Category Archives: Sexual Issues

Sexual Abuse and Shame – By: Aimee Wood LCSW

There are many aspects of shame that can develop for a survivor of sexual abuse. Here at the Better Being Mainline, a common false belief for survivors of sexual abuse is: “I am disgusting because what happened to me is disgusting.” Individuals who survive such a violation can begin to take on and internalize what happened to them in a negative way. It is common for survivors to confuse what was done to them with who they are as a person, and who they are sexually. Not only is this type of thinking false, but it’s also extremely emotionally and sexually damaging. Holding on to this belief even in the slightest would perpetuate a negative sexual self. Carrying such thinking would understandably negatively impact one’s comfort and interest in sex.

The abuse is not you. It is not who you are at your core. The abuse is something that happened to you. What happened to you, what someone else did is completely separate from your core self. Meaning, your thoughts, feelings, your love for those around you, your compassion for others is entirely separate. If you were bad because something bad was done to you, then every time something disgusting, bad, or upsetting that happened to you, your core would be defined and impacted by all of those moments, big and small. For example, have you ever found yourself soaking wet from dirty rain water because a car driving by went right through a huge puddle? Have you ever gotten dirty and hands filled with car grease from fixing a flat tire? Or for anyone who has cared for/raised children before, being peed or pooped on is inevitable. Do any of these situations make you who you are? Just like sexual abuse, these are all situations that happened to you. You did not ask for this.

The following are common shame based false beliefs, also known as intrusive thoughts:

– Self blame: “Why didn’t I try to stop it? If I tried, I wouldn’t be here today.”

– “If I was nicer (or fill in the adjective) to the abuser, he/she wouldn’t have hurt me.”

– Why do I still feel like this after all of this time? I should be over it by now.”

– My body responded positively (orgasm, lubrication, erection, etc) So I must have wanted it enjoyed it.

– “Why can’t I just be normal today? No one wants to put up with me now.”

– “I am damaged goods. Who will want me now with all of my baggage?.”

Go to the bank, or to your wallet, and take out a twenty dollar bill. Try your best to find a flat, crisp, and clean bill. Take this bill and do your worst physical damage to it. Crinkle it up into a ball, write on it, pour coffee on it, etc. Do your best and most creative damage to this twenty dollar bill without completely shredding it. Even tear it a little, or stomp on it with the dirtiest pair of your shoes. Once you’ve done everything you can think of while keeping the bill in tact, take the bill and unfold it/flatten in and set it down or hold it out in front of you, and answer yes or no to this one question: After all of that abuse to the twenty dollar bill, how much is it now worth? Does it still hold of it’s worth? It’s still worth twenty dollars, even after all of the grit, grime, misuse of the bill, it is still intact and worth just as much as it always has been.

Only you can determine your worth, and it’s up to you to maintain your worth, regardless of what happens to you. If you are questioning your value and worth right now, wondering if you are damaged and disgusting, this is just your mind responding to the abuse you survived and trying to go through the process of working through the trauma. It’s up to you to remind yourself and your brain that any devaluing thoughts you may be having right now are all false beliefs in response to your trauma. These thoughts are not true, they are not reality. Some people have bruises or broken limbs after an accident. Consider this faulty thinking your “broken limb.” This is a side effect of the trauma you survived. If you continue to remind yourself of that, and continue to separate you from what happened to you, you will be on a better road toward emotional healing and recovery. Carry that beat up, dirty $20 bill around with you for a week, and take it out daily as a reminder.

Self compassion is essential to your healing process. Be as kind to yourself as you would to your good friend sharing something of these negative thoughts and feelings. If you need help challenging some of these intrusive thoughts and to learn to be more compassionate to yourself, it may be time to consider individual therapy. It helps to talk to someone who can help you organize and sort through some of these thoughts and emotions.

Help is available, call today to schedule your first appointment: 610-608-0390

When Sex is a PTSD Trigger

A “trigger” is an experience that causes a strong physiological and/or emotional reaction because it reminds the person experiencing reaction about a traumatic event. Sexual assault, rape and even some medical trauma may cause sex to become a trigger. In addition many different types of trauma could impact the way a person experiences their body and sex. If you have experienced difficulty with sex since a traumatic event, consider the following suggestions.

