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Dr. Marisol G. Westberg

Psychotherapist

How Sexual Trauma Impacts Intimacy and Sexuality

If you find yourself feeling distressed about sex—whether it’s the anticipation of it, during the act, or afterward—it may point to a history of sexual abuse. Many sexual issues, such as lack of desire, anorgasmia, performance anxiety, and even infidelity, can often be better understood when viewed through the lens of past trauma or abuse. This shift in perspective not only helps in treatment but also alleviates the shame often associated with these issues. The distress is no longer a sign that something is wrong with you, but rather a reflection of something that happened to you.

What Is Sexual Trauma/Abuse?

When I work with clients, I often ask, “Has anything funky or uncomfortable happened to you when you were younger?” This gentle inquiry opens the door to exploring possible experiences of sexual abuse. Frequently, individuals may not label their past experiences as abuse, but they intuitively know that something didn’t feel right. Sexual abuse refers to any non-consensual sexual act or behavior, typically perpetrated through force, manipulation, or coercion, that causes harm. It extends beyond physical contact to include any form of sexual exploitation or violation of boundaries, whether emotional, verbal, or psychological.

Recognizing the Signs of Sexual Abuse Trauma

Sexual abuse can manifest in therapy in numerous ways, often revealing itself through heightened emotional responses, sudden outbursts, or intense reactions during discussions about sexual intimacy. For instance, a client might experience overwhelming feelings of fear, shame, or rejection in response to sexual advances or even within their own sexual desires. These responses can be indicative of past sexual trauma, even if the client has not yet disclosed such experiences.

One common reaction is the feeling of intense anxiety or discomfort during sexual activities. This could be due to the individual associating sexual desire with past abuse, where feelings of desire are intertwined with memories of violation. For example, a client who was abused by a babysitter might react strongly to their partner’s sexual advances, not because they lack desire, but because those advances trigger traumatic memories.

Impact of Sexual Abuse

Victims often carry long-lasting scars in the form of trauma, guilt, shame, and fear, affecting all aspects of life, particularly mental health, self-esteem, relationships, and overall well-being.

These following statistics demonstrate just how deeply abuse can affect survivors, often leaving lasting impacts on both their mental and physical health.

Consequences To Sexual Abuse

Impact of Sexual Abuse On Relationships

The effects of sexual abuse often manifest in sexual relationships.

Many survivors face challenges such as fear of intimacy, trust issues, or even hypersexuality as a way to regain control.

Others may develop sexual avoidance, struggling with physical or emotional closeness due to the trauma they’ve experienced.

Survivors may also experience sexual issues, such as low sexual desire, difficulty with orgasm, or physical pain during intercourse.

Factors such as fear, lack of trust, shame, and other markers of PTSD influence our communication, conflict resolution, reactivity, and availability with another human being.  

Impact On Relationships

1. Fear of Intimacy

  • Trust Issues: Survivors often struggle with trust, especially in intimate relationships. They may feel uncomfortable or anxious when it comes to physical touch or sexual activity, even with a partner they care about.
  • Emotional Detachment: Some survivors may distance themselves emotionally and sexually to protect themselves from being hurt again.

2. Hypersexuality or Avoidance

  • Hypersexual Behavior: For some survivors, sexual abuse can lead to increased sexual activity or risky behaviors. This may stem from a desire to reclaim control over their body or as a way to cope with the trauma.
  • Sexual Avoidance: Others may avoid sex entirely due to feelings of shame, guilt, or fear of re-experiencing the trauma. Survivors might also struggle with feelings of being “triggered” by reminders of the abuse during intimate moments.

3. Body Image Issues

  • Negative Self-Perception: Survivors may develop a distorted or negative view of their own body as a result of the abuse. This can lead to discomfort with nudity, sexual activity, or even general physical self-care.
  • Disconnection from the Body: Many survivors experience a disconnection or dissociation from their own body, finding it difficult to feel present or comfortable during sexual experiences.

4. Sexual Dysfunction

  • Low Sexual Desire: Survivors of sexual abuse often report a loss of interest in sexual activity, which can be linked to anxiety, depression, or PTSD.
  • Physical Pain: Some survivors experience vaginismus (involuntary muscle spasms during penetration) or erectile dysfunction due to the psychological and emotional stress linked to the trauma.
  • Difficulty with Orgasm: Due to emotional detachment or physical discomfort, survivors may have difficulty achieving orgasm or experiencing sexual pleasure.

5. Confusion About Sexuality

  • Sexual Identity Confusion: Sexual abuse may cause survivors to question their sexual orientation or identity, especially if the abuse involved manipulation or occurred during developmental years.
  • Boundaries and Consent: Survivors often struggle with understanding or setting sexual boundaries, leading to confusion about their own needs and desires in consensual relationships.

6. Emotional Triggers and Flashbacks

  • Flashbacks: During intimate moments, survivors may experience flashbacks or emotional triggers related to their abuse, which can make it difficult to enjoy or engage in sexual activity.
  • Avoidance of Triggers: Some survivors may avoid certain positions, physical gestures, or settings that remind them of the abuse, limiting their sexual expression.

7. Shame and Guilt

  • Feelings of Shame: Sexual abuse can create intense feelings of shame or self-blame, especially if survivors internalize the abuse as something they caused.
  • Guilt Around Pleasure: Survivors might feel guilty about experiencing sexual pleasure, fearing that enjoying sex somehow diminishes the trauma they endured.

