• You have described Sex Therapy in your section on Sex Therapy for Sexual Difficulties. Why do you have a separate section on Sex Therapy for Survivors of Sexual and Non-Sexual Trauma and Abuse?
• What traumatic experiences might affect sexuality?
• What are negative effects of trauma/abuse on sexuality?
• What if one member of a couple has been abused but the other has not?
• What if my partner will not come to therapy?
• Can I still participate in sex therapy if I am single?
• Where can I find out more about Sex Therapy for Survivors of Sexual and Non-Sexual Trauma and Abuse?
• How can I contact you for further information?

You have described Sex Therapy in your section on Sex Therapy for Sexual Difficulties. Why do you have a separate section on Sex Therapy for Survivors of Sexual and Non-Sexual Trauma and Abuse?

Sex therapy for survivors of sexual and non-sexual trauma and abuse requires a special blending of sensitivity and skills to address the multiple intertwined issues with which the person is struggling.  The combination of issues is more complex.  You are dealing not only with trauma but also the sensitive topic of sexuality-an issue that is difficult enough on its own. 

In my work providing sex therapy for survivors of sexual and non-sexual trauma and abuse, I work to balance the needs of the individual with respect for the damage that has been done as a result of the trauma.  I am always sorting out what negative affects results from which damage done.  Usual sex therapy assignments may be too much for a trauma survivor early in their healing.  So we work together to adjust exercises to find the right combination of growth yet safety. 

Sex therapy with individuals who have been abused and couples in which one or both partners have been abused is an opportunity to identify and learn about the influence of the abuse on their relationship including their sexual relationship.  Often couples do not feel able to discuss these difficult issues at home on their own.  They don’t know what is going on except that their love relationship and/or marriage is being ripped apart by this barrier that they don’t understand.

Individuals and couples often feel scared and relieved when they come into my office.  Scared to be talking about difficult and even taboo subjects such as abuse and family secrets.  Afraid to discuss how they were responded to about the abuse, which influences how they deal with it.  Wary of broaching the topic of how they are affected by the abuse in their current functioning individually and as a couple and family. In therapy I help clients to learn about the effects of abuse on their functioning generally as well as sexually.

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What traumatic experiences might affect sexuality?

Sexual and non-sexual trauma and abuse including sexual, verbal, physical, emotional, spiritual abuse, abandonment and neglect all may negatively affect sexuality.  The traumatic experiences may have happened as a child or adult-once or repeatedly-by someone known or a stranger.  Click here for more information on therapy for adult survivors of abuse and here for more information on Post-traumatic Stress Disorder (PTSD).

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What are some of the negative effects of sexual and non-sexual trauma and abuse on sexuality?

General negative effects of trauma and abuse may include:

• Fear, anxiety and depression
• Posttraumatic stress disorder (PTSD)
• Physical damage and pain
• Trauma based thoughts and beliefs
• Difficulties with trust and control in intimate relationships

Specific negative effects on sexuality may include:

• Automatic negative responses to sexual thoughts, feelings and behaviors
• Flashbacks to traumatic experiences in sexual situations
• Triggers in current relationship to negative intrusive thoughts and feelings from prior trauma
• Dissociation in sexual situations
• Avoidance of sexual thoughts, feelings and behaviors
• Obsessive sexual thoughts/feelings and compulsive sexual behavior
• Difficulties with individual and partnered sexuality
• Physical damage from sexual trauma/abuse resulting in pain in sexual contact
• Negative attitudes and beliefs about sex/relationships
• Problems with sexual willingness, desire, arousal and orgasm
• Negative feelings about their body
• Upsetting sexual fantasies related to the abuse

Sexual and non-sexual trauma and abuse affects all aspects of our lives.  It intrudes into our sense of who we are in the world, what we can and can’t control, if we are ever safe, and what sex means to us. 

Sex and abuse may become melded so that sexuality is defined by trauma rather than by loving connection.  Our sexuality is shaped by the experiences we have in relation to others. When those relationships equates pain and sex what is “normal” to us is shaped by those experiences.

Sex for survivors of abuse can mean many different things.  It may mean powerlessness over their bodies and their boundaries, not feeling able to control what they do or is done to them sexually as their experiences were ones in which they did not have control over what was done to them.  Or they may learn that the only control they have in life is to be sexual in ways that are degrading to them – familiar experiences from the trauma they experienced.  Sex and shame may become paired.  Here we see some of the roots of sexual addiction in which the survivor identifies sex as their most important need. 

Survivors may be aversive to sexual feelings, thoughts or activities.  They are reminded of the abuse they experienced. They want to feel close and be sexual with their beloved partners.   Instead they feel horror and avoid sexual contact.  Or they submit to sexual contact silently while experiencing flashbacks and intrusive negative thoughts and feelings related to the abuse they experienced.  They don’t feel able to talk to their partner about what is going on with them for fear that they will be left or seen as damaged.  So they suffer in silence thinking that love is about suffering.  Or they become asexual.  Or they become compulsively sexual by themselves or with other people.

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What if one member of a couple has been abused but the other has not?

It is very important to address the intrusive negative effects of abuse on the partner who has not been directly abused and who may not know much about abuse and its’ effects.

They experience the ripple effects of abuse.  Sexual trauma/abuse affects not only the victim but also those people who care about the victim.  They feel so much related to what has happened to their partner.  They struggle with the flashbacks and triggers to trauma along with the survivor.  They feel confused and helpless as to how to assist the survivor to heal and enjoy close sexual intimacy.  They feel hurt and appalled to be associated in intimate sexual contact with the perpetrator who so hurt their loved one.

Their own life experience with sexuality may have been positive so they don’t understand why their partner has such different and negative associations to sex.  They feel scared, angry, helpless and overwhelmed when their loving touch is experienced by the survivor as intrusion and assault.  They want their partner to want to be with them intimately not to painfully tolerate their touch or dissociate in order to “get through” sexual contact.

Openly dealing with the negative effects of abuse on sexuality is critical for a couple to heal together.  Communication is fundamental so they can work together as a team to negotiate vulnerable and difficult issues.  I help them to learn about the negative effects of abuse on both of them.  Together we work to support both of them in their growth individually and as a couple.

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What if my partner will not come to therapy?

I encourage you to come to therapy yourself.  Individual work can be very helpful to address these issues even when you are in a relationship in which your partner is not yet willing to come to therapy.  When and if your partner is ready to begin to address these issues we can work together to help them with their growth and integrate them into your sexual healing.

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Can I still participate in sex therapy if I am single?

Absolutely, there is so much to learn about your own sexuality and healing.

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Where can I find out more about Sex Therapy for Survivors of Sexual and Non-Sexual Trauma and Abuse?

Click here for a suggested reading list and click here to access internet resources that I have compiled.

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How can I contact you for further information?

Click here for my contact information and here for my office information.

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