When Sex is a Trigger
For some people with PTSD sex can be a trigger. Sex as a trigger is common among survivors of sexual assault and rape. However, other types of trauma could still impact a person's desire to have sex or impact a person's feelings about sex. Some people with PTSD may try to avoid sex altogether, while for others they may only try to avoid certain acts or certain aspects of sex. If sex is a trigger for you, and you are finding it difficult to be sexually intimate with your partner, consider the following suggestions below.
When Sex is a Trigger: Consider other reasons why you may not want to engage in a particular sexual activity.
The next time you find yourself not wanting to engage in a specific sexual activity, take a moment to consider the following six questions: Have I ever liked this specific sexual activity? Do I like my partner as a person? Am I physically attracted to my partner? Do I like my partner's approach to sex? Is my partner bad in bed? Am I even in the mood? These questions help you to figure out what else could be influencing your lack of desire besides your trauma. As a survivor of sexual violence you might too easily fault your traumatic experience as the only reason for your lack of desire. There are other valid reasons why you may or may not want to engage in sexual activity that have nothing to do with your trauma.
When Sex is a Trigger: Identify the pieces of sexual intimacy that are triggering.
Sexual intimacy encompasses how you and your partner relate physically and emotionally. Thus, you need to not only think about sexual activities that are triggering, but also think about patterns of relating that may be triggering. Consider the issue of control in the relationship. Think about who is usually in control in bed, going out to dinner, when you're running errands, paying bills, etc. Are you triggered when your partner is in control? What about when you are in control? How do these experiences differ for you? What is control? How does control get switched back and forth? Feeling in control is often a requirement for survivors of sexual violence to feel safe, not only in bed, but in the relationship. This means you need to feel safe in communicating your needs to your partner, both sexual and otherwise. Also consider the differences in triggers when your partner initiates sex versus when you initiate sex. Think about who has the power in the relationship? How are the power dynamics impacting your ability to feel safe or in control?
When Sex is a Trigger: Identify triggers in your surroundings.
Think about where and when you have been triggered during sexual activity. Consider whether certain aspects of your setting are triggering. Consider the lighting in the room, your partner's smell, the size of the room, the color of the room, the temperature of the room, the time of day, etc. Are certain aspects of your surroundings similar to where or when your trauma took place? If so, change your scenery. This could mean moving to a different room, changing sexual positions, engaging in sex in the morning instead of at night, turning on the lights or even painting your walls a new color. These are all great examples of changes you can make to reduce the triggers in your environment. Whether these changes are temporary (like switching sexual positions) or more permanent (like moving the furniture around in your room), this is another way to exert control. Another consideration is to think about what you are bringing to your surroundings. For instance, if you are already anxious you are more likely to be sensitive and are more likely to be triggered. Think about what you brought to the surroundings emotionally the times when you have been triggered.
When Sex is a Trigger: Understand the power of touch.
Touch can be comforting, soothing, exciting, etc. However after experiencing trauma you might perceive touch differently. Different types of touch are likely to trigger different reactions. Think about how you were touched during the trauma. Were you touched roughly? Were you squeezed or scratched? Was the touch slow or fast? Were you touched differently in different areas of your body? If for example, if during your assault the perpetrator very tightly squeezed your forearms to keep you from moving, you are likely to be triggered by similar touch. Then when your partner touches your forearms, or even grabs you a bit tightly you may begin to experience PTSD symptoms. You might dissociate or have the same physical reaction you experienced during the trauma like getting a stomach ache or feeling overcome by intense fear. Identify what types of touch and where, trigger you to experience PTSD symptoms. You might also be €œcycling your experience of touch. This means one moment touch feels good, the next it feels terrifying. Your experience of touch will flip flop quickly if you are cycling. It is important for you and your partner to understand what types of touch are triggering because it helps both of you understand your reactions and allows you to both process what is happening.
When Sex is a Trigger: Determine if you are dissociating during sex.
As a survivor of sexual violence you may find yourself dissociating during sexual experiences. Dissociation is one of our body's clever survival mechanisms. During the trauma your body likely released pain reducing chemicals. As these chemicals were released, your ability to feel (both emotionally and physically) was reduced. The process of dissociation protects you from the full impact of the trauma. However in your body's attempts at protecting you from further trauma, it may begin to default to dissociation when you are triggered by an experience that reminds you of the trauma. For survivors of sexual violence, sexual activity could trigger dissociation. If you have ever felt the following things during sexual activities you may have been dissociating: a feeling of shutting down, feeling numb, feeling detached from your body, feeling as if you are having an out of body experience, feeling spaced out. Some survivors will also experience flashbacks of their trauma during dissociation with can be particularly distressing. The point at which you can recognize you are dissociating represents is a major hurdle in your recovery process. It signals the fact that you are in a safe enough space in your life to go back and process what happened to you. Processing trauma of course cannot happen in the moment of the trauma and must be revisited to heal.
