Sexual Intimacy After Sexual Assault or Sexual Abuse

Many adult survivors of sexual abuse find that their sexual attitudes and reactions are impacted after a sexual assault or sexual abuse. While these effects are not permanent, they can be very frustrating as they can decrease the enjoyment of one's sexual life and intimacy with others for some time. Fortunately, even if one does not actively work on sexual healing, as the sexual assault or abuse is healed, the sexual symptoms will diminish.

Experiencing sexual symptoms after sexual assault or abuse is not only very common, but it is also understandable; "sexual abuse is not only a betrayal of human trust and affection, but it is, by definition an attack on a person's sexuality."² Some people may react to this attack by avoiding sexual activity and isolating their sexual selves, perhaps fearing losing control of their body or feeling vulnerable to someone else. Others may react by having more sexual activity than they had before this experience; possibly because they may feel that sex is less important to them now or that it is a way for them to regain a sense of power. No matter what your reaction after a sexual assault or sexual abuse, it is important to remember that it is part of your healing, helping you process what happened to you and regain a sense of normalcy.

Common sexual symptoms

The sexual effects that a survivor may experience after sexual abuse or sexual assault may be present immediately after the experience(s), or they may appear long afterward. Sometimes the effects are not present until you are in a trusting and loving relationship, or when you truly feel safe with someone. The ten most common sexual symptoms after sexual abuse or sexual assault include:

1. Avoiding or being afraid of sex
2. Approaching sex as an obligation
3. Experiencing negative feelings such as anger, disgust, or guilt with touch
4. Having difficulty becoming aroused or feeling a sensation
5. Feeling emotionally distant or not present during sex
6. Experiencing intrusive or disturbing sexual thoughts and images
7. Engaging in compulsive or inappropriate sexual behaviors
8. Experiencing difficulty establishing or maintaining an intimate relationship
9. Experiencing vaginal pain or orgasmic difficulties
10. Experiencing erectile or ejaculatory difficulties

Discovering your specific sexual symptoms is an important part of beginning sexual healing. It can be very upsetting to think about all the ways that the sexual assault or abuse has influenced you sexually, yet by knowing, you can begin to address those symptoms specifically. One way to uncover your sexual symptoms is to complete the Sexual Effects Inventory in The Sexual Healing Journey by Wendy Maltz. This inventory is a tool to give you a general picture of your sexual concerns at this time, and it will indicate to you how the sexual assault or abuse may have impacted your attitudes about sex, your sexual self-concept, your sexual behavior, and your intimate relationships. Although completing the inventory can be overwhelming, it can be a good place to start in understanding how your sexuality has been impacted by the abuse.

Many of the effects of the sexual assault/abuse on your sexuality are a result of the sexual abuse mindset. This mindset consists of false beliefs about sex, and it is common to experience after a sexual assault or abuse. False beliefs about sex are commonly developed because the sexual assault or abuse is confused with sex. It is important to remember that while sexual activity was a part of the sexual assault or abuse, it was not healthy sex because it was not consensual and the perpetrator used sexual activity to gain power over you, making it abusive sex. The following table summarizes the differences between healthy sexual attitudes and sexual attitudes that equate sex to sexual abuse. With time, and the suggestions given later, it is possible to shift a sexual abuse mind-set to healthy sexual attitudes.

Moving towards healthy sexual attitudes and reactions

The passing of time and positive sexual experiences by yourself or with a partner will naturally move you towards more healthy sexual attitudes. You can also actively begin the process of shifting your ideas that promote the sexual abuse mind-set to healthy sexual attitudes by trying some of the following:

1. Avoid exposure to people and things that reinforce the sexual abuse mindset. Avoid any media (TV programs, books, magazines, websites, etc.) that portray sex as sexual abuse. This includes avoiding pornography. Pornography consistently depicts sexually aggressive and abusive situations as pleasurable and consensual. As an alternative to pornography there are erotic materials, often named erotica, where the sexual situations shown display sex with consent, equality, and respect.
2. Use positive and accurate language when referring to sex. When referring to body parts use the proper names, not slang terms that can be negative or degrading. Ensure that your language about sex reflects that sex is something positive and healthy, and that it is something that you can make choices about. Do not use words that reinforce the idea that sex is sexual abuse, such as "banging" or "nailing."
3. Discover more about your current sexual attitudes and how you would like them to change. Spend time considering how you would feel about sex if you had never been sexually assaulted or abused. Consider how you want to think and feel about sex in the future.
4. Discuss ideas about healthy sexuality and sex with others such as with your friends, partner, therapist, or support group members.
5. Educate yourself about healthy sex. Read books, take workshops, or talk with a counselor.

One way you can determine if you are about to engage in healthy sex is by asking yourself if your current situation meets all the requirements of the C.E.R.T.S. healthy sex model.

Sexual Activity

For many people it is essential to take a break from sexual activity at some point in their healing. This break is an opportunity for you to consider your own sexual self without any concerns about someone else's sexual desires. It also ensures that your time and energy can be focused on healing and not on worrying about sex or sexual advances. Taking a break from sexual activity is an important option for survivors to have, regardless of how long they have been in a relationship and whether or not they are married or common-law.

When you decide to be sexually intimate with someone, challenge yourself to take some steps towards engaging in healthier sexual activity, such as:

Only have sexual activity when you really want to, not when you feel you should want to (such as after a long period away from your partner, on your anniversary, or on another special occasion).

1. Take an active role in sexual activity. Communicate with your partner about how you are feeling, your preferences, including what you don't like or what makes you uncomfortable, as well as your desires.
2. Give yourself permission to say no to sexual activity at any time, even after you have initiated or consented to sexual activity.

