Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 2

Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 2

This article talks about some skills and strategies to heal the traumatized part of your brain and move toward the intimacy you deserve. If you missed the last article about the ways that sexual abuse/assault impacts intimacy and sexuality, I’d recommend going back and reading that article before beginning this one.

Remedies

Every nervous system is a little different. What works for one person may not work for another. There are many options for healing trauma and developing a healthy intimate and sex life, so I encourage you to choose options that resonate best with you.

Shift Ideas about Sex

A good place to start might be with the ideas you and your partner(s) hold about sex. Often survivors of sexual assault hold negative beliefs about sex. These beliefs result from parts of our brains confusing sexual assault (violence) with sex (consent, pleasure, equality). The two are not the same, and we need to rewire our brains to reflect this. I recommend having a look at Wendy Maltz’s comparisons chart here https://healthysex.com/healthy-sexuality/part-one-understanding/comparisons-chart/. This will help explain the difference between ideas about sex that come from experiences of abuse, versus healthy ideas about sex.

You can continue to develop a healthy sexual mindset by avoiding media that portrays sexual assault or sex as abuse or talking about sexual attitudes with friends or with a therapist. You can also educate yourself about sexuality and healing through books and workshops. One book I strongly recommend is Come as You Are by Emily Nagoski.

Communication with Partners

This may be the most important recommendation in this article. You cannot have consensual sex without communicating about it. That’s true for anyone, whether they’re an assault survivor or not. Sex remains a taboo subject in our culture, even though sex is very normal and most people have some form of sex at some point in their lives. When things are taboo and not widely talked about and understood, people develop feelings of shame about the taboo subject. Shame lurks in the darkness. This feeling of shame or embarrassment or even just awkwardness keeps many people from talking about sex with their partners despite engaging in sex.

  1. Consent is dynamic: It can be given and withdrawn at any time

All people, and especially survivors of assault/abuse need to be able to give and withdraw consent AT ANY TIME during a sexual or intimate act. Many survivors will experience flashbacks or triggers at various times through physical or sexual activities. Because they don’t feel safe to tell their partner to stop (often out of fear for making them feel bad), they will instead dissociate and push through the sexual experience. When you do this, you are telling your brain and body that what you feel doesn’t matter and that the other person’s pleasure or comfort is more important.

While it may feel frustrating to have to stop mid-sex or mid-kiss or mid-hug because something has triggered you, listening to your body will actually help the healing process go much faster. Each time you override what your brain and body needs, the trauma gets reinforced and the triggers continue to come back. Slower is faster when healing from trauma. This is something partners need to understand. If a survivor is saying no, it’s because they trust you enough to say no, not because they’re not attracted to you. Every “no” is sexy because it’s getting you closer to an enthusiastic, consensual “yes”

  1. Understand and Communicate your preferences

In addition to understanding and respecting the need to withdraw consent at any time, it’s important to talk about sexual preferences. What feels good, what feels neutral and what doesn’t feel good. Communicate when something felt uncomfortable and explore together to find what does feel comfortable. When sex is approached with curiosity and exploration rather than rigidness and shame, it becomes increasingly safe and pleasurable for both parties.

  1. The need to take a break

Sometimes survivors of sexual abuse and assault may need to take a prolonged break from sexual activity. This can happen when the individual is in a relationship or not. The break allows space to focus on healing and figuring out what feels good and what doesn’t without worrying about the anxiety of managing their partner’s advances. When you are ready to engage in sexual activity again, do so when you want it, not when you believe you “should.” You have a right to be an active participant in your own sex life. Communicate your likes and dislikes and give yourself permission to say no at any time.

How to Manage Triggers and Flashbacks

As mentioned above, some survivors will experience triggers or flashbacks during physical touch or sexual activity. Flashbacks and triggers are often thought of as images of the traumatic experience. But they can also be experienced as unpleasant sensations, or a lack of sensation, an experience of disconnection, or an experience of overwhelm. When this happens it’s important to stop whatever is triggering the flashback, i.e. stopping the sexual activity or the physical touch. When you have a flashback, a part of your brain thinks it is in the past when the trauma happened, You need to remind that part of your brain that you are in the present moment and that the danger has passed. Another word for this is “grounding.”

