Trauma and Sexuality

Recent longitudinal studies by Robert Pynoos and associates have reported endemic levels of multiple traumas experienced by youth with consequences in the areas of impulsivity, attachment problems, dissociation, and negative self-image. Each of these difficulties will influence sexual development, such that practically all individuals with unresolved developmental trauma will have some relational-sexual difficulties. When the trauma includes attachment trauma, in which the persons who are designated to love, take care of, and teach children are the ones who hurt, abuse, neglect, or abandon them, the core schema of trust, safety, power, control, and intimacy are injured, affecting the vulnerability implicit in partner sexuality. Affected individuals go through cycles of avoidance of closeness and intimacy, followed by bingeing in an overdependent way, resulting in hyposexualities and hypersexualities. If the trauma includes molestation or rape, sexual development can become paired with fear and betrayal. The child's sexuality becomes awakened too early with little guidance, and the child becomes “sexualized,” often associated with shame. [Page 697]This may also result from parents openly dating multiple partners or exposing children to sexual behavior, pornography, or sibling sexual abuse.

Sexuality includes gender identity, genital eroticism, attachment, and intimacy, as well as one's own comfort with one's self and one's body. Trauma also affects affect regulation, affect tolerance, and recognition of emotional states. Affection and sexual feelings are emotions, and therefore can be dissociated, so they can be numbed, misinterpreted, or exaggerated. According to the BASK model of dissociation developed by Bennett Braun, the numbing and intrusion typical of posttraumatic responses include behavior, affect, memory, and sensations. As a result, an individual who suppresses or avoids can experience hyposexuality (low desire) or hypo-arousability (difficulty with physiological arousal). Sensations are affected in that touch can be associated with terror or flashbacks. Intrusion responses include being flooded with hypersexual (body sensations) and sometimes paired with violent or paraphiliac imagery. When this occurs, the person experiences attraction to and arousal in response to people or situations evocative of the original episode of abuse. The dissociative continuum includes genital sensations from body memories. For example, an individual will experience body memories as the need to masturbate, find a partner, or use pornography in a sexually compulsive manner. In some cases, the individual indulges in self-harmful behavior to feel “safe.”

Fantasy can also be intrusive or trauma-bonded and feed directly into the trauma. As a result, an individual can require violence, anger, or pain to be orgasmic. The most extreme example of this is when a victim becomes a victimizer and seeks to hurt self or others with sadomasochistic or pedophiliac behaviors or acts of rape.