Childhood Sex Abuse: The

Long, Hard Road to Sexual

Healing
Recovery from childhood sex abuse takes years, but
sexual healing is possible.
For survivors of childhood sexual abuse, recovery is painful. It typically takes years. It can
threatenor destroysurvivors relationships with the perpetrators and family members
who maintain relationships with them. Survivors sexual relationships often dont survive
the process. But with therapy, survivors can recover and build healthy, happy, deeply
nurturing sex lives.

Therapeutic approaches vary, but Staci Haines, author of Healing Sex: A Mind-Body
Approach to Healing Sexual Trauma who herself survived child sex abuse and now is a
therapist for other survivors, combines traditional talk therapy with hands-on efforts aimed
at reintroducing survivors to their bodies. A focus on the body, sometimes called somatic
therapy, helps survivors feel comfortable in their own skin, a process that eventually
enables them to experience erotic pleasure.

One focus of talk therapy is overcoming survivor guilt. Survivors often think the abuse was
in some way their fault. Eventually, they understand that they where children. They had no
power in the abusive relationship, and as a result, are not to blame for what happened.
This allows them to forgive themselves. It also allows them to get angry at the abuser, an
important step in healing.

Talk therapy also explores survivors dissociation, aversion to sex, having sex only to keep
their lovers happy, faking pleasure, and faking orgasm.

On the body/somatic side of therapy, the goal is to overcome dissociation and learn to
enjoy sensual touch. To feel is to heal, Haines says. It can be very intense to relive what
survivors experienced during their abuse, the feelings deep in their bodies. But this is
critical. Body awareness allows survivors to move beyond dissociation, and eventually
experience real sexual pleasure.

However, before sexual healing, most survivors need a period of celibacy, or perhaps
sensual contacthand-holding, cuddling, huggingbut not genital play. For some, the
sexual time-out lasts several months, for others, years.
When I first started therapy, one survivor recalls, I couldnt stand being touched. For a
time, my lover and I had no physical contact. Then I wanted to be in his arms, to feel close
to him, but all I could tolerate was being hugged. Eventually, we began to explore being
more sexual.

To gain comfort with physical pleasure and sexual sensations, an important tool
is masturbation. Know thyself, Haines explains. Masturbation is the foundation of sexual
self-education. During masturbation, survivors can relearn how to be fully present in the
moment, how not to disappear while having sexual feelingswithout all the complications
of partner sex. Masturbation allows survivors to relearn how to experience sexual pleasure
on their own terms. It gives them power. By time they return to partner sex, they have
more sexual self-knowledge, which forms a healthy foundation for enjoyable sex.

Haines program of guided masturbation is similar to the masturbation-based program for

teaching pre-orgasmic women how to have orgasms. Both programs put the woman in
control, and allow her the luxury of discovering her own sexuality in her own way on her
own timetable. Not surprisingly, many survivors experience difficulty with orgasm. For
them, the masturbation program is even more crucial.

But masturbation often triggers flashbacks. When flashbacks strike, Bass and Davis, co-
authors of The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse,
advise, Open your eyes. Ground yourself in the present. Understand that touching
yourself, or being touched by a lover, is not abuse, even if it conjures up painful memories.
Tell yourself that its your right to receive loving touch, that touch is pleasurable, and that
you deserve pleasure. Its not harmful, shameful, or wrong.

Masturbation begins the process of sexual self-rediscovery, but the real challenge for
survivors is to return to partner sex. One key is for survivors to have total control over it.
This can be very difficult for survivors lovers. But over time, survivors need for hyper-
control usually subsides and sex can become more reciprocal, relaxed, playful, and loving.

Flashbacksand the situational triggers that send survivors careening back into the
dismal pastare frightening, but Haines counsels survivors to use them as tools in
healing: Suppose the abuse involved having the survivors father on top of her. Having her
husband in the same position might trigger flashbacks. Some survivors might tell the
husband: I cant have you on top of meever. They orchestrate sex to avoid all the
situations that trigger any reliving of their abuse. But most survivors have lots of sexual
triggers. If they set up their sex lives to avoid them all, pretty soon, they have cant have
sex at all.

Instead of avoiding flashback triggers, Haines urges survivors to embrace them:

Embracing triggers means not shutting down when they come up. It means thinking:
Okay, my husband is on top of me. Im triggered, thinking about my father. Im slipping
back into the past. Im not present in the here and now. But instead of avoiding this type of
sex, Im going to turn into this trigger, and really feel it.

Embracing flashback triggers is similar to the emotional process of confronting any fear:
The more you face it, the easier it becomes. Over time, triggers lose their ability to
traumatize survivors. Over time, Haines explains, survivors emerge from their trauma to
a place where the emotions surrounding the abuse no longer control them, or limit their
lives, including their sex lives. Its a place where survivors can honestly say: In the past, I
was a victim, but I'm not anymore. In the past, sex was used against me. It isnt anymore.
Today, sex can be pleasurable.

A recent study by University of British Columbia researchers used variants of talk and
body therapies to reduce survivors sexual distress. They enrolled 20 survivors in
a cognitive behavioral therapy (CBT) that helped them re-interpret their stories from abuse
to personal empowerment. Half of the group also learned mindfulness meditation (MM),
which focuses on nonjudgmental awareness of the present moment. MM trains people to
observe their thoughts, whatever they may be, and then let them go. At the end of the
month-long study, both groups reported less sexual distress, but compared with the CBT-
only group, those who also learned MM reported greater relief.

The Stages of Recovery (adapted from The Courage to Heal)

The Emergency Stage. Emotional turmoil as memories of the abuse surface.

Remembering. For those who did not suppress their memories, remembering involves
getting in touch with how it felt. For those who did, it involves facing both the memories
and their feelings.

Believing it happened. Survivors often doubt their own memories, especially when other
family members say, Youre crazy.

* Breaking the silence. The beginning of healing involves talking about the abuse--with
friends, family, a therapist, and the survivors lover.

Understanding that it wasnt your fault. Children often believe they bring sexual abuse on
themselves. Children are powerless. The abuser is to blame.

Grieving. Many survivors have spent years emotionally shut down because of the abuse.
Many feel detached from their bodies. Grieving is part of healing. It allows survivors to
experience what theyve lost: innocence, trust of others, trust in themselves.

Anger. A key element in healing is the ability to get angry at the abuser.
 Confronting the abuser. This is not for everyone. But for some survivors, it can be a
powerful element of healing.

Forgiveness. Some survivors eventually forgive the abuser. Others cant and dont. But
its important for survivors to forgive themselves for any role they feel they played in the
abuse, and anything they regret they did to survive it.

Resolution and moving on. Over time, with therapy, feelings of victimization usually
stabilize then eventually subside. The survivor comes to terms with the abuse and those
on the periphery of it, usually other family members. Survivors cant change what
happened, but over time, they arrive at a place where it neither controls nor haunts them.
They feel healed.

Previously: Childhood Sexual Abuse: Traumatic and Horriblebut Sexual Recovery Is

Possible

Next: How Men Can Help Sexually Abused Women Heal

References:

Brotto, L.A. et al. Pilot Study of a Brief Cognitive Behavioral Versus Mindfulness-
BasedIntervention for Women with Sexual Distress and a History of Childhood Sexual
Abuse, Journal of Sex and Marital Therapy (2012) 38:1.

Davis, L. The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse (20th
Anniversary edition). William Morrow, NY, 2008.

Haines, S. Healing Sex: A Mind-Body Approach to Healing Sexual Trauma. Cleis Press,
San Francisco, 2007.