Hi Dr. Pinhas,
I am not too sure how to approach this topic, so I apologize in advance for the possible rambling that may occur. I am taking your human sexuality class, but I am not comfortable enough with the subject matter to identify myself. I am hoping that you may be able to shed some light on some issues that have caused me a great deal of pain and difficulty. I have so much shame and embarrassment surrounding these issues that I could never speak to someone about what I am going through.
I am a female in my early twenties. I was diagnosed with multiple personality disorder when I was fifteen years old and, more recently, I was diagnosed with PTSD. I was abused verbally, physically and sexually for a period in excess of 20 years. The abuse began within the nuclear family unit; however, by the time I was fourteen, I had been subjected not only to incest but to acquaintance, stranger and gang rape. These horrific and torturous experiences have left me with more issues than I could possibly discuss here, so I will stick to the ones that are causing me the most psychic indigestion at this moment in time.
For the last three years, I have been experiencing vivid flashbacks about the abuse. These memories are often so intrusive and disturbing that they render me unable to function. One of the questions I have is about something that happens sometimes during these episodes. On more than one occasion I have noticed that I am “wet” after experiencing a flashback. This is something that has really scared and upset me. The abuse that I suffered was always about force; there was never a “grooming” period and no one was ever gentle with me. It was so sadistic; my abusers took a lot of pleasure in torturing me. I don’t understand why this is happening, especially as the flashbacks are so terrifying that often times I end up curled up in a ball shaking and crying. Why does this happen to me?
I thought I heard you mention in class (or maybe I read it somewhere) that when the sympathetic nervous system is activated for flight or fight, the increase in sympathetic discharge could be responsible for a man getting an erection during rape.My flashbacks feel as real as the first time I was attacked, so even though the event isn’t physically occuring in that moment I am wondering if my body is reacting like it is happening. I also thought you said that men and women’s “parts” kinda work the same. Is it possible that this is the reason for my problem, or am I reading way too much into it? Am I a freak? It really scares me and I wish I knew why it is happening.
The other question I had was about my current sexual experiences. For me, there is an incredible amount of fear surrounding sex. I have never had a comfortable experience. I am currently in a relationship with a woman (I cannot stand to be touched by a man right now). She knows something happened to me, but she is unaware of the full extent of the abuse. I am comfortable with her as a person and I don’t believe that she would intentionally hurt me, but when we have sex I panic. I like kissing and cuddling, but the second her hands venture south I freak out. I feel this incredible fear, and I just want to escape. This happens before she even touches my vagina. If she touches my hips or my groin I instinctively pull away. I am not controlling the reaction. She thinks I am ticklish, but the truth is I am terrified. When she performs oral sex on me I just want to cry. If she penetrates me in any way I feel pain. Sometimes I have flashbacks and then everything goes blank. It is frightening because I am not in control of the body, and I don’t recall engaging in the experience. Do you have any ideas about how to get over my fears and issues? I don’t want to be on my own forever, so I feel like I have to do sex. I also don’t want to discuss the abuse further with my partner because of the shame and guilt. Please help L
Thank you.