Grounding Strategies/Orienting back to the present moment

  • 5,4,3,2,1
    • Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, 1 you can taste
  • Deep breaths
    • Breathe in for 4, hold for 7, out for 8 (or any variation of that where you breathe out longer than you breathe in
  • Box breaths: in for 4, hold for 4, out for 4, hold for 4 (repeat 4 times)
  • Stand up and move your body – get the adrenaline out
    • Run on the spot, go for a walk, jumping jacks
  • Watch youtube video that makes you laugh (laughter is grounding)
  • Play a categories game
  • Say the alphabet backwards
  • Show these strategies to your partner and do them together

Once you’ve successfully grounded (and give yourself as much time as your nervous system needs for this, remember slower is faster), take some time to rest and find comforts. Your nervous system has just gone through a lot. It can also be good to think about what triggered you and to discuss with you partner how to change that in the future. You may want the help of a counsellor to determine this.

Counselling

Trauma counselling can really help you to overcome the impacts the trauma has on your life. You may also want to incorporate some couples counselling to help improve communication so that the two of you can work as a team on this.

There are 3 types of trauma counselling that can be beneficial. You may benefit from a mix of all three.

  1. Top-Down counselling:

This type of counselling helps you to change the thought patterns and behavioural habits that have formed as a result of the trauma. You will learn to notice the emotions and to change the behaviours and thoughts that tend to come as a result of the emotions. Some examples of this include CBT and DBT.

  1. Bottom-Up Counselling:

Emotions and survival responses are physiological. You may notice a tightness in your chest when you feel anxious, a lump in your throat when you feel sad, a pit in your stomach when you feel embarrassed, or any variety of physical manifestations of emotions. When we feel an emotion our bodies are automatically mobilized to do something with it. For example, if you see a grizzly bear, your body might instinctively run or freeze or even try to fight it. You don’t even have to think about it, your brain does it automatically! Your body also knows how to heal from the trauma, but often circumstances prevent us from being able to allow our bodies to do what they need to do. Bottom-up counselling approaches such as EMDR, Sensorimotor Psychotherapy, or Somatic Experiencing can help you to process the trauma by mindfully allowing your body and brain to do what it needs to do to heal. This will also greatly improve your relationship to your body

  1. Mindfulness Counselling or Practices

Through mindfulness practices you can train your nervous system (brain and body) to become fully present. You learn to notice when triggers are happening while keeping a foot in the present-moment so that you don’t become overwhelmed. With mindfulness you can learn to allow emotions to come and go naturally without being swept away. If you’d like to start mindfulness on your own I’d recommend starting with short 2 minute practices and slowly working your way up. Examples of mindfulness-based counselling include Mindfulness Based Cognitive Therapy and Mindfulness Based Stress Reduction.

I hope these tidbits can help you get started, or to continue on your healing journey. You deserve a healthy intimate life that includes boundaries, consent, pleasure and joy. Slower is faster; trauma takes time to work through, but it is very treatable, and you don’t have to do it alone.

Sources

Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/

Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York.

University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf

Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 1

Developing a Healthy Sex Life After Sexual Abuse/Assault – Part 1

Note: This article speaks in broad terms about sexual assault and abuse. If you feel overwhelmed at any point reading this article, I encourage you to stop reading (or skip to the section on “grounding”) and allow your body to do what it needs to do to come back to the present. Whether it’s going for a brisk walk, doing some deep breathing, or calling a trusted friend. As this article will discuss, there’s no need to push yourself past the point of overwhelm. Healing can only take place with patience.

