We're wrapping up SAAM here in April. We've talked facts and prevention but I wanted to bring in something that most people, including likely your therapist, don't talk about: how past sexual abuse affects intimacy.

Sexual abuse can have long term effects on physical health and emotional wellness. The more early childhood trauma you were exposed to, the higher your risk for health and wellness challenges. But less well known is how past sexual abuse affects intimacy. From the work I do with survivors, I knew that there was a linkage. So I conducted a brief survey last summer that looked at exactly that issue.

The response below was the first that came in:

Like many abuse survivors, Jane is suffering alone with this. And that can make dealing with something as personal as intimacy challenges even harder. So let's get this out of the way: there's nothing wrong with Jane. Her inability to orgasm after sexual abuse is common. (Also common are flashbacks, pain during sex, lack of desire and an inability to get aroused.) But what's going on? There are a combination of reasons for a lack of orgasm. Let's look at four different factors:

Ability and desire to be vulnerable. Trauma such as rape can take away our ability to be vulnerable. But this unique kind of brave openness is a way that we build and deepen connections with others. If we aren't being vulnerable with trusted people in our lives, we feel lonely and frustrated. "Why doesn't anyone understand me?" is a natural thought. When vulnerability doesn't happen during intimacy, it's a double whammy! We're frustrated, feel disconnected and our satisfaction with sex is compromised.
Unpredictability of our body. Even if we feel excited about our partner and want to be vulnerable, our body can betray us. This can show up many ways including an inability to orgasm. Some survivors experience a betrayal of their body for the first time during abuse. In spite of not wanting what was happening, their body responded in a sexual way. Although this can be heartbreaking and confusing, it is completely normal. Even years after abuse ends, our body can betray us.
The nature of an orgasm. An orgasm is a surrender to sexual excitement. Inherent in orgasm is a relinquishing of control and predictability. But power and control is at the center of abuse. As a result, abuse survivors tend to hold fast to what they can control. Yielding control to someone else, especially sexually, can be scary. As if that's not enough, the part of our brain that controls behavior becomes less controlled during orgasm. So survivors might be fighting against their own instincts and biology itself during sex.
Triggers. Triggers from abuse are unpredictable. Triggers are more likely to surface during vulnerable times or momentous life experiences. They can show up years after abuse has ended and even if the survivor is in a loving relationship. Having someone touch you in a specific place or hearing a certain word could be a trigger that inhibits orgasm.

There are many possible factors for survivors like Jane who have challenges in intimacy. And yet, while an understanding of how past abuse can impacts present day can be helpful, just as important is a sense of agency about the abuse. So what can Jane do?

One thing she can do is talk about the abuse. I know from Jane's survey that she told partners that she is a sexual abuse survivor. And yet, sexual abuse is not a "one and done" topic. We know that triggers and challenges like a lack of orgasm can surface any time. Continued conversations about our abuse and how it's showing up in our lives is an essential, everyday practice. These conversations must happen with trusted friends, family and in peer support groups. All too often survivors talk about abuse only with their therapist. Support outside a professional's office strengthens relationships and keeps focus on the present.

Jane also needs to talk specifically about her inability to orgasm. It's important for her to use her own language to talk about what's going on.

I don't think it's possible for Jane to know what she knows without speaking out loud to a trusted person. We have to voice something in order for it to be real. When pain exists only as a personal deficiency in our mind, we can fool ourself into thinking it doesn't matter or that we are wrong or defective. But when we speak pain aloud, we own it, instead of it owning us. From that place we move to resolution.

I can't emphasize enough the importance for Jane of having trusted people in her life. If this is a challenge (and it is for many of us), Jane can work on this with vulnerability statements. Examples of low risk vulnerability statements would be saying "no" to something small or sharing a personal story. Being sexual with someone is a high risk area for many of us. So starting low risk is as an easier way to practice vulnerability and build a team of trusted people.

Finally, it's imperative that Jane's chosen partner is a desired partner. A desired partner is one that causes butterflies, in a good way. Feeling indifferent to a partner or going through the motions is a recipe for disaster. No sizzle=all fizzle. It's also a red flag to feel anxious, scared or sexually pressured by a partner. If a current partner reminds Jane of any kind of negative experience, desire will go down. We're more likely to orgasm when we relax and get excited by the person we're with. That's also the sign of a healthy relationship.

It can be embarrassing and lonely to be unable to orgasm with a chosen partner. But Jane isn't wrong and she isn't alone. And there are real steps that she and others like her can take to feel sexual in the way they want to.