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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 psychological or physical situations harmful to us. 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 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 behavior.

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.

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Trauma and Sexuality

| By Paul | | Comments (22)

I wrote around the edges of sex from a personal perspective back in July in First Post on Sex and Parental Trust. I'd like to talk about the subject again, from a less personal perspective this time.

Sexual healing is probably the least talked about subject in the clinical literature of childhood sexual trauma. And it's one of the most difficult subjects to bring up in therapy. It's much easier to talk about post-traumatic and dissociative symptoms. And if sex is used as self-injury, it seems easier to talk about practically any other form of self-injury except sex.

But as I said before, the healing journey is messy and is certainly not easy. For those of us who were abused in sexual ways as children, it's important to understand that sexual healing is a quite necessary part of healing. Somehow we need to find ways to overcome the shame and guilt and talk about who we are sexually. This is especially true if we consider who we are sexually to be bad or wrong.

Human sexuality is one of the core aspects of our being. Of course, for those of us abused sexually as children, sex is probably not going to be so "normal". This is just a simple fact. For us, sexuality was affected in profound ways.

Mark Schwartz and Lori Galperin wrote an excellent article titled "Hyposexuality and Hypersexuality Secondary to Childhood Trauma and Dissociation" (Journal of Trauma and Dissociation, Vol. 3, No. 4, 2002). They wrote of the interplay between sexual acting out and dissociation, and suggested that being able to talk about the details of the experiences in therapy helped to decrease dissociation which then lessened the risk of behaviors. According to them, it all goes back to dissociation. If we can become more present, we gain more control. I tend to agree with their assessment as this has been the case for me.

We have heard this before, but it's worth saying again, that "when sexual abuse occurs, sexual arousal often becomes activated prematurely, but within a context of betrayal, fear, confusion, shame and violence," according to Schwartz and Galperin. What this means is that there is a linking between sexuality and violence that otherwise would not be there. And we have heard before that hypersexuality is "often a reenactment of the original incident repeated over and over." This reenactment is about control and mastery.

But there is no resolution. According to Schwartz and Galperin "it is as if the brain is unable to assimilate the overwhelming, confusing and often contradictory behavior, affect, sensations and knowledge implicit in the sexual abuse and thereby drives the person to repeat in order to finally establish a solution" or to complete the stress response cycle. While I think they are talking about sexual acting out behaviors, I think this holds true for continuous sexual fantasies, use of pornography, and masturbation which are all in the context of re-enacting abuse.

So, we were both conditioned and injured.

I don't have many answers to this problem. But I do think that sexual healing is similar to other aspects of trauma healing and that we, as survivors, do need to talk about it. I know it has something to do with acceptance and validation, in the beginning. I have talked many times here about acceptance. Acceptance of where we are at seems to allow us to plot a course for change. And, of course, overcoming the shame is crucial.

For related blog posts, see Using Pornography That Mirrors Your Child Abuse and Masturbation as a Form of Self-Injury after Sexual Child Abuse by Faith at Blooming Lotus.

I look forward to hearing your thoughts. As always, please be careful in your comments in regards to content that may be triggering to others.

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I seem to live in a virtual bubble when it comes to sex. Since forever, a very specific part of me has used pornography amongst other things, some of which became rather unsafe for me. I eventually classified all that as self-harm, with some activities being more harmful than others. Some are purely psychological harm and others are also physical harm.

The purpose has always been to confirm a core belief, that I am supposed to be hurt sexually.

I thought for a long while that this part of me was just evil. I eventually found out that was not the case, but rather was just doing what he thought he was supposed to in order to protect some of the younger hurt parts of me. I still don't fully understand how that protects younger parts, when in the end it triggers everyone. Well, maybe I do. In some ways it works to shield them from the abuse since it displaces it. But as we became more aware all over, this kind of coping didn't work as well.

This part of me has been the cause of my getting into some trouble over the years. As far as I can remember, the acting out started around junior high when I prank phone called girls in my school and the police ended up coming to my house. I don't have the full story on what happened. I suppose I denied it, which was the truth from my perspective. My father confronted me and I think we had a little talk and that was the end of it.

Sex remained an issue and gets dealt with sometimes in ways I'm incredibly uncomfortable, embarrassed, and ashamed about. It's rarely about serious self-harm and more a nuisance. It's been dealt with insofar as this part knows the really harmful stuff, all intended to hurt me, is not acceptable because it's hurtful to others inside. I know it will all have to be dealt with eventually, but for now I live with a quirky relationship with sex and accept it.

But tonight, while at my parents, they seemed to be very distrustful of me when I was fixing my Dad's computer. At first I didn't put two and two together. And if this were a year or two ago, I would never have. But, now with my increased awareness, I made a connection that may have been not true, but it was a connection I made and it troubled me.

They were around for all the "getting caught" stuff, the "lying", the breakdowns and suicide attempts, and the multiple personality diagnosis. It was the way it had to be. I had to survive by hiding what was happening to me and how I managed it in my head. So, I cannot help but wonder if my parents were thinking I'm not trustworthy because I'm not always in "control"?

If that's the case, then does how far I've come count for nothing? I built a career, bought a house, married, and had kids. I did all that in as whole a way as I could. They know I still have trouble and work at healing, but I thought they knew I was trustworthy and a decent person.

Or do they? That is the question.

Or perhaps a better question is what I say to myself about all this?

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