Many survivors of sexual assault face difficulties with intimacy and/or sexuality at some point in their lives. While this is a very common experience, it’s certainly not the case for all survivors. Traumatic events affect people in a variety of different ways dependent on each person’s life experiences and their unique nervous systems. This article will focus on the people who do struggle with sex and intimacy after traumatic events. It will show that even though it can feel really hopeless at times, there are some amazing ways forward to achieving a healthy and satisfying sex life. We have some powerful innate abilities to heal trauma, but it often takes patience, support and work to get there.

Understanding the Impacts

Sexuality and the Central Nervous System – Stress and Love

Sexuality is impacted by the emotional systems managed by a very primal part of your brain often called “the reptilian brain.” This part of your brain is responsible for stress feelings as well as love feelings, all of which have helped us to survive as a species. Stress and love are also the main emotions that impact intimacy and sexual desire.

Stress responses are the neurobiological processes that help you deal with threats. Your brain prioritizes one of the following three main components based on survival needs: fight (anger/frustration), flight (fear/anxiety), or collapse (numbness, depression, dissociation).

Love is also a survival strategy; it’s the neurobiological process that pulls us closer to our tribes and bonds humans together. Love is responsible for passion, romance, and joy. It’s also responsible for the agony of grief and heartbreak.

Common Reactions

When a person lives through a traumatic event, the stress response in their central nervous system (brain and body) often gets locked into survival mode. It has detected that there is danger and so it learns that it must always be scanning for any sign of danger. As a result, there are two very common reactions to sexual trauma that affect a survivor’s sex life.

  1. Sexual Avoidance/Difficulty Experiencing Pleasure

The main function of the central nervous system is to prioritize survival needs in order of importance. For example, if you can’t breathe, you’re unlikely to notice that you’re hungry until you get oxygen again. Similarly, although love is indeed a survival mechanism (bringing us together with our tribes), the brain tends to prioritize attention to stress over love because stress points to a more immediate threat: the possibility of another dangerous and violent act.

After a sexual assault, sensations, contexts and ideas that used to be interpreted as sexually relevant (like physical touch) may instead now be interpreted by your brain as threats. So sexual situations actually make your brain sound the “danger” alarm bell. Our central nervous systems confuse sex (an act of consent, equality and pleasure) with sexual assault (an act of violence and power over another). Remember, your nervous system’s primary function is to keep you alive and safe, so anything that feels in any way similar to a violent situation from the past will sound your brain’s alarm bell.

Basically, you may be experiencing love or desire, but your brain is still stuck on survival mode. This makes it almost impossible to experience pleasure, desire and closeness.

  1. Engaging in Compulsive Sexual Behaviours

Remember how love is also a survival strategy? It draws us closer to others and makes us feel whole. So instead of stress hitting the sexual brakes, some people get locked into patterns of feeling out of control sexually and having multiple partners. In this case, sometimes the innate survival strategy prioritizes closeness for that feeling of being whole; however, when this is a survival mechanism, it’s often happening from that “collapse” stress response, or a more dissociated place. People stuck in this pattern may experience a brief feeling of relief but may still struggle with the deeper components of intimacy.

  1. Additional common symptoms
  • sexual avoidance/anxiety
  • sex feeling like an obligation
  • dissociation during sexual activity/not present
  • negative feelings associated with touch
  • difficulty achieving arousal/sensation
  • feeling emotionally distant
  • flashbacks/intrusive thoughts or images during sexual activity
  • engaging in compulsive sexual behaviours
  • difficulty maintaining an intimate relationship
  • vaginal pain in women; erectile dysfunction in men
  • feelings of shame
  • negative beliefs about sex

This is a short list of reactions, there are many more impacts on a person’s sense of self and experiences in relationships. If you’d like to get a better sense of how your traumatic experiences may have impacted your sex life, you can have a look at Wendy Maltz’s Sexual Effects Inventory here https://www.havoca.org/survivors/sexuality/sexual-effects-inventory/

Remedies: Developing a Healthy Sex Life 

This short article was just to give you an idea of some of the many ways that sexual assault can impact intimacy. These impacts sometimes show up directly after the assault and sometimes show up years later.

