Sex Injury: Past and Present
In Trauma and Sexuality, I wrote about sexual healing being a taboo subject in both the literature and in therapy. Not many want to talk about it. Yet it is one of the main areas where childhood sex abuse victims were damaged. It is my contention that since the problem is not addressed directly in the literature and hard to bring up in therapy, that we all tend to discuss the issues tied to sex in an unconsciously masked kind of way. We can talk about being hurt sexually and what was done to us (and think we are talking about sex directly). About being suicidal. Depressed. Triggered. Switchy. And on and on.
But, while all of these are important to talk about, none talk about our relationship to sex in the present. Many of these are symptoms of what is a core issue in the present. So I like to face it all head on. What is our relationship right now to sex? How is sex in the present dysfunctional? How is sex in the present hurting us? Helping us? Recreating? Overcoming? And how do all these questions about the present relate to the past?
I understand, I think, the essential barriers to talking about sex, even in the "safe" confines of the therapy office. For those of us sexually abused as children, we focused on hiding the fact that we were being hurt in that specific way. It should not be hard to appreciate that this is fertile ground for creating shame and guilt; stains on our soul which stay with us through adulthood and whose purpose seems to be only to deny us from seeking healing of any kind (or even thinking we are worthy enough to heal).
Not to mention those of us who were sexually abused were generally taught (we generally call them "the rules") to behave a certain way in dealing with sex, through a number of manipulative means. As with any kind of learning, neuronal circuits are formed. Sex abuse ties in with reward, pleasure and fear circuits in the brain moderated by powerful neurotransmitters like dopamine. Literally, there is an imprint on our brains. These imprints are terribly difficult to heal from. But we can heal from them if we deal with them directly instead of dancing around the perimeter. It is very easy to dance around the perimeter, however.
My belief is that the first step in sexual healing is acknowledging the original sexual injury, and that it is an injury in the present. The second step is being able to break down some of the guilt and shame barriers to talking about the subject. But there is more.
Obviously, each of us were affected in different ways sexually. Some become hyposexual and just run away from sex. Some become hypersexual. Neither of these extremes is necessarily bad as long as you are comfortable in them. But most of us are not comfortable with who we are sexually and this is why it is an area we must heal. It is unavoidable.
To further complicate matters, many of us use sex to recreate and perpetuate our abuse, whether it be through fantasy or in real-life, though I do believe there is a marked difference between the two. In the literature, re-enactment is a more commonly discussed sexual outcome. In these situations, we are continuing the cycle of abuse by placing ourselves in harmful psychological or physical situations. It can often be a way to resolve an intolerable conflict around control of our bodies, or to maintain an outcome we expect, to cement core beliefs of worthlessness, and on and on.
I think of all of this in terms of neuronal imprints and in terms of being a way to manage overwhelming feelings. I believe it is probably likely that the degree of sexual re-enactment is correlated with degree of dissociation. With dissociative identities, parts were created for specific purposes and roles which are harder to move out of. Further, it is easier to realize how re-enactment solves certain problems—like being able to tolerate overwhelming feelings of "parts" of us—while isolating other parts of us who are traumatized by present-day behaviors.
These are explanations and not excuses. Since, in most cases, the original abuse is not happening anymore, we are responsible for our behavior. In this case, I think it is most aptly labeled as self-abuse behavior.
When one is able to label one's own re-enacting as self-abuse, then the third, perhaps the most important, step in beginning to achieve sexual healing is reached. We can achieve this only when we realize that the "positive" effects of recreating our own abuse are dwarfed by the negative effects. And this takes a good deal of self-awareness and brutal internal honesty.
If we keep these three steps in mind—acknowledging original injury, overcoming guilt and shame, and labeling re-enactment as self-abuse—then we are making a great effort to heal. The prognosis, I think, is good.
While sexual healing may seem daunting, the good news is that once you have achieved all three steps, there is no going back. Yes, there are "setbacks", but once you gain awareness, you cannot lose it, you can only temporarily misplace it.
A huge disclaimer here goes without saying: I am not an expert. This post is based on my personal experiences and interactions with other survivors over the past 20 years. It is not meant to be a comprehensive, or even necessarily scalable view on the sexual effects of abuse. I think there is a good chance it may be quite scalable. But I do not pretend to assert that as fact.