  • Consider other life factors: There many be other reasons you may not want to engage in sex with your partner unrelated to the trauma. Make sure to evaluate whether you have always been bothered by or haven’t enjoyed certain sexual activities. Relationship distress and other life stressors such as an illness, death of a parent or friend, a career change, or a move, can impact sexual desire. Make sure you are not attributing all of your sexual symptoms to the trauma when there could be other factors that are influencing your experience of sex.
  • Examine your surroundings: Certain aspects of your environment may be also causing you to feel triggered, or are magnifying the experience of feeling triggered. Everything from the furniture arrangement, time of day, temperature, lighting, etc. could be triggering. Change the setting in order to reduce feeling triggered. Make changes that make create a sense of safety and do not remind you of the trauma.
  • Determine what activities are triggering: Is everything sexual trigger or only certain activities? Is every touch triggering, or only certain types of touch? Do you feel triggered as soon as your partner initiates sex or is it only once a particular sexual act is initiated? If you can figure out what specifically is causing you to feel triggered, you can identify which sexual activities may need to be temporarily on hold while you heal from the trauma. You can also give your partner feedback about what specifically is triggering so they know how to not trigger you.
  • Go with pleasure: Equally as import as identifying your triggers is identifying what activities you still enjoy and find pleasurable. Find something, even if small (like holding hands, or cuddling with clothes on) that feels safe and enjoyable to do with your partner. Engage in these activities when you desire.
  • Make sure you feel in control: Many trauma survivors must feel in control in order to feel safe enough to engage in sex. You may need to change the way you and your partner initiate, the types of activities you engage in during sex, the type of touch, etc. in order to feel safe and in control. Tell your partner the importance of feeling safe and in control and how they can help you to feel this way.
  • Learn your early red flags of dissociation: You should never engage in sex during dissociating. However, once you’re dissociating it may be hard if not impossible to make decisions about sex. In addition, you could be reenacting your trauma by having sex while dissociating. Therefore, you need to learn what the early signs of dissociation are for you. Early signs could be feeling “spaced out,” feeling dizzy, feeling numb, being unsure of where you are, nausea, sweating, shaking, etc. Learn your particular signs so that you can prevent yourself from engaging in sex when triggered or dissociated.
  • Use grounding techniques: “Grounding techniques” help to manage anxiety and trauma like reactions. In addition, make sure your partner knows what these grounding techniques are so that they can prompt you if your anxiety escalates quickly. Grounding techniques can include affirming statements like “I am safe and I am with my partner,” or “I can stop at any point if I feel overwhelmed.” Another technique would be to tune into all five senses and start describing what you are experiencing (i.e. “I am feeling my partner’s back,” “I smell the flowers on the bedside table”). Focusing on the five senses may help you to stay in the moment and prevent dissociation. You can also use diaphragmic breathing and other mindfulness skills to stay in the present.

Healing from a trauma is a long-term process. It is normal to find that you and your partner may need help managing trauma symptoms that are impacting your sex life. Consider seeking counseling for yourself and/or your partner if the trauma symptoms seem overwhelming and you do not feel as though you are healing from the trauma.

Women & Infertility

A woman is considered to be infertile if she has not become pregnant after one year of actively trying to become pregnant. Infertility is thought to affect 10% of all women in the United States (www.womenshealt.gov). Infertility can be caused by Polycystic Ovarian Syndrome, Primary Ovarian Insufficiency, Pelvic Inflammatory Disease, Endometriosis and Uterine Fibroids. Certain STDs can also impact a woman’s ability to become pregnant or carry a pregnancy to term. Scar tissue from previous surgeries or ectopic pregnancies can also cause infertility in women. Aging also impacts a woman’s ability to become pregnant or carry a pregnancy to term. After age 30, a woman’s ability to get to pregnant becomes more difficult each year. In addition stress, not being within a healthy weight range, smoking, drug or alcohol abuse and an unhealthy diet can contribute to infertility.

If you have been having sex regularly without birth control and have not become pregnant after one year, you should consult with your OBGYN. The doctor will want to know if you have been ovulating regularly. To do this you can either keep track of your daily morning body temperature, tracking how your cervical mucus appears or using ovulation test kits. Your doctor may order blood tests to detect ovulation or an ultrasound. Depending on the results of these tests your doctor may order a hysterosalpingography, which is an x-ray of the uterus and fallopian tubes. This x-ray can detect some types of scaring or other obstructions that could be causing infertility. Sometimes a laparoscopic surgery is needed to get a better look at what could be causing infertility.