Stay tuned for the next article which will talk about some of the many ways to heal the parts of your brain that are impacted by the trauma and to help you to find safety and pleasure in intimacy.

Sources

Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/

Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York. 

University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf

How Can Therapeutic Dance/Movement Help Me?

How Can Therapeutic Dance/Movement Help Me?

Many people feel apprehensive or intimidated when they hear the word “dance.” Movement is a beautiful and intricate part of who we are. We are in constant motion, from blood flowing through our veins to neurons firing during thought processes and through the simplicity of breath. Our very existence depends on the continuous movement happening within the body.

Therapeutic dance, or movement, is a mind-body approach for working with emotions towards holistic wellness. We often dismiss the subtle signs of stress from our bodies until it becomes a chronic issue, preventing us from functioning in our daily lives. Therapeutic dance and movement explores the presence of emotions within the body and shows us how to care for the emotional symptoms that we may find.

What do you mean by emotions living in the body?

Have you ever noticed sayings like, “I have butterflies in my stomach,” “That gave me the heebie-jeebies,” or “My blood is boiling”? These sayings are examples of how we experience nervousness, fear, and anger in the body. Some people describe these feelings in their body as “gut feelings.” We often override gut feelings using the mind and ignore what is happening in the body. Learning to trust in the body’s wisdom is an important skill to possess in today’s fast-paced world.

In therapeutic dance and movement, the connection between the mind and the body is facilitated as a conversation used to achieve a deeper understanding of the self. Emotions in the body are made aware by paying attention to the subtle shifts in the body and linked back to spoken language.

What does an appointment look like?

Clients are often surprised that a session does not have to involve dance whatsoever. Sessions are NOT like a dance class, experience in movement is not even required. Therapeutic dance/movement is an approach that gives your body the space to express what words cannot. Do you ever move your hands when you talk? That’s a form of therapeutic movement! A session can consist of talking to someone, along with the optional invitation of moving, breath-work, or spontaneous dance. It’s entirely up to you! Another way to interpret therapeutic dance/movement is as a counselling session. Your whole body is invited into the conversation, and expression is created from the inside to the outside.

There have been times clients have said, “I’m not sure why I just did that.” The body knows what the mind may not understand quite yet. Therapeutic dance/movement helps to bring understanding and self-compassion to patterns of being. Session goals are co-created between client and practitioner. With this, a therapeutic movement session becomes a journey of creative expression and experiential processing.

What can therapeutic dance/movement help with?

Therapeutic dance/movement can help with anything, such as stress, pain, difficulty sleeping, relationship issues, chronic illness, temper tantrums, developmental disabilities, and neurodiverse diagnoses.

 Some other issues therapeutic dance/movement can support:

  • Feeling stuck
  • Feeling agitated or angry
  • Anxiety
  • Depression / low mood
  • Trauma
  • Autism Spectrum Disorder
  • Attention Deficit Hyperactivity Disorder
  • Tantrums and intense emotional upsets
  • Strengthening relationships

How Can I Start Moving?

Whether you want to start moving by speaking, storytelling, writing, drawing, or dancing, get your emotions moving today by calling our office to book a therapeutic dance/movement session. Have a quick question about therapeutic dance/movement? Click here to email our therapeutic dance/movement practitioner, Stefanie.

What on Earth is EMDR?

What on Earth is EMDR?

If you’ve ever wondered what on earth EMDR is, you’re not alone! While EMDR is well supported by research and has been found to be highly effective for many clients, it can sometimes be a strange concept for people to get used to.

 

So, What Is EMDR?

 

EMDR has been around now for about 25 years and is a highly evidence-based method of treating trauma and anxiety. EMDR stands for Eye Movement Desensitization and Reprocessing and gets its name in part from the fact that it primarily relies on eye movement to work.

 

A client undergoing EMDR is encouraged to move their eyes from side to side in a slow, steady manner while contemplating questions or discussion pieces that relate to their treatment. As odd as it sounds, the reason EMDR works is precisely because of how the brain processes memory. When we are asleep, our brains enter REM sleep (Rapid Eye Movement), and during this stage of sleep the brain is processing and filing the day’s experiences into our memory, so the next day can occur with a relatively clean slate.

