call 484-894-1246 or visit 4dcounseling.com. See ad page 51.