The cause of your infertility will guide the treatment. Some women can successfully become pregnant, and carry to term with the use of hormone drugs. Another option to treat infertility is artificial insemination or assisted reproductive technologies (ART) such as in vitro fertilization. Some women have had success getting pregnant despite their infertility with the use of alternative medicine. Some women use alternative medicine in conjuncture with western medicine. Alternative medicine options include acupuncture, traditional Chinese medicine, massage, Reiki or homeopathy.

Some women find counseling to be helpful when struggling with infertility. Counseling can be used to:

  • Cope with the stress of infertility and the related treatments
  • Address any emotional barriers that could be contributing to infertility
  • Explore the various fertility treatments and the impacts they may have on you and your partner
  • Identify ways to increase social and emotional supports
  • Help you and your partner decide what is best for your relationship given the specific options presented to you by your treating physician
  • Help couples improve their sexual connection after the stress of infertility treatments

When Body Image Issues Follow You Into the Bedroom

Discomfort about your body can make you feel not only self-conscious in general, but also not confident in the bedroom. You may find yourself avoiding intimate situations with your partner or avoiding dating entirely. To overcome negative body image, it can be helpful to examine past events that influenced your body image.

Children and teens receive commentary about their body’s and appearances from parents, teachers, siblings, friends, strangers, etc. Sometimes this commentary is positive, “That dress looks great on you,” “I like your new haircut,” “I wish I had arms like yours…” Other times the commentary can be pretty mean, “Better watch what you’re eating,” “You’re legs are so hairy,” “You don’t have the right body type for that sport…” It’s the meaner comments (sometimes not even intentionally mean) that stick with us and can linger with us even as adults.

If you find yourself feeling really negative about a particular part of your body, ask yourself the following questions:

  • What parts of your body do you feel negative or self-conscious about?
  • When did you start to feel negative about your body or certain body parts?
  • What messaged did you receive about these body parts as a child/teen? Write down the specific messages—as well as who made the comments.
  • As a child/teen how did you feel when you heard these comments about your body?
  • How does it feel now to revisit these comments?
  • When were you able to ignore or brush off negative comments?
  • When were the comments most hurtful? Or had the deepest impact?
  • What were the differences between the times you could brush off the comments, versus the times when it was too much?
  • As a child/teen how did you cope with these negative comments? Did you avoid certain people, places and things? Activities? Types of clothes?

After you’ve identified where these negative influences came from, and how they influenced your body image, turn your attention to how these messages may STILL be impacting your life. As an adult you may still avoid, hide, or feel overly aware of certain parts of your body that you received negative comments about. These behaviors obviously impact behaviors in the bedroom—wanting to turn off the lights and not be seen, not wanting to remove a certain piece of clothing, being too in your head to enjoy the moment, only wanting to engage in certain sexual positions, etc. Try the following suggestions if you believe your negative body image is following you into the bedroom:

Check in with your partner: Does your partner know why you’re avoiding, hiding or not present during sex? Share with your partner how the insecurities about your body image are impact your sex life. He/she may already have known or suspected, or perhaps they will be surprised to hear your concerns. You may even learn your partner has their own insecurities.

Ask for positive feedback: Ask your partner to give you more positive feedback about your body and the parts he/she likes about your body. To your surprise they may even be the parts you are self-conscious about. Make sure to return the praise and compliment your partner…everyone has some insecurity about their body!

Get rid of the distorted images: While you can’t get rid of all the distorted images you encounter on a daily basis (for instance passing a billboard), you can choose to not purchase certain magazines or watch certain shows that feature airbrushed and digitally altered images. These images are not real. Do not compare yourself to unachievable and superhuman standards!

Look around: Once you’re turned your attention away from altered images, realistically compare your body to those you see around you. All of us have imperfect bodies! There is natural variation of any body part, and likely you will realize the aspects of your body that you are worried about aren’t radically different from those around you.

Take a risk: Avoidance fuels anxiety. The more you avoid, the more anxious you will become about the activity you are avoiding. Pick an activity you’re avoiding like wearing a certain piece of clothing or lingerie, engaging in a certain sexual position or even keeping some lights on during sex. If you are struggling with choosing an activity, make a list of the activities you are avoiding and select the easiest one. Go with that first.

Focus on the Positives: Instead of obsessing about what you don’t like about your body, focus on what you do like. When a negative thought pops into your head about your body, immediately redirect this line of thinking by saying something positive about your body. If you’re struggling with identifying what you like about your body, ask your partner or friends what they like…just be ready to accept the positive feedback. Others can shower you with positive feedback but ultimately you have to believe it.