"I hate sex. It feels like invasion of myself and my body by someone else. Life would be great if no one ever expected me to be sexual again."---Tina, raped by her father as a child.

"My penis and my heart feel disconnected. I use sex as a way to blot out pain when I'm feeling down. Masturbation is a lot easier than having sex with my wife. She wants a lot of kissing and hugging and I'm uncomfortable with all that closeness."--Jack, molested by a neighbor as a young teen.

Like Tina and Jack, many survivors of sexual abuse suffer from a variety of sexual problems. And it's no wonder. Sexual abuse is not only a betrayal of human trust and affection, but it is, by definition---an attack on a person's sexuality.

Our sexuality is the most intimate, private aspect of who we are. Our sexuality has to do with how we feel about being male or female, and how comfortable we are with our body, our genitals, and our sexual thoughts, expressions, and relationships.

When you were sexually abused -- whether you suffered a gentle seduction by a loved relative or a violent rape by a stranger -- your view and experience of your sexuality were effected by what happened to you.

The good news is that a variety of effective healing techniques now exist to help survivors overcome the sexual repercussions caused by abuse.

What are the sexual problems caused by sexual abuse? The ten most common sexual symptoms of sexual abuse are:

• avoiding or being afraid of sex
• approaching sex as an obligation
• experiencing negative feelings such as anger, disgust, or guilt with touch
• having difficulty becoming aroused or feeling sensation
• feeling emotionally distant or not present during sex
• experiencing intrusive or disturbing sexual thoughts and images
• engaging in compulsive or inappropriate sexual behaviors
• experiencing difficulty establishing or maintaining an intimate relationship
• experiencing vaginal pain or orgasmic difficulties
• experiencing erectile or ejaculatory difficulties

What is sexual healing? Sexual healing is an empowering process in which you reclaim your sexuality as both positive and pleasurable. It involves using special healing strategies and techniques to actively change sexual attitudes and behaviors which resulted from the abuse. The process of sexual healing often includes: gaining a deeper understanding of what happened and how it influenced your sexuality, increasing your body and self-awareness, developing a positive sense of your sexuality, and learning new skills for experiencing touch and sexual sharing in safe, life-affirming ways.

Sexual healing can take several months to several years, or more, to accomplish. It is considered advanced recovery work and thus, best undertaken only after a survivor is in a stable and safe lifestyle and has addressed more general effects of sexual abuse, such as depression, anger, self-blame, and trust concerns.

There are different levels of sexual healing work that a survivor can pursue; from simply reading about recovery to engaging in a series of progressive exercises, called "relearning touch techniques." These exercises provide opportunities to practice a new approach to intimate touch. While some survivors are able to progress in sexual healing on their own, others find it essential to enlist the guidance and support of a trained mental health practitioner. Professional care is recommended because of the high possibility that sexual healing will stir up traumatic memories and feelings.

You don't need to be in a relationship to do sexual healing work. Some exercises are designed for single survivors. However, if you have a partner, your partner needs to become educated about the sexual repercussions of abuse and learn strategies for participating actively and effectively in the healing process.

Here are some ideas for how to get started in sexual healing:

1. Learn about healthy sexuality.

   A first step in sexual healing is to learn to distinguish abusive type sex from healthy sex. If you commonly use words like, "bad" "dirty" "overwhelming" "frightening" "hurtful" and "secretive" to describe sex, you need to realize that these are descriptive of "sexual abuse." "Healthy sexuality" is something very different. It is characterized by choice, consent, equality, respect, honesty, trust, safety, intimacy, and sensual enjoyment.

   In the books that you read and the movies you watch, decrease your exposure to abusive sex images and increase your exposure to examples of sex in which partners are responsible and express love and caring for each other.

2. See yourself as separate from what was done to you.

   We are all born sexually innocent. Due to sexual abuse or subsequent sexual behavior, you may erroneously believe that, sexually, you are bad, damaged goods, or merely a sexual object for someone else's use. Let the past be past, and give yourself a healthy sexual future. You are not strapped to the negative labels an offender may have called you or to the way you saw yourself as a result of the abuse. Now you have choice and can assert your true self with others. Old labels will disappear as you stop believing them and stop acting in ways that reinforce them.