When Sex is a Trigger: Stop conditioning yourself for dissociation.
If you have sex when you do not desire to, your body may default to dissociation as a coping mechanism to protect you from any further trauma. If you continue this pattern, you may be conditioning your body to dissociate during sex. This means when you are ready and want to have sex you may still dissociate. It is important that you do not engage in any sexual activity if you do not want to! Further ingraining a pattern of dissociation during sex will only make recovery from your trauma more difficult. In addition, each time you engage in sexual activity that you do not want to, you are revictimizing yourself. In order to heal sexually you must say no to unwanted sexual activity. Some survivors may need to take a temporary break from sexual activities that cause them to dissociate in order to break the pattern of conditioning oneself for dissociation. This break allows survivors to step back and better understand their behavior.
Part of preventing dissociation during sex is becoming familiar with your pattern of dissociation. Consider the following questions to learn about how your body feels when you begin to dissociate: Does your breathing pattern change? Do some body parts feel numb? Do some body parts experience pain even when not being touched? Does your heart begin to race? Do some body parts seem to disconnect or drift away? Consider the following questions to learn about what happens in your mind when you begin to dissociate: Does your mind go blank? Do you experience racing thoughts? Do you experience flashbacks? Do you feel as if you are watching yourself from up above? When you begin to feel your body and mind dissociate take a moment to determine what triggered you. What was happening just before you dissociated? Often people dissociate to escape physical sensations or emotions that are uncomfortable. Once you familiarize yourself with the sensations and feelings that cause you to dissociate, you can slowly learn to tolerate these sensations and feelings. Eventually these sensations and feelings will not feel so overwhelming. You will slowly be able to change your pattern of dissociation during sexual intimacy by learning to sit with and experience the emotions and sensations that are triggering to you. In addition, once you become familiar with the ways your mind and body feel during dissociation you can confront your dissociation.
When Sex is a Trigger: Learn how to confront dissociation during sexual intimacy.
If you desire to engage in sexual activity, it is important to have coping skills to confront dissociation, as it will likely happen. First, tell your partner what it is like for you to have sex. This is a critical part to maintaining safety in the bedroom because it gets your partner on the same page. There are several techniques to confront dissociation that you and your partner can try. Learn which techniques work for you and inform your partner. One technique is to state something like €œI want to be in my body, or €œI want to be in the present when you feel yourself slipping away. When you begin to experience dissociation try noticing where you are and who you are with. Reach out and touch your partner. Look him or her in the eyes. Lightly grab your partner's arm, hair or perhaps your favorite body part of your partner. Touch your sheets, a piece of furniture, something to remind you that you are in a safe place and not back where the trauma took place. If a specific part of your body feels numb to you, gently touch it, rub it, tell yourself €œThis is my neck. Another technique is to tell your partner that you are dissociating. Have your partner remind you where you are and who you are with. Have your partner state, €œYou're at home, with me, your partner. You are safe. Have you partner tell you to return to your body by saying something like, €œCome back to your body, or €œCome back to being here with me. Another way to confront dissociation during sexual intimacy is to redirect your attention back to how your body feels. Focusing on how your body feels in the moment may allow you to return to your body.
If you are unable to interrupt and stop your dissociation then stop engaging in the sexual activity. If this occurs take time to think about what was triggering about that particular sexual experience. Get feedback from you partner about what he or she thinks may have been triggering about the experience. Consider whether a new memory, feeling or sensation came up during the sexual experience. Often unprocessed aspects of the trauma will emerge as you make progress in your healing. While it may feel frustrating to have to yet again process another aspect of your trauma, when you experience new material from your trauma it is actually a positive sign that you are healing. Your body stores those memories until you are able to handle their content.
Remember...
Healing from trauma is a process which requires you to be forgiving and patient with yourself. When sex is a trigger, it can be one of the most challenging triggers to understand and overcome. If sex is a trigger for you enlist the support of your partner to help you reclaim your ability to be sexually intimate. Consider seeking sex therapy if you and your partner find you are unable to make progress in this aspect of your recovery.