 

Sometimes we get stuck on intrusive thoughts or traumatic material because the experience or issue has not managed to get appropriately filed in our memory. EMDR replicates the REM stage of sleep while the client is awake and alert, and supports the processing of painful memories or recurring intrusive thoughts. Interestingly, because EMDR mimics REM sleep it tends to work quite quickly. If the issues are not too complex, clients can often feel a sense of relief from their suffering in just a few sessions.

 

It’s important to know that at no time during EMDR is the client out of control or in a trance of any kind, and of course, the client can always choose to end an EMDR session at any point if they don’t prefer working in this way or find that they are too uncomfortable. This said, clients almost always leave an EMDR session feeling better than when the session began.

 

The second part of EMDR stands for Desensitization and Reprocessing. The goal of EMDR is to desensitize the client to something that was previously painful and to support them in reprocessing the painful issue.

 

So, what does this look like in an appointment? A client undergoing an EMDR session can expect to meet with a therapist in a comfortable room where they will both sit. The client will be asked some questions by their therapist, and then guided to use back-and-forth eye movement. During this time all the client has to do is sit quietly and allow themselves to think. Following about 1 minute of this, the therapist will check in with some questions and guidance. The eye movement sets will be repeated a number of times as the therapist leads the client through a set format of questions and feedback. Toward the end of the session, the therapist will switch gears and invite the client to “reprocess” the issue being addressed.

 

Clients then typically end an EMDR session feeling quite calm. The only side effect is that some folks find EMDR somewhat tiring, as the brain has been stimulated to work quite hard for the time of the session.

 

The good news is that while EMDR is especially effective for conditions like PTSD, it has also been reported as effective for panic attacks, complicated grief, dissociative disorders, disturbing memories, phobias, pain disorders, performance anxiety, stress reduction, addictions, sexual and/or physical abuse, body dysmorphic disorders and personality disorders.

 

As not all therapists have the necessary training, it’s important to note that EMDR should be done only with a therapist who is properly certified in working this way. If you’re curious about whether this treatment could work for you, reach out to us! We’re here to help.

 

Kathryn Priest-Peries is a Registered Clinical Counsellor and Registered Social Worker who has Advanced Level Training in EMDR and has been a practicing therapist for over 30 years.

Read more about Kathryn here.

Click here to request an EMDR appointment with Kathryn.

What Is Post-Traumatic Stress Disorder (PTSD)?

What Is Post-Traumatic Stress Disorder (PTSD)?

In today’s world, many of us have experienced events that are deeply troubling. These include car accidents, physical assault, gruesome deaths, difficult childhoods, witnessing violence, working in fields where tragic things occur, etc. None of these experiences in themselves will result in post-traumatic stress disorder. Indeed, many events in life can be extremely upsetting but may not lead to post-traumatic stress disorder. For some, however, such events stay with the individual and change their ability to cope significantly.

Let’s begin with a bit of discussion about the difference between a difficult event and a traumatic one. I like to refer to difficult events as small-t traumas. These are events that can upset us for days, weeks, and even months. They take time to adjust to and with time and social support the individual is eventually able to function as well as they did prior to the difficult event. Capital-T traumas tend to be events that impact the psyche in ways that prevent us from returning to our previous ability to function. These tend to be events that are outside of the realm of normal human experience, i.e., they are statistically unlikely. Therefore, it is difficult for the sufferer to find social support as most people cannot identify with the events that have occurred. In addition, traumatic events tend to happen quite suddenly and therefore overwhelm the brain in terms of its ability to process what has occurred. There is a great deal of science that explains this but it is beyond the scope of this blog. Capital-T traumas can result in full-blown post-traumatic stress disorder.

 

How do I know when I need to get help for PTSD?

 

How does one know if they have post-traumatic stress disorder and should, therefore, seek help? There are several factors that experts agree are consistent with a diagnosis of post-traumatic stress disorder.

