Saturday, 19 January 2013

Abuse Survivors & Sexual Intimacy #childabuse #survivors

Abuse Survivors & Sexual intimacy



Many couples, where one or both partners have experienced childhood sexual abuse or sexual assault, do have joyful, fulfilling, intimate sexual relationships. An experience of sexual abuse does not automatically mean that sex and sexual enjoyment will be difficult.  Sometimes, however, sexual abuse can impact on partner’s sexual relationship and require some working through.  This page details some common difficulties, along with steps that can be taken to enhance sexual intimacy, for couple where a male partner has experienced childhood sexual abuse or sexual assault.         

Foundations for enjoyable sex 

Before focussing in on some particular challenges faced by couples where the male partner has experienced sexual abuse, it is useful to remember that negotiating, developing and maintaining sexual intimacy can be a challenge in ANY relationship.  It’s great when satisfying sex and sexual relationships, just happen.  However, this is not always the case for everyone 100% of the time.  Each partner and each relationship will involve working out what is sensual, playful, sensitive, joyful and fulfilling sexual intimacy for them and how can they make this happen in safe mutually satisfying ways for them.  Typically, enjoying sexual intimacy in longer term relationships involves a bit of work.
Some building blocks for satisfying sexual relationships are:
1. Accurate information about your own sexuality, your partner's, and about sex itself.
2. Having or developing an orientation based on pleasure (arousal, love, lust, and fun), rather than performance.
3. Having the kind of relationship in which good sex can flourish.
4. Being able to communicate verbally and nonverbally about sex.
5. Being assertive about your own desires and able to focus fully on your own pleasure and also being exquisitely sensitive to your partner and being able to respond sexually with them.
6. Understanding, accepting, and appreciating sex differences.

Factors that can impact on satisfying sex

“Ever since the kids came along it seemed like we were not as close as we’d been before, especially in the bedroom.  I just thought that things would get better in time, but they’re worse now.  We don’t talk about it much and we hardly ever have sex any more.  He says it’s the same for everyone and that there’s nothing wrong.  So when he finally told me about the abuse I was totally knocked over! But, at the same time it kind of made sense.  I had sometimes thought that maybe something might have happened to him.  Whilst, I felt so sad for him, it was a relief to know.”
Disentangling what might be impacting on shared pleasure in sexual intimacy can be tricky.  Given that sexual abuse can have such a profound impact on people’s lives, it is not surprising that when difficulties do appear couples can focus in on the legacy of the abuse as the source of the problem, when there might be other factors at play.  It is important to consider additional factors that are known to impact on enjoying sex and sexual intimacy in relationships: 
• Stress
• Alcohol
• Sleep difficulties
• Medication
• Body image, obesity
• Erectile dysfunction and other physical factors
• Low testosterone
• Depression
• Relationship difficulties and the impact of parenting
All of the above can influence individual and couples sexual intimacy and might need checking out and working on. 
It is good to remember that cultural factors and gender expectations also shape men and women’s approach to sex.  It is not uncommon for men in our society to grow up believing sex is simply something that they do with their bodies, rather than an expression of emotional intimacy. Not forgetting that expectations about sexuality and sexual relationships change - Ideas that people in long term relationships should have a full and satisfying sex life are recent. Up until the 1960s men’s role was very much that of provider, ensuring that the family had a roof over their heads and food on the table.   See Men and Intimacy.

Particular problems related to sexual abuse 

It is understandable that given that sexual abuse involves unwanted sexual contact or inapproriate exposure to sexualised material and content that sex and sexually intimate relationships become a place where difficulties can appear.  Sometimes, men who have been sexually abused have been able ‘to do’ or ‘perform’ sex in a casual way in their teens or twenties, yet identify difficulties when engaging in sex within the context of a loving relationships. For some men, the experience of sexual assault can at times “play itself out’ in the area of sex and intimacy.  If the sexual assault has occurred within an emotionally intimate relationship, for example, with a trusted adult, then it makes sense that when sex and intimacy come together later in life alarm bells can sound for some men. 
An experience of childhood sexual abuse or sexual assault can impact on sexual relationships in the following ways:
• Increased confusion during sexual and emotional intimacy.
• Discomfort with touch in certain areas of the body.
• Limit the type of sexual activity as considered ok or enjoyable.
• Require certain circumstances to be in place for example, lights on/or off when sex occurs.
• Experience difficulties in achieving sexual arousal or ejaculation.
• Feeling distress, shame or guilt about a sexual response, interest or fantasy.
• Low libido or avoid sex altogether.
• Excessive interest and validation of manhood through sex.
• Engaging in sexually compulsive behavior.
• ‘Checking out’ and emotionally disengaging.
• Require the use of pornography or sexual aids to achieve arousal or ejaculation.
• Difficulty trusting sexual partners.
• Experiencing, panic attacks, disassociation or flashbacks during sexual activity.
• Difficulties in sexual relationships, confusing sex with love, care-giving, abuse, pain, with being powerless or being powerful.
Note: Most men are raised to believe that physical sexual arousal can only occur when there is sexual desire.  If a man has experienced physical arousal, even ejaculation, as part of being abused, it can be extremely confusing for him, and he may believe that he was in some way responsible for what occurred, and this may even have been suggested to him.  Thus, his whole sense of being a man and his sexuality start to come into conflict (See Sexual Assault & Arousal).  The fact that 80% of men who are sexually abused in childhood are sexually abused by men, means that they are often confronted by questions relating to sexuality.  Some straight identifying men may also have been told, or secretly fear, that they are gay.  This can get in the way of sexual and emotional intimacy with partners.