It can be helpful to discuss guidelines regarding your shared sexual intimacy that can help you feel safer during sexual encounters. The following is an example of a list of guidelines that you can use in your own relationship. Discuss this list with your partner, and feel free to add to it or take away items so that it results in a complete list of ground rules that make you both feel more comfortable.

The HealthySex Trust Contract⁴

• It's okay to say no to sex at ANY TIME.
• It's okay to ask for what we want sexually, without being teased or shamed for it.
• We don't ever have to do anything we don't want to do sexually.
• We will take a break or stop sexual activity whenever either of us requests it.
• It's okay to say how we are feeling or what we are needing at ANY TIME.
• We agree to be responsive to each other's needs for improving physical comfort.
• What we do sexually is private and not to be discussed with others outside our relationship unless we give permission to discuss it.
• We are ultimately responsible for our own sexual fulfillment and orgasm.
• Our sexual thoughts and fantasies are our own and we don't have to share them with each other unless we want to reveal them.
• We don't have to disclose the details of a previous sexual relationship unless that information is important to our present partner's physical health or safety.
• We can initiate or decline sex without incurring a negative reaction from our partner.
• We each agree to be sexually faithful unless we have a clear, prior understanding that it's okay to have sex outside the relationship (this includes virtual sex, such as phone or internet sex).
• We will support each other in minimizing risk and using protection to decrease the possibility of disease and/or unwanted pregnancy.
• We will notify each other immediately if we have or suspect we have a sexually transmitted infection.
• We will support each other in handling any negative consequences that may result from our sexual interactions.

Once you and your partner have agreed on your complete set of guidelines in your sexual relationship, you should also discuss what the potential consequences will be for breaking one of the guidelines.

Automatic Reactions to Touch

Even once you have set up guidelines to make sexual activity feel safer for you, you may experience automatic reactions to touch, such as a flashback, a panic attack, a sense of sadness, a sense of fear, dissociation, nausea, pain, or freezing. These reactions are unwanted and upsetting to both you and your partner, and fortunately, with time and healing they will minimize in frequency and severity.

In order to gain control of your body and mind during an automatic reaction, you want to ensure that you stop all sexual activity. Take time to make yourself aware of and acknowledge that you are having an automatic reaction. Try to consider what triggered it.

Once you have made yourself aware that you are experiencing an automatic reaction, take some time to calm yourself and make yourself feel safe again. Pay attention to your breathing, and try to take slow, deep breaths.

Take some time to bring your mind and body back to the present by reorienting yourself in your surroundings. Remind yourself that you are no longer living the sexual assault or abuse. Using your different senses, make yourself aware of your current environment. What do you see? What do you hear? Touch some of the objects around you to ground yourself to the present.

After you have overcome an automatic reaction, take some time to rest and recover. These reactions are overwhelming for both your body and mind. When you are ready, take some time to think about the trigger of your automatic reaction, and if there is some way you could alter the situation somehow so that the trigger does not happen or does not affect you in the same way. For example, perhaps changing the set up of the room would be helpful, or asking your partner not to do the activity that you believe may have set off your flashback. Also, if you are being triggered while being intimate with a partner, discuss with your partner what you would like her/him to do when you have an automatic reaction (e.g. stop what they are doing, hold you, talk to you, sit with you, etc.) Ask your partner to watch for signs that you are having an automatic reaction, and to stop sexual activity immediately when you have one.

Relearning Touch

Many survivors find that because of their sexual assault or abuse they experience sexual touch or certain sexual activities as negative and unpleasant. Through specific therapeutic exercises you can learn to enjoy and feel safe during sexual touch. There are exercises that you can do on your own, and also those that you can do with a partner. A series of relearning touch exercises are described in Chapter 10 of Wendy Maltz's book The Sexual Healing Journey.

If you are in a partnership at the time that you want to actively begin healing sexually, it is important that you work together. It is essential that you feel safe and comfortable with your partner, and that your partner always respects your limits and is prepared to follow your lead throughout this process. Partners who act in ways that mimic sexual assault or abuse, such as touching without consent, ignoring how you feel, behaving in impulsive or hurtful ways, will prevent you from healing. Building emotional trust and a sense of safety in a relationship are important prerequisites to enjoying sexual intimacy.

Conclusion

Fortunately, the effects that sexual assault or abuse have on your ability to enjoy sexual intimacy can be minimized and healed with time and efforts. The process of sexual healing is one that must be done slowly and patiently, and it works best if it follows or coincides with other healing regarding the assault or abuse. The guidance of a counselor can be very beneficial in the process of sexual healing, and is often recommended as this process can trigger difficult memories and emotions. While sexual healing is something that may take much time and energy, ultimately it will lead to enjoyment of sexual intimacy that is consistently positive and pleasurable.

Resources (other than those referenced earlier)

Incest and Sexuality: A Guide to Understanding and Healing by Wendy Maltz

The Survivor's Guide to Sex: How to Have an Empowered Sex Life After Child Sexual Abuse by: Staci Haines

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis

Victims No Longer: The Classic Guide for Men Recovering From Sexual Child Abuse by: Mike Lew

Sources

1 Much of the information in this pamphlet was taken from Wendy Maltz's book The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse (2001). For more detail on the information found here please read this book.

2 Wendy Maltz, 1999 (www.healthysex.com)

3 The Sexual Healing Journey by Wendy Maltz (p.99)

4 Taken from www.healthysex.com by Wendy Maltz