Response from Dr. Pinhas
L, First let me express to you, how deeply sad I am that you have been traumatically violated over the course of your short life. The flashbacks are clearly part of the sequelae of PTSD. Because the sympathetic nervous system is in operation during a fight/flight reaction and your body is on trauma alert with a flood of stress hormones , it is not unusual for vaginal lubrication to occur. It must be so disheartening when you experience “wetness”. It is, as if, your body is telling you that you voluntarily wanted the traumatic violative experiences to happen.. as if, you get aroused, by the trauma. You are not a “freak”… nor a masochist that has converted pain into pleasure. This could not be further from the truth. Your wetness, is simply a physiological reaction to a “fight/flight” episode induced by your PTSD. Do not read anymore into it. It will make you go crazy. Accept it as part of your body’s response to trauma. Now onto your second concern. How to get over your fear and anxieties about being sexually involved with your partner. The first question, I would like to ask you, is whether you’ve had any psychological therapy? I can tell by your question, that you were diagnosed with a dissociative disorder at 15 years of age. Does that mean that you’ve continued to engage a therapist in the process of trying to heal? if you are not in therapy, I would recommend that you do so….. Seek out a well trained clinician, especially one with EMDR training which is a very useful way of cutting into the the experience of affective flooding. This will help you in going on with your life. As for your sexuality….. You need to talk to your partner about your history and how it is effecting you. I clearly understand that you are experiencing shame and that mitigates against a full disclosure, but you might need her help with your problem. Might she be willing to engage with you in a sensate focus while you engage yourself in self-hypnosis and visualization techniques? Conceptually, these are a series of exercises that would be designed for you and your sparse sexual tolerances. Essentially, the short version, of this therapy would involve you putting yourself into a peaceful place, visualizing something completely relaxing, while you do a series of graduated, non-threatening tactile bodily exercises with no demands for performance and no sexual goals. This would be akin to hugging and kissing in a more detailed, progressive way. In your case, you would have to go it ever, so slowly, so as not to arousal threat. This approach is a start. We will be going over this type of generic exercises in class in the latter portion of the semester. Wishing the best for you.
Thank you so much for answering my questions. I had the chance to think over your response this evening, and I have to tell you that taking in what you said about the wetness has been incredibly freeing. That issue has caused pain and anxiety since it started over two years ago, and I never thought I’d be able to tell anyone. I can’t thank you enough for taking that pain away :)
About the dissociative disorder: I am still not buying into it totally that I suffer from it. I tried to tell a psychologist about my symptoms before but the minute I told her about voices in my head she freaked out and I withdrew into myself. A friend of mine, who is a counselor, has apparently met two alters but when she tries to talk to me about it I get embarrassed and close off. I am terrified to approach anyone for help with this because I’m scared of being labelled a freak. I think I need help, though, because bad things happen that I’m not always aware of.
I am nervous to approach my partner with the technique you suggested. I don’t want to hurt her feelings. I am scared that if I tell her that sex is causing me so much pain and anxiety that she will feel bad because I didn’t tell her before and I have been allowing her to do things to my body that feel bad to me.
Anyway, thank you for your help. It’s much appreciated.
L. I am glad I could be of help on the physiological vaginal wetness problem. Now about that psychological issue of yours…. Maybe you do have a dissociative disorder on the magnitude of multiple personality disorder; maybe you don’t. If, however, you speak about it to a friend that is a counselor who has met two “alters” of yours, then perhaps, you are dissociating. There is nothing to be embarrassed about. When one experiences severe trauma, splitting off feeling states/selves from the overall identified self is a way that the psyche protects itself. Think of these split off selves as ways of protecting yourself when you are bombarded with external trauma that obviously threatens you. This is not psychosis…. Once again, you keep going back to labelling yourself as a “freak” when in fact your body and mind are just trying to protect itself from an onslaught. Some clinicians are not comfortable dealing with MPD because they have little experience in dealing with it. Make sure you are in the right therapist’s office. Consider that your anxiety in going to a clinician has more do to with your anxiety about how you see yourself and as such, you are hypersensitive to what you may experience in the clinician… their discomfort, their anxiety…. when in fact between the two of you, the discomfort, and anxiety may be coming from you, in the form of projection.
You say that you don’t want to hurt your partner’s feelings by telling her you are in physical discomfort and emotional pain during sex. How about your feelings? Once again, I think you are selling yourself short and disrespecting yourself when you don’t communicate honestly with her. You need to get honest to dig yourself out of the hole you put yourself in, by keeping your fear and discomfort to yourself. Once you withhold an emotional experience, it feels hard to now begin to tell the truth about it. This happens to a lot of women, especially those who fake orgasm. How does a person set the