How sexual abuse can shape understandings of sex

It is useful to note that an experience of sexual abuse can produce a particular mind set or frame of reference, where sex become viewed in unhelpful negative terms rather than a psotivei energy that consenting adults can enjoy. See below for an excellent list compiled
Sex as sexual abuse Sex as positivie sexual energy
 Sex as uncontrollable energy Sex as controllable energy
 Sex is an obligation Sex is a choice
 Sex is addictive Sex is a natural drive
 Sex is hurtful Sex is nurturing, healing
 Sex is a condition for receiving love Sex is an expression of love
 Sex is a 'doing to' someone Sex is sharing with someone
 Sex is a commodity Sex is part of who I am
 Sex is absence of communication Sex involves communication
 Sex is secretive Sex is private
 Sex is exploitive Sex is respectful
 Sex is deceitful Sex is honest
 Sex benefits one person Sex is mutual
 Sex is emotionally distant Sex is intimate
 Sex is irresponsible Sex is responsible
 Sex is unsafe Sex is safe
 Sex has no limits Sex has boundaries
 Sex is power over someone Sex is empowering

Note: Negotiating and enhancing sexual relationship with partner, where there are difficulties, can be a challenge if the partner does not know about the experience of sexual abuse (this can further isolate the man and have him trying to control, work it out or manage situations and bodily reactions). 
“I always knew there were some no-go zones – things that we just didn’t do and places I just didn’t touch but I never knew why.  It now makes lots of sense to me what those things have been about and I can see that we can still have a close relationship without having to do it all.  In fact, it is better now that I know what is uncomfortable for him and why.”

As a couple it is useful to:

  • Be aware that it is not uncommon for memories and difficulties relating to sexual abuse to re-appear during sexual contact. Situations or contact that replicates the experience of the abuse are likely to be particularly challenging.
  • Develop an awareness of what are or might be the sensitive areas, scenarios, trigger points following an experiences of sexual abuse, e.g. who was involved, males/ females, relationship context, the ways of engaging or disengaging, the places, acts, positions, touches, smells, sounds, feelings.
  • Place an emphasis on slowly developing understanding of sexual preferences on prioritising safety and choice, on becoming familiar and comfortable with your body, on talking, on being together and in tune with your partner and their body, wishes and desires.

Talk, take time and prioritise choice.

  • Increased emotional engagement and communication have been specifically identified as improving sexual relationship where the male partner has experienced sexual abuse. 
  • If difficulties arise, take time to check in and reassure yourself that it is not about you being unattractive or somehow having done something wrong.
  • If possible, talk to your partner about the difficulties, – offer some ways forward that you have already thought about, for example, experimenting with intimate touch without the focus being on genital intercourse.
  • Be really clear about your partner’s and your boundaries and limits.  Everyone has a right to say “No” to things that don’t feel comfortable or safe.
  • Know that when your partner is sexual with you he is taking a big step in trust...the occasional stumble is to be expected.
Note:  Be cautious of application of standardised sex therapy techniques for engagement and enhancing sexual pleasure that do not consider and adjust for the influence of an experience of sexual abuse.  Some sex therapy techniques can be very prescriptive, giving people specific homework to do, rather than prioritizing people’s sense of personal choice and control.  

Seek help if difficulties persist

Sex ought to be an enjoyable, fun, life giving aspect in intimate partner relationships.  If, after talking things through and trying different ways to introduce more sexual intimacy into your relationship, difficulties persist, do seek help from a qualified counsellor or sex therapist.  Ideally you are looking to talk with a professional person who has understanding, knowledge and experience in addressing histories of sexual trauma in ways that support enhancement of sexual intimacy.

Anderson Jacob, C. McCarthy Veach.  Intrapersonal and familial effects if childhood sexual abuse on female partners of male survivors.  Journal of counselling psychology 2005, 52:3, 284-297
Hall, K. ‘Childhood sexual abuse and adult sexual problems: A new view of assessment and treatment’. Feminism and Psychology 2008 18:546-556.
Sanderson, Christiane. Counselling Adult Survivors of Child Sexual Abuse, 3rd Ed.  London: Jessica Kingsley Publishers 2006.
Schachter, C.L., Stalker, C.A., Teram, E., Lasiuk, G.C., Danilkewich, A. (2009). Handbook on sensitive practice for health care practitioner: Lessons from adult survivors of childhood sexual abuse. Ottawa: Public Health Agency of Canada.

Find this article and many other excellent resources for male survivors of sexual abuse HERE at Living Well

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