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Sex Therapy for Abuse Survivors

Relationships and sexuality are often core areas affected by physical and sexual abuse. It is common for survivors to do a great deal of healing and find that sexuality continues to be a challenge. Given our dual expertise in trauma therapy and sex therapy, we have developed this as a particular niche for our work. We work with both couples and individuals, trading lenses among sex therapy, trauma therapy, and couple therapy, finding that all of these aspects need attention.

Issues Frequently Addressed:

Everyone is unique in their trauma story and in their triggers. You may experience something not on this list. But for the sake of example, here are some issues we often find in working on sexuality with survivors:

• Flashbacks (whether visual, emotional, tactile — any kind)
• Dissociation during sex, including “checking out” to get it over with, seeing yourself from outside your body, or not remembering what happened
• Feeling or acting young during sex
• Anxiety, fear, terror
• Feeling pain or numbness in your body during sexual experiences
• Avoidance of sex, or of things you may worry could lead to sex (like affection initiated by a partner)
• Not being able to tolerate certain kinds of touch, or touch to particular parts of your body
• Not feeling able to have sex without being drunk or high
• Having had lots of sexual experience, but not having been very present or in your body during it
• Repulsion to some aspects of sexuality
• Lack of accurate sexual information
• Fantasies that may trouble you, become intrusive, or replay your abuse
• You or your partner not understanding the reactions you are having in sex, or why sex is so difficult

What to Expect:

We will work carefully with you to find the right pace and intensity of work. On a 10-point scale (where 0 is calm and 10 is extreme distress), we often encourage our clients to work in the range of 4-6. Without pushing yourself enough, you may not find the gains you are seeking, but if you push yourself too far, you risk being flooded, and no one heals when they are flooded. We also believe very strongly in consent. You get to say no to any question, any suggestion, any exercise, period. You also get to say if you’re not sure, and then we’ll slow it down and explore your reaction.

Together we will monitor reactions and deepen our understanding of your triggers while developing strategies for coping and moving through. What often results is a true desensitization, where the things that were once so provocative and upsetting are now much more comfortable, and very possibly even enjoyable. Our hope for you is not just to tolerate sexual experiences and get through them (the ‘white-knuckling’ approach), but rather, to truly experience sex in a different, safe, and positive way — to find pleasure in the ways that are authentically yours.

It always bears stating that sex therapy is like all other psychotherapy: we talk about what’s happening for you. There is never touch or nudity involved in sex therapy.

We know it can be intimidating to move into this work, but we feel very hopeful, having been witness to many moving success stories.

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Evanston Relational Psychotherapy is LGBTQ-affirmative and welcomes people of all genders, sexual orientations, relationship configurations, and lifestyles.

We acknowledge the realities of racism, embrace an antiracist stance, and strive to be culturally sensitive and honoring of intersectional realities. We also recognize that this is a work in progress for all of us, and invite dialogue if we err. We have an ongoing commitment to educate ourselves in these areas.