3. Stop sexual behaviors that are part of the problem.

   You can't build a new foundation for healthy sex until you've gotten rid of sexual behaviors that could undermine healing. Sexual behaviors that need to go, typically include: having sex when you don't want to, unsafe and risky sex, extramarital affairs, promiscuous sex, violent/degrading sex, compulsive sex, and engaging in abusive sexual fantasies. If you can't do it on your own, seek help from 12-step programs and other supports. It takes time to break old habits and learn how to channel sexual energy in ways that nurture the body as well as the soul.

4. Learn to handle automatic reactions to touch.

   Many survivors encounter unpleasant automatic reactions to touch and sex, such as: flashbacks of the abuse, fleeting thoughts of the offender, or strange reactions to something a sexual partner does or says during lovemaking. While these reactions are common, unavoidable, even protective, results of trauma -- years later --they can get in the way of enjoying sex. By developing understanding and patience you can learn to handle them effectively.

   When you experience an unwanted reaction to touch, stop and become more consciously aware of the reaction. Then calm your self physically with slow breathing, self-massage and relaxation techniques. As soon as you can, affirm your present reality by reminding yourself of who you are now and that you have many options. You may also want to alter the activity in some way to make it more comfortable. Automatic reactions will diminish over time as you become more aware of and responsive to them.

5. Familiarize yourself with touch techniques.

   You can use special touch exercises to help you relearn intimate touch in a safe and relaxed way. Different from traditional sex therapy techniques (which can be overwhelming to survivors), the "relearning touch" techniques provide a wide assortment of exercises from which to choose as you feel ready. You can do some relearning touch exercises on your own, while others require a partner. Detailed descriptions of the exercises can be found in my book, The Sexual Healing Journey, and my video, "Relearning Touch".

   These exercises help you develop skills such as: feeling relaxed with touch, breathing comfortably, staying present, communicating with a partner, having fun, and expressing and receiving love through physical contact. The exercises are progressive and follow a sequence from playful, non-sexual touch to sensual, pleasuring touch activities. When necessary, you can address specific sexual problems, such as orgasmic and erectile difficulties, by modifying standard sex therapy techniques using the new skills acquired in relearning touch.

   You can repair the damage done to you in the past. You can look forward to a new surge of self-respect, personal contentment, emotional intimacy. When you reclaim your sexuality, you reclaim yourself.

References
Maltz, Wendy and Suzie Boss. (1998). In the garden of desire: Women's sexual fantasies as a pathway to passion and pleasure. New York: roadway Books.

Maltz, Wendy and Beverly Holman. (1987). Incest and sexuality: A guide o understanding and healing. San Francisco, CA: Josey-Bass/Lexington Books.

Maltz, Wendy. (1988). Identifying and treating the sexual repercussions of incest: A couples therapy approach. Journal of Sex & Marital Therapy 14, (2) (Summer): 142-170.

Maltz, Wendy with Steve Christiansen and Gerald Joffee. (1988 video) Partners in healing: Couples overcoming the sexual repercussions of incest. Eugene, Ore.: Independent Video Services, (800) 678-3455.

Maltz, Wendy with Steve Christiansen and Gerald Joffee. (1995 video) Relearning touch: Healing techniques for couples. Eugene, Ore.: Independent Video Services, (800) 678-3455.

Maltz, Wendy. (1992). The sexual healing journey: A guide for survivors of sexual abuse. New York: Harper Perennial.

Maltz, Wendy. (1995). The maltz hierarchy of sexual interaction. Sexual Addiction and Compulsivity 2, no. 1: 5-18.

Maltz, Wendy. (1996). Passionate hearts: The poetry of sexual love. Novato, CA: New World Library.

5/24/99

WENDY MALTZ, LCSW, is an internationally recognized conference presenter, workshop trainer, and public speaker with more than 20 years of clinical experience treating sex and sexual abuse concerns. She is author of numerous sexuality books including the groundbreaking The Sexual Healing Journey. She has produced two highly acclaimed videos for couples on sexual healing techniques. Maltz is codirector, with her husband Larry, of Maltz Counseling Associates in Eugene, Oregon.