Sexual Empowerment After Sexual Trauma

Sexual assault is an extremely widespread problem with a myriad of  far-reaching impacts. According to the Center for Disease Control and Prevention (CDC), over half of women and almost 1 in 3 men have experienced sexual violence in their lifetimes. 

Sexual struggles are only part of the difficulties people might experience after sexual trauma. Additionally, there are lots of reasons people experience sexual dysfunction, some of which have nothing to do with sexual trauma. Below are some of the common reasons:

• Overall health, included disease and pain 

• Relationship

• Poor communication

• Discrepancies in desire 

• Poor body image 

• Stress, psychiatric comorbidity 

• Attitudes towards sexuality 

The focus of this blog post, however, will be on difficulties related to sexuality and intimacy following sexual trauma, including the following: 

• Anxiety before, during, or after sex

• Avoiding sex, especially when you previously enjoyed sex 

• Lack of arousal/desire 

• Changes in mood can also impact lack of arousal or desire 

• Confusion or negative associations with arousal/desire due to non-concordant desire

• It is normal to experience physical arousal (erection, lubrication, etc) when exposed to any sexual-related stimuli. This does not necessarily mean that you’re aroused or imply consent and it is quite common in sexual assault for the survivor to feel aroused or even orgasm. Again, this does not imply consent. I’m passionate about educating folks about non-concordant desire, as it can lead to victim-blaming, self-blame and confusion. A TedTalk from sex educator Emily Naskoski explains it very well.  In the TedTalk, she compares arousal to your mouth watering when you bite into a grimy apple. Your mouth watering is a natural response, even if you don’t actually like the taste of the apple or want to continue eating it.  

• Pain with intercourse  

• It’s important to consult with your medical professional as pain might be due to physical injury or infection, particularly following acute trauma. That said, pain can continue on in the absence of injury and infection due to negative associations formed during the trauma experience. 

• Feelings and thoughts of self-blame and self-hatred following the trauma can also lead to difficulties with sexual function 

• Examples of common thoughts include, “I’m bad, dirty, or disgusting.” You can imagine how these types of thoughts might contribute to both lack of desire, as well as inability to stay present when engaging in sexual activity. 

• Promiscuous behavior with lack of focus on your own pleasure or safety

• Though many people don’t associate increased sexual activity with sexual assault, it can be quite common. Survivors might fluctuate between avoidance of sex and increased engagement in sexual activity (often associated with drug and/or alcohol use). Sometimes folks are trying to re-create a more positive experience or simply feel that sexual experiences are void of all meaning following an assault. I certainly don’t want to shame anyone for the amount of or type of sex they’re engaging in. There’s a lot of variability regarding how much sex people desire, how often, and with whom. This can be perfectly healthy at a wide range and can fluctuate naturally over lifetimes and different periods of life. It can become problematic, however, if the sexual behavior is putting you or others in danger or causing physical and emotional damage. For example, a lack of concern for exposure to STDs, pregnancy, or physically unsafe situations with partners who are disrespectful or even violent (not in the context of BDSM, which is consensual-read more about consent below). 

Taking steps towards healing 

If you haven’t already, consider therapy for trauma healing. This can be a great first step in managing overall trauma-related symptoms.  If cost is a barrier, contact your local sexual assault center or RAINN to see what services are provided for free. These can be great resources! There are lots of different types of treatment to choose from, including therapies that I offer, such as EMDR and Cognitive Processing Therapy. Reach out if you’d like to discuss further and explore if these options might be a good fit for you. If you’ve already completed treatment and/or are feeling better generally but still notice some of the issues above related to sex, it’s still a good idea to reach out to a therapist to discuss! You might also consider the following: 

1) Take a pause from Sex 

• Especially if you’re engaging in risky sexual encounters, it’s important to consider using protective measures and possibly taking a momentary pause from sex to re-examine your own desires. 

• Ask: “Does your partner/s consider your needs, wants and desires as important and relevant as their own?” and  “Are you making your own choices? Not being pressured, pushed or manipulated?”

• If you’ve been pressured or are putting pressure on yourself to have or enjoy sex, it can also be helpful to start with a pause to relieve some of the pressure (which is certainly not helping to make sex enjoyable!) 

• Identify behaviors that can result from trauma and consider specific unwanted behaviors, including some that you engaged in before the trauma that maybe you never liked and just thought you were supposed to be doing! 

2) Re-frame your relationship to your body and sex 

• Challenge negative beliefs about your personal value and blame in your assault

• Sexual assault is never your fault and it’s not a reflection of who you are

• Challenge false ideas about sex

• Sex is not a way to get love. It is not something you do to someone or for someone, but with someone (or with yourself!) 

• We can’t expect someone else to give us sex on demand, nor do we owe anyone sex

• Sex is not just goal oriented towards orgasm for you or partners. Shift the focus to sensations and experiences. 

• Learn to be in your body and manage stress more generally by utilizing mindfulness, relaxation, and soothing

• Notice pleasurable feelings in non-sexual situations

• What signals appear in the body when you do/do not want to engage in an experience (generally, not just sexually)? 

3) Move toward healthier sexual behaviors 

• Educate  yourself (and partner/s, if applicable) about anatomy and sex information

• http://w3.ashasexualhealth.org/sexual-and-reproductive-anatomy/

• Read “Come as You Are” by Emily Nagoski 

• Consent, Consent, Consent! Consider the consent FRIES acronym from Planned Parenthood

• Freely Given. Consent does not involve coercion, manipulation, or the use of influences related to substance use. 

• Reversible. Consent can be withdrawn at any point. Just because you’ve consented to something before, or even consented just a minute ago, doesn’t mean you consent to it now. You’re allowed to change your mind! You can say you’re uncomfortable with an activity or touch without any explanation.

• Informed. You can only consent to something if you know what you’re consenting to! For example, consenting to “hook up” might be different things to different people. Another example might be if someone says they’ll use a condom and they don’t, there isn’t full consent. 

• Enthusiastic. Only engaging in activities that you really want to do, not what you think your sexual partner/s want or 

• Specific. Consent is for one activity, one time.

• Begin with solo touch

• What touch is okay in this context? What are the signals that tell you something is pleasurable?

• If you’re in a relationship, sexual experience is also influenced by the overall quality of the relationship and vice versa. How is the rest of your quality time and communication? Consider if a relationship or sex therapist is indicated. 

• Establish healthy ground rules of sexual encounters with others

• What touch are you okay with? How will you convey to a partner that something is or isn’t okay? 

• Communicating when you change the type or degree of sexual activity (i.e. “Is this OK?”) 

•  Explicitly agreeing to certain activities 

• Move at your pace! 

At every step, it’s important to keep in mind who you’re doing this for: you. If that’s not the case, the experiences could be re-traumatizing and cause you to further want to disengage with sex and/or lead to further negative experiences. This process is about taking ownership of your body and re-connecting to sensations, emotions, and feelings. This will promote awareness of your sexual needs and empower you in sexual situations. Please reach out if you’re considering therapy for additional support.