By Ginny Puckett, LPC, ACS
Introduction
Trauma leaves a lasting impact on the body and mind, often in ways that people don’t immediately associate with sexual health. Although sexual trauma can certainly lead to difficulties with intimacy, the reality is that even nonsexual trauma can impair sexual functioning. In a review of the literature, Yehuda, Lehrner, and Rosenbaum (2015) explain that regardless of whether a trauma survivor has experienced sexual trauma, sexual dysfunction is a common complaint in individuals with PTSD. Experiencing trauma can profoundly disrupt a person’s sense of safety and ability to trust and feel connected to others–key elements that are essential for healthy intimate relationships.
Before diving deeper into the effects on sexual health, it’s important to clarify what trauma is and how it shapes the body’s responses.
Defining Trauma
Simply put, trauma is any experience that overwhelms a person’s ability to cope and undermines their sense of safety. Traumatic experiences vary widely, and what one person may experience as traumatic may not have the same effect on another. Common examples of traumatic experiences include childhood abuse or neglect, sexual assault, being in an accident or natural disaster, witnessing or experiencing violence or bodily harm, experiencing sudden or violent loss, and working in a high-stress line of work (first responders, firefighters, law enforcement, etc.)
To understand how trauma impacts sexual dysfunction, it is also important to understand the role of the autonomic nervous system. The autonomic nervous system controls the automatic functions of the body that are needed to survive such as sleep, heart rate, blood pressure, digestion, arousal, and stress response. The sympathetic branch of the nervous system is activated when it senses a stressor and prepares us to act accordingly, while the parasympathetic branch is responsible for bringing us back into a more relaxed state. These two branches create a balancing act, and our general wellness and survival depend on this balance. However, trauma has the potential to disrupt this balancing act, making it difficult for the body to properly regulate itself.
How Trauma Disrupts Sexual Functioning
The autonomic nervous system also plays a role in sexual functioning. Healthy sexual functioning requires the balancing act of the nervous system as we previously discussed. According to Yehuda et al. (2015), “Sexual arousal mimics the physiological experience of fear, and once these associations have been forged in the intense experience of trauma, it can be difficult to uncouple them.” Healthy sexual functioning requires an inhibition of the fear response, but a chronically dysregulated nervous system may have difficulty distinguishing between sexual arousal and danger.
So what does this mean for trauma survivors? This means the experience of arousal can signal impending threat or danger to the nervous system rather than pleasure, even during a consensual sexual experience. The hyperactive threat response in trauma survivors can impair sexual functioning in a variety of ways such as erectile dysfunction, loss of desire, and problems with orgasm. This may also present as flashbacks, panic attacks, and/or dissociation during sexual experiences. The impact of sexual dysfunction extends beyond the bedroom. In fact, a study on sexual functioning in military personnel found that sexual problems were associated with reduced quality of life and lower happiness scores (Wilcox, Redmond, and Hassan, 2014).
Seeking Help
If you are a trauma survivor who is struggling with intimacy, it’s important to know that sexual difficulties are common and treatable through sex therapy. The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) affirms that sexuality is an inherent, essential, and beneficial dimension of being human. Sexual problems are not trivial issues and can deeply impact your mental health and overall wellbeing. Sex therapy can help you reclaim this important part of life and offer you tools to start rebuilding intimacy at your own pace.
To learn more about sex therapy and schedule a free consultation with Ginny Puckett, visit www.ginnypuckettlpc.com
Sources:
The American Association of Sexuality Educators, Counselors, and Therapists
https://www.aasect.org/our-mission.html
Chudakov B, Cohen H, Matar MA, Kaplan Z. A naturalistic prospective open study of the effects of adjunctive therapy of sexual dysfunction in chronic PTSD patients. Isr J Psychiatry
Relat Sci 2008;45:26–32.
Wilcox SL, Redmond S, Hassan AM. Sexual functioning in military personnel: Preliminary estimates and predictors. J Sex Med 2014;11:2537–45.
Yehuda, R., Lehrner, A., & Rosenbaum, T. Y. (2015). PTSD and sexual dysfunction in men and women. Journal of Sexual Medicine, 12(5), 1107-1119.