What To Do About It

1.  Increase Awareness

Survivors need to become aware of their experiences and the ways in which those experiences may continue to affect their present lives. Validation comes in the form of recognizing that their feelings and reactions are normal responses to trauma. Once validated, survivors can begin to shift the meaning they’ve assigned to the trauma—moving from “it was my fault” to recognizing that their anxiety or other struggles are the result of past experiences, not inherent flaws.

2.  Reclaim Power, Control, Agency

A cornerstone of therapy for survivors of sexual abuse is restoring their sense of power, control, and agency—elements that were taken from them during the abuse.

3.  Increase Empathy of Self

Survivors must learn to treat their own bodies with empathy and understanding, much like they would a traumatized child. 

4.  Become Aware Of Wants and Needs

In therapy, a key focus is helping survivors develop a deeper understanding of their personal boundaries, needs, and desires.

Survivors often struggle with this due to a history of having their boundaries violated.

By creating a safe space where they can explore these issues, survivors can learn to express what they truly want in their sexual and emotional relationships, free from the shadow of past trauma.

5.  Change Relationship To Body

Through therapy, they learn to reclaim that agency, starting with the understanding that their bodies deserve to be respected, and that they have the right to control their own experiences. This newfound control helps survivors rebuild their relationships with themselves and with their partners in a way that fosters intimacy and emotional connection, without reliving the trauma of the past.

6. Deconstructing Shame and Rewriting the Narrative

Shame is a pervasive feeling among survivors of sexual abuse, often rooted in the belief that they were somehow responsible for the abuse. Therapy focuses on deconstructing these beliefs by helping clients reframe their experiences. For instance, a common therapeutic exercise is asking clients what they would say to a child who experienced similar abuse. This externalization helps clients apply the same compassion to themselves, reducing the self-blame and shame that often accompany sexual trauma.

Additionally, therapy can involve revisiting the aftermath of the abuse—how the survivor was treated, what they believed about themselves, and how those beliefs have influenced their lives. By reconstructing these narratives in a more compassionate and understanding light, clients can begin to heal from the trauma and rebuild their sense of self.

7.  The Role of Partners in the Healing Process

Healing from sexual abuse doesn’t happen in isolation, especially when the survivor is in a relationship. It’s crucial for partners to be involved in the therapeutic process to understand the trauma’s impact and avoid taking the survivor’s reactions personally. When partners are educated about the trauma, they can offer better support and help create a safe and understanding environment that facilitates healing.

Partners should also be encouraged to participate in therapy sessions where appropriate, helping to bridge the gap between understanding and action. This involvement helps ensure that the survivor feels supported, not just by their therapist but also by their partner, making the healing process more cohesive and effective.

8.  Reclaiming the Body: Addressing Dissociation

Dissociation is a common coping mechanism for survivors of sexual abuse, where they mentally “check out” from their bodies during traumatic events. This dissociation can persist long after the abuse has ended, making it difficult for survivors to connect with their bodies, feel their emotions, or experience pleasure.

Therapeutic approaches that focus on body awareness and mindfulness can be particularly helpful. These might include gentle exercises that help the survivor reconnect with their physical sensations in a safe and controlled way. The goal is to help them feel present in their bodies again, reclaim their ability to experience pleasure, and integrate their physical and emotional experiences.

9.  Ego and Identity

Sexual abuse can profoundly distort a person’s sense of value and identity. Many survivors internalize harmful beliefs that their worth is tied solely to their sexual desirability. This can lead to behaviors aimed at proving their sexual appeal, which might manifest as seeking multiple sexual partners or needing constant affirmation of their attractiveness.

Therapy involves helping clients unpack these beliefs and recognize that their value extends far beyond their sexuality. For instance, a client might explore why they feel the need to be desired by others and whether this stems from a place of trauma. By understanding these motivations, clients can begin to redefine their self-worth on healthier, more holistic terms.

FAQ

Sexual abuse can impact intimacy, as survivors may find certain sexual activities or touch triggering, leading to discomfort or distress. This situation can also result in frustration for their partner, affecting the relationship dynamics. Open communication and understanding from both sides are crucial to navigating these challenges.

For a healthy sexual relationship, it’s essential for your partner to trust that you won’t pressure them into anything they’re uncomfortable with. They need to feel confident that you’ll respect their physical responses to intimacy.

Discuss with your partner if they’re open to hearing about your desires during sex. Explain that, due to past sexual abuse, being able to say no is crucial for your healing process. Finally, ask them how they would prefer you to communicate your refusal, ensuring mutual understanding and respect in the relationship.

If you’re feeling uncomfortable during intimacy, it’s important to communicate this to your partner. Try to stay present and remind yourself that you are in a safe environment. It’s okay to pause sexual activity and only resume if and when you feel a genuine desire to. This approach respects both your well-being and the mutual respect in the relationship.

Healing involves respecting and even honoring when your partner says no. Encouraging them to express refusal is crucial, as it marks a significant step towards recovery.

Therapy can foster awareness and understanding, helping to alleviate feelings of shame and self-blame. It normalizes the effects of abuse, equips you with coping strategies, and strengthens the relationship by guiding discussions about sexual abuse and its management in intimate moments.

Yes, but sexual abuse can be compared to a physical injury that might resurface occasionally.