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 Consent is dynamic: It can be given and withdrawn at any time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

A Grief Observed: How We Process Grief and Loss

A Grief Observed: How We Process Grief and Loss

As some of you may have picked up, the title is a tribute to one of my favourite authors of all time, C.S. Lewis, who was no stranger to grief and loss. A part of his story is the loss of his wife, and A Grief Observed is a tribute to her and commentary on his own grief process; and I dare say, well worth the read. It’s not reading his books, however, that has me thinking about grief and our own emotional processes.

The past month or two has been a difficult one in our local community of South Delta as well as our new home in South Surrey. There have been a number of lives lost, families coping with tragedies, car accidents with serious consequences, and even new developments in a case where a family lost a husband and father due to a violent incident in Tsawwassen.

How does one take all of this in, and continue? I’m often asked how it is that I do my job every day, dealing with trauma (much of my clinical caseload), and tragedy in the community that we love so deeply. I’m not going to lie – there are days where it’s difficult. Some days where it’s incredibly difficult. This past week was one of the hardest. I was asked to speak at a service for a young man who took his own life. There is nothing I could possibly write here to describe the devastation felt by his family who loved him so very much. There’s nothing that I could write here that would come close to trying to explain their loss and pain, or the pain that leads him to end his life by suicide at such a young age.

This, however, is the reality of our existence. Grief and loss are ubiquitous – it doesn’t matter how young or old, how rich or poor, how educated or not, we are – things happen in life and we are left with the consequences. How is it that we are to respond to grief and loss when it enters our lives? What do we say to an individual, a couple, or a family in any of these situations? The truth is that there really is very little that can be said. What we need in these times is empathy.

Brené Brown speaks a lot about empathy, and one of the things that she has said rang truer to me in this past week than any other, and that is that very seldom can anything we say make anything better. What makes things better is a connection – the knowledge that someone is there with us, walking through this difficult part of life, and connecting with us on an emotional level.

This is the heart of counselling, and why it is that I do what I do, and why we take a trauma-sensitive, emotion-focused approach at our clinic. I know that as I’ve processed my own grief and trauma throughout my life, the help of a Registered Clinical Counsellor has been invaluable. Knowing that it’s not something someone says that makes things better, how is it that a counsellor can help us in our process? Sometimes it’s hard to put a finger on. Here are three ways that I believe counselling can help us as we walk through our own grief:

  1. We can be heard without judgement.

In the same video I referenced above we heard Brené Brown comment that it’s hard to refrain from judgement because most of us enjoy it. We carry judgements around with us throughout our days and our lives, it’s a natural human tendency. Often, rather than trying to understand, we’re listening to respond. This is where a counsellor can be helpful, and where we can all practice the empathic stance of non-judgement – it’s an intentional choice, and one of the key skills a counsellor employs. We listen to understand, and we suspend judgement.

  1. We can be understood from our own perspective.

One of the key skills taught to counsellors in their training is what is called the “not knowing stance” and it is something that I focus a lot on with the interns that I train. One of our natural tendencies as human beings is to assume that we know and understand how someone feels when they have an experience we have also had. Often, we may respond with, “Oh yeah, I totally know what how that feels!” This is dangerous, however, because just because we have a similar experience, doesn’t mean we have similar emotions and reactions, and it doesn’t mean the event has the same impact on us that it does on someone else. If we respond in this way, we run the risk of the person feeling that they aren’t heard, and definitely, aren’t understood. This “not knowing stance” assists counsellors to get to the client’s understanding of their experience and understanding it from their perspective – this is the root of empathy.

  1. We can know that we are not alone.

What you get from reading A Grief Observed, is a picture of the ongoing process of grief. Grief is not a linear, finite path; instead, it is a winding road that goes over hills, through valleys, and up mountains, and occasionally one reaches a clearing and finds peace. That is until the journey begins again. This is a difficult, emotionally draining journey – I imagine if I were to undertake a literal grief journey, I’d want someone there with me while I walk. This is true of our emotional journey, and the role of the counsellor in the process of grief. A journey mate, a companion, one who reminds us that we are not alone in the good, the bad, and even the ugly; and also, not alone when we find times of peace. One who also has the skills to help us participate in the journey, and travel safely.

There is more to be said about grief and loss, but I hope this helps some of you who have been on this journey recently, and some who have been on it for a while. Know that you are not alone, there are people around you to listen, hear, and understand. If one of our Registered Clinical Counsellors can be helpful in your process, please give us a call; we’re here to journey with you.

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