Sexual Intimacy After Sexual Assault or

Sexual Abuse1
Many survivors find that their sexual attitudes and reactions are impacted after a sexual
assault or sexual abuse. While these effects are not permanent, they can be very
frustrating as they can decrease the enjoyment of ones sexual life and intimacy with
others for some time. Fortunately, even if one does not actively work on sexual healing,
as the sexual assault or abuse is healed, the sexual symptoms will diminish.
Experiencing sexual symptoms after sexual assault or abuse is not only very common,
but it is also understandable; sexual abuse is not only a betrayal of human trust and
affection, but it is, by definition an attack on a persons sexuality. 2 Some people may
react to this attack by avoiding sexual activity and isolating their sexual selves, perhaps
fearing losing control of their body or feeling vulnerable to someone else. Others may
react by having more sexual activity than they had before this experience; possibly
because they may feel that sex is less important to them now or that it is a way for them
to regain a sense of power. No matter what your reaction after a sexual assault or
sexual abuse, it is important to remember that it is part of your healing, helping you
process what happened to you and regain a sense of normalcy.
Common sexual symptoms
The sexual effects that a survivor may experience after sexual abuse or sexual assault
may be present immediately after the experience(s), or they may appear long
afterwards. Sometimes the effects are not present until you are in a trusting and loving
relationship, or when you truly feel safe with someone. The ten most common sexual
symptoms after sexual abuse or sexual assault include:
1. Avoiding or being afraid of sex
2. Approaching sex as an obligation
3. Experiencing negative feelings such as anger, disgust, or guilt with touch
4. Having difficulty becoming aroused or feeling sensation
5. Feeling emotionally distant or not present during sex
6. Experiencing intrusive or disturbing sexual thoughts and images
7. Engaging in compulsive or inappropriate sexual behaviours
8. Experiencing difficulty establishing or maintaining an intimate relationship
9. Experiencing vaginal pain or orgasmic difficulties
10. Experiencing erectile or ejaculatory difficulties
Discovering your specific sexual symptoms is an important part of beginning sexual
healing. It can be very upsetting to think about all the ways that the sexual assault or
abuse has influenced you sexually, yet by knowing, you can begin to address those
symptoms specifically. One way to uncover your sexual symptoms is to complete the
Sexual Effects Inventory in The Sexual Healing Journey by Wendy Maltz. This inventory
1

Much of the information in this pamphlet was taken from Wendy Maltzs book The Sexual Healing
Journey: A Guide for Survivors of Sexual Abuse (2001). For more detail on the information found here
please read this book.
2
Wendy Maltz, 1999 (www.healthysex.com)

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is a tool to give you a general picture of your sexual concerns at this time, and it will
indicate to you how the sexual assault or abuse may have impacted your attitudes
about sex, your sexual self-concept, your sexual behaviour, and your intimate
relationships. Although completing the inventory can be overwhelming, it can be a good
place to start in understanding how your sexuality has been impacted by the abuse.
Many of the effects of the sexual assault/abuse on your sexuality are a result of the
sexual abuse mind-set. This mind-set consists of false beliefs about sex that are
common to experience after a sexual assault or abuse. False beliefs about sex are
commonly developed because the sexual assault or abuse is confused with sex. It is
important to remember that while sexual activity was a part of the sexual assault or
abuse, it was not healthy sex because it was not consensual and the perpetrator used
sexual activity to gain power over you, making it abusive sex. The following table
summarizes the differences between healthy sexual attitudes and sexual attitudes that
equate sex to sexual abuse. With time, and the suggestions given later, it is possible to
shift a sexual abuse mind-set to healthy sexual attitudes.
Sexual Attitudes 3
Sexual Abuse Mind-set
Healthy Sexual Attitudes
(sex = sexual abuse)
(sex = positive sexual energy)
Sex is uncontrollable energy
Sex is 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 doing to someone
Sex is sharing with someone
Sex is a commodity
Sex is part of who I am
Sex is void of communication
Sex requires 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
Moving towards healthy sexual attitudes and reactions
The passing of time and positive sexual experiences by yourself or with a partner will
naturally move you towards more healthy sexual attitudes. You can also actively begin
the process of shifting your ideas that promote the sexual abuse mind-set to healthy
sexual attitudes by trying some of the following:
1. Avoid exposure to people and things that reinforce the sexual abuse mind-set.
Avoid any media (TV programs, books, magazines, websites, etc.) that portray
3

The Sexual Healing Journey by Wendy Maltz (p.99)

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2.

3.

