Abstract
Most health practitioners and clients approach vulvar pain (vulvodynia) as a physical problem. This article describes an integrated psychotherapy model that addresses pain and reactivity using Stephen Porges’s evolutionary polyvagal theory. The model draws on clinical literature and articulates therapy that addresses the client and therapist using Eric Berne’s idea of a phenomenon happening to one another. The author illustrates theoretical concepts with features of the client group and with one woman’s therapy to achieve script change and resolve pain. The usefulness of this model with other clinical symptoms is suggested.