What are treatments for sexual difficulties due to sexual abuse?

Howard Fradkin, PhD

There are many categories of sexual difficulties. First, there is the issue of survivors who either avoid sex on the one end of the continuum or on the other end may be addicted to sex. Then there is the issue of survivors who have difficulty with being comfortable enough during sex to effectively function. Some survivors have flashbacks of their abusive experiences during sex, and struggle to stay present during sex as a result. There are those survivors who learn to hate their bodies or regard themselves as sick or dirty because of the abuse.

Many survivors struggle with sexual orientation questions. Even though sexual orientation is now believed by most professionals to be established at birth, survivors often are confused because of the gender of the person who abused them and the meaning they attribute to that experience. If a perpetrator tells a victim, “I care about you,” it can be very confusing for the victim. And for many survivors, they experience some degree of sexual arousal while being abused, because perpetrators are often experts at stimulating their victims, and also because a victim is powerless to control their natural response to such stimulation, even when they feel uncomfortable, even when they may be experiencing pain at the same time.

There are, as you can see, many types of sexual difficulties. Treatment needs to include a safe enough place for a survivor to speak about his or her own abuse experience. It is necessary to learn about what they learned about their bodies and themselves during the abuse. Survivors must learn how to release the shame they are carrying, as it is at the root of much sexual dysfunction. Survivors need a safe enough and educated professional who can help them become educated about sexual orientation, and help them to accept themselves without judgment.

Jan L. Shifren, MD
Reproductive Endocrinology
People with a history of sexual abuse or rape are likely to develop sexual difficulties. For individuals and couples facing such problems, a treatment plan might include such steps as these:
  • individual and group therapy for the survivor of abuse
  • simultaneous individual or group therapy for the partner
  • couples or sex therapy to educate the couple about the sexual impact of abuse and to help them find ways to stay close and connected
  • couples or sex therapy to address any sexual or complicated relationship issues once the survivor of abuse feels ready to do so.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.