The first of these is physical symptoms. Following a traumatic event, it is not uncommon for the sufferer to report extreme fatigue, dizziness, headaches, as well as a host of gastrointestinal difficulties. In addition, the event itself may have left the individual with chronic pain. For example, motor vehicle accidents often result in observable injuries that are painful. If these symptoms persist beyond the length of time in which healing should occur, this may be a symptom of PTSD.

Secondly, those with post-traumatic stress disorder typically report nightmares about the traumatic event and other flashbacks. Flashbacks sometimes called triggers, occur when something relatively small reminds the sufferer of the entire traumatic event and the sufferer experiences a very high level of distress. An example of this might be smelling alcohol following an event in which an assailant was intoxicated or smelled like alcohol. The sound of sirens can also be a common trigger.

In addition, PTSD sufferers tend to exhibit a specific form of anxiety in which they begin to avoid situations that might remind them of the traumatic experience. This is done so that the sufferer can avoid feeling the distress and pain that they felt during the initial event. For example, if the traumatic event involved harm coming to a child, the sufferer may begin to avoid settings where there are children. These avoidances can make it very hard to resume normal life as some of them are quite common settings and or objects.

The next symptom that commonly occurs with PTSD is social withdrawal. This can take the form of an otherwise friendly person who begins to decline invitations that they would normally attend. The sufferer may also begin to spend time alone and become very quiet even within their own family. Added to this, the sufferer may begin to use alcohol or drugs in an attempt to withdraw from the feelings and memories associated with the trauma. They may also begin to engage in risky and seemingly wild activities such as driving erratically, walking alone in high-risk situations, etc., as a means of distracting themselves from the traumatic memory.

Repression or trying to forget the event is another symptom of PTSD. This can take the form of the sufferer destroying anything that might remind him or her of the traumatic event. It can even go so far as to result in a memory loss wherein the sufferer does not have a conscious memory of the traumatic experience.

Folks with post-traumatic stress disorder often become emotionally numb. Their loved ones may begin to notice a difference in that the sufferer appears to have no feelings. Sufferers themselves often describe feeling numb. This is the mind’s way of protecting us from becoming overwhelmed when something horrible has occurred.

Another common symptom of PTSD is what is called hyperarousal. Basically, this means that the individual becomes very jumpy and is easily startled. They may be startled by a sound that was present during the initial event such as a loud banging sound or may as easily startled by anything that they consider sudden. Individuals with PTSD often appear to be on edge as if they are waiting for the next bad thing to happen.

With all of the triggers, nightmares, hyperarousal, attempts to avoid being reminded of the traumatic event, and physical discomfort that may be present, it is no wonder that trauma survivors are commonly irritable. Irritability is the final factor that is typically present in a person with PTSD.

 

Is there hope for me or my loved one if PTSD is involved?

 

If the above describes yourself or someone you love, there is much reason for hope. PTSD is not a lifelong condition. However, it can be life-threatening if it is not addressed because the suffering is so intense. Ways of addressing PTSD include talking about it with someone trusted and who can really listen. Formal help in the form of counselling is recommended. It is important to identify and work with a therapist who has expertise in the assessment and treatment of PTSD. Such a therapist is likely to use methods such as progressive relaxation, Eye Movement Desensitization and Reprocessing (EMDR), talk therapy, art therapy, or neurofeedback, and may work in concert with the sufferer’s physician or other members of a healing team.

It is possible to return to living a full and happy life just like before the trauma. While the traumatic event cannot be forgotten, it does not have to define or debilitate a person who has survived a terrible experience. With the right help, it is possible to learn from even life’s most terrible experiences rather than be controlled by them.

Kathryn Priest-Peries is our newest Associate at Alongside You, starting in January. She has lived experience with, and a high level of expertise in working with Post-Traumatic Stress Disorder. If you identify with this article and would like to meet with her, please contact the office and we would love to set up an appointment for you.

Kathryn Priest-Peries

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