Resuming a love life after sex abuse

By Al Cooper, Ph.D.
SPECIAL TO MSNBC

Q: I am 24 and have been married for four years. Even though I enjoy being intimate with my husband and have had great sex with wonderful men, I have never had an orgasm. I am a little worried because I feel like I am missing out on a great sexual experience during the prime years of my life.

I was sexually molested as a child by many different men and realize that has a big impact on my current sexual problem. I have been through therapy, but nothing really seemed to help. So now I am just stuck with the confused, lonely feeling that I will never be intimately close to anyone. Help!!!!

A: At 24, you are much too young to give up hope. And you can be helped.

From your description, it appears that good news is sprinkled among the bad. Research and clinical experience consistently confirm that sexual trauma affects self esteem, relationships and sexual function — and the longer it is left untreated, the worse the problem becomes.

But you have sought and benefited — at least in terms of understanding your problem — from psychotherapy.

When therapy is good, it can make a tremendous difference in terms of the quality of your relationships. Therapy will help you understand how much you can trust a man as well as address feelings of guilt and low self esteem.

Who knows where you would be without the healing you have already done? The therapy may, in part, have helped you to choose a good partner and find a loving, stable relationship.

Unfortunately, there are times when general psychotherapy does not fully address specific sexual blocks. Fortunately, there are avenues worth pursuing to help you resolve this delicate and difficult situation.

QUESTIONS TO ASK YOURSELF

One approach operates on the assumption that the molestation may be directly contributing to your difficulties. Ask yourself some questions: Do you have flashbacks or memories that are triggered by sexual stimulation? Do negative feelings such as anger, fear, disgust or sadness, come up in relation to sexual activities? Do you feel numb or dissociated from your sensations?

Do you hate your body or sexual organs and feel they were somehow to blame for the abuse? Do you believe that having an orgasm is somehow a surrender, defeat or a sign of being “out of control” in a negative way (instead of believing that orgasm is a positive and natural response and release)?

If you answer “yes” to most of these questions, then there are probably significant lingering effects of your early sexual trauma. There is an excellent book by Wendy Maltz called “The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse” that can help you to explore this area. The book contains a “sexual effects inventory” to help survivors determine if and how past abuse may be affecting their sexuality.

In addition, Maltz delineates a series of exercises that address problems with sexual touch. The 10 to 15 “relearning touch” exercises are designed to help survivors of sexual abuse develop basic skills necessary for enjoying sexual intimacy. Among them: feeling relaxed with touch, breathing comfortably, staying “present,” communicating with a partner, having fun and expressing love through physical contact. Some are playful, non-sexual touch exercises, others are sensual, pleasuring touch activities. The book also helps you learn how to integrate these exercises with standard sex therapy techniques to become more orgasmic.

Even when the direct effects of the abuse have been addressed, however, an early history of sexual trauma may limit the development of a couple’s relationship if sex seems like it is “wrong” or “dirty.” Such feelings may make it uncomfortable to ask for sexual acts from a partner and decrease experimentation.

Both deny a woman effective clitoral stimulation, contributing to an inability to reach orgasm. For more than 70 percent of women, thrusting alone during intercourse is insufficient to produce orgasms: rather, the clitoris needs to be directly stimulated.

PERFORMANCE ANXIETY

It’s encouraging that you have already shown you are capable of enjoying sex to some degree and are clearly motivated to enjoy it even more. Part of your difficulties may stem from a lack of information on how to get the necessary stimulation as well as not communicating to your partner what is the most effective way to do so. In addition, there may be a bit of “performance anxiety” fed by fears that your early experiences will prevent you from ever being “intimately close to anyone.” In turn, this apprehension may be causing you to become overly focused on the orgasm itself, which can compound your difficulties.

Relax! Learning to have orgasms may take time, but is very doable with the right “instructions,” especially when motivation is strong.

Basically, achieving orgasm involves a process of progressive self-exploration — alone at first, then shared with a partner. Once you are comfortable having orgasms on your own, “bridging” exercises can help you transition to orgasms with a partner. Touch yourself while being held by your partner, then gently show him how you like to be touched. The exercises will help you learn how to be more assertive in bed, how to ask for what you like best and how to be comfortable setting the pace of lovemaking.

If you would need a professional to help guide you through the transition, contact the American Association of Sex Educators, Counselors and Therapists for a referral to a trained therapist in your area.

You sound like a bright, motivated, insightful young woman. At 24, you have your whole life ahead of you. And it’s clear that you are determined that past abuse should not deprive you of achieving your sexual potential.

With your attitude, you are likely to be successful. Good luck!