4.
5.
6.

sex as sexual abuse. This includes avoiding pornography. Pornography

consistently depicts sexually aggressive and abusive situations as pleasurable
and consensual. As an alternative to pornography there are erotic materials,
often named erotica, where the sexual situations shown display sex with consent,
equality, and respect.
Use positive and accurate language when referring to sex. When referring to
body parts use the proper names, not slang terms that can be negative or
degrading. Ensure that your language about sex reflects that sex is something
positive and healthy, and that it is something that you can make choices about.
Do not use words that reinforce the idea that sex is sexual abuse, such as
banging or nailing.
Discover more about your current sexual attitudes and how you would like them
to change. Spend time considering how you would feel about sex if you had
never been sexually assaulted or abused. Consider how you want to think and
feel about sex in the future.
Discuss ideas about healthy sexuality and sex with others such as with your
friends, partner, therapist, or support group members.
Educate yourself about healthy sex. Read books, take workshops, or talk with a
counsellor.
Many people find it empowering to know their sexual rights.
Bill of Sexual Rights

1. I have a right to develop healthy attitudes about sex.

2. I have a right to receive accurate sexual information.
3. I have a right to sexual privacy.
4. I have a right to protection from bodily invasion or harm.
5. I have a right to my own feelings, beliefs, opinions, and perceptions about sex.
6. I have a right to set my own sexual limits.
7. I have a right to say no to sexual behavior.
8. I have a right to experience sexual pleasure.
9. I have a right to be in control of my sexual experience.
10. I have a right to control touch and sexual contact.
11. I have a right to stop sexual arousal that feels inappropriate or uncomfortable.
12. I have a right to develop my sexuality according to my sexual preferences and
orientation.
13. I have a right to have a loving partner.
14. I have a right to have a partner who respects me, understands me, and is
willing to communicate with me about sex.
15. I have a right to talk to my partner about my sexual assault and/or sexual
abuse.
16. I have a right to enjoy healthy sexual pleasure and satisfaction.

University of Alberta Sexual Assault Centre

One way you can determine if you are about to engage in healthy sex is by asking
yourself if your current situation meets all the requirements of the C.E.R.T.S. healthy
sex model.
1. CONSENT:
Can I freely and comfortably choose whether or not to engage in
sexual activity? Am I able to stop the activity at any time during the
sexual contact?
2. EQUALITY:
Is my feeling of personal power on an equal level with my partner?
Does neither of us dominate the other?
3. RESPECT:
Do I have a positive regard for myself and for my partner? Do I feel
respected by my partner? Do I feel supportive of my partner and
supported by my partner?
4. TRUST:
Do I trust my partner on both a physical and emotional level? Do
we have a mutual acceptance of vulnerability and an ability to
respond to each other with sensitivity?
5. SAFETY:
Do I feel secure and safe within the sexual setting? Am I
comfortable with and assertive about where, when and how the
sexual activity takes place? Do I feel safe from the possibility of
unwanted pregnancy and/or STDs?
Sexual Activity
For many people it is essential to take a break from sexual activity at some point in their
healing. This break is an opportunity for you to consider your own sexual self without
any concerns about someone elses sexual desires. It also ensures that your time and
energy can be focused on healing and not on worrying about sex or sexual advances.
Taking a break from sexual activity is an important option for survivors to have,
regardless of how long they have been in a relationship and whether or not they are
married or common-law.
When you decide to be sexually intimate with someone, challenge yourself to take some
steps towards engaging in healthier sexual activity, such as:
1. Only have sexual activity when you really want to, not when you feel you should
want to (such as after a long period away from your partner, on your anniversary,
or on another special occasion).
2. Take an active role in sexual activity. Communicate with your partner about how
you are feeling, your preferences, including what you dont like or what makes
you uncomfortable, as well as your desires.
3. Give yourself permission to say no to sexual activity at any time, even after you
have initiated or consented to sexual activity.
It can be helpful to discuss guidelines regarding your shared sexual intimacy that can
help you feel safer during sexual encounters. The following is an example of a list of
guidelines that you can use in your own relationship. Discuss this list with your partner,
and feel free to add to it or take away items so that it results in a complete list of ground
rules that make you both feel more comfortable.

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The HealthySex Trust Contract 4

- Its okay to say no to sex at ANY TIME.
- Its okay to ask for what we want sexually, without being teased or shamed for
it.
- We dont ever have to do anything we dont want to do sexually.
- We will take a break or stop sexual activity whenever either of us requests it.
- Its okay to say how we are feeling or what we are needing at ANY TIME.
- We agree to be responsive to each others needs for improving physical
comfort.
- What we do sexually is private and not to be discussed with others outside
our relationship unless we give permission to discuss it.
- We are ultimately responsible for our own sexual fulfillment and orgasm.
- Our sexual thoughts and fantasies are our own and we dont have to share
them with each other unless we want to reveal them.
- We dont have to disclose the details of a previous sexual relationship unless
that information is important to our present partners physical health or safety.
- We can initiate or decline sex without incurring a negative reaction from our
partner.
- We each agree to be sexually faithful unless we have a clear, prior
understanding that its okay to have sex outside the relationship (this includes
virtual sex, such as phone or internet sex).
- We will support each other in minimizing risk and using protection to decrease
the possibility of disease and/or unwanted pregnancy.
- We will notify each other immediately if we have or suspect we have a
sexually transmitted infection.
- We will support each other in handling any negative consequences that may
result from our sexual interactions.
Once you and your partner have agreed on your complete set of guidelines in your
sexual relationship, you should also discuss what the potential consequences will be for
breaking one of the guidelines.
Automatic Reactions to Touch
Even once you have set up guidelines to make sexual activity feel safer for you, you
may experience automatic reactions to touch, such as a flashback, a panic attack, a
sense of sadness, a sense of fear, dissociation, nausea, pain, or freezing. These
reactions are unwanted and upsetting to both you and your partner, and fortunately,
with time and healing they will minimize in frequency and severity.
In order to gain control of your body and mind during an automatic reaction, you want to
ensure that you stop all sexual activity. Take time to make yourself aware of and
acknowledge that you are having an automatic reaction. Try to consider what triggered it.
Once you have made yourself aware that you are experiencing an automatic reaction,
take some time to calm yourself and make yourself feel safe again. Pay attention to
your breathing, and try to take slow, deep breaths.

Taken from www.healthysex.com by Wendy Maltz

University of Alberta Sexual Assault Centre

Take some time to bring your mind and body back to the present by reorienting yourself
in your surroundings. Remind yourself that you are no longer living the sexual assault
or abuse. Using your different senses, make yourself aware of your current
environment. What do you see? What do you hear? Touch some of the objects
around you to ground yourself to the present.
After you have overcome an automatic reaction, take some time to rest and recover.
These reactions are overwhelming for both your body and mind. When you are ready,
take some time to think about the trigger of your automatic reaction, and if there is some
way you could alter the situation somehow so that the trigger does not happen or does
not affect you in the same way. For example, perhaps changing the set up of the room
would be helpful, or asking your partner not to do the activity that you believe may have
set off your flashback. Also, if you are being triggered while being intimate with a
partner, discuss with your partner what you would like her/him to do when you have an
automatic reaction (e.g. stop what they are doing, hold you, talk to you, sit with you,
etc.) Ask your partner to watch for signs that you are having an automatic reaction, and
to stop sexual activity immediately when you have one.
Relearning Touch
Many survivors find that because of their sexual assault or abuse they experience
sexual touch or certain sexual activities as negative and unpleasant. Through specific
therapeutic exercises you can learn to enjoy and feel safe during sexual touch. There
are exercises that you can do on your own, and also those that you can do with a
partner. A series of relearning touch exercises are described in Chapter 10 of Wendy
Maltzs book The Sexual Healing Journey.
If you are in a partnership at the time that you want to actively begin healing sexually, it
is important that you work together. It is essential that you feel safe and comfortable
with your partner, and that your partner always respects your limits and is prepared to
follow your lead throughout this process. Partners who act in ways that mimic sexual
assault or abuse, such as touching without consent, ignoring how you feel, behaving in
impulsive or hurtful ways, will prevent you from healing. Building emotional trust and a
sense of safety in a relationship are important prerequisites to enjoying sexual intimacy.
Conclusion
Fortunately, the effects that sexual assault or abuse have on your ability to enjoy sexual
intimacy can be minimized and healed with time and efforts. The process of sexual
healing is one that must be done slowly and patiently, and it works best if it follows or
coincides with other healing regarding the assault or abuse. The guidance of a
counsellor can be very beneficial in the process of sexual healing, and is often
recommended as this process can trigger difficult memories and emotions. While
sexual healing is something that may take much time and energy, ultimately it will lead
to enjoyment of sexual intimacy that is consistently positive and pleasurable.
Resources (other than those referenced earlier)
Incest and Sexuality: A Guide to Understanding and Healing by Wendy Maltz
The Survivors Guide to Sex: How to Have an Empowered Sex Life After Child Sexual Abuse by: Staci Haines
The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis
Victims No Longer: The Classic Guide for Men Recovering From Sexual Child Abuse by: Mike Lew
www.sexualhealth.com - A website by the Sexual Health Network on sexuality and sexual recovery.

University of Alberta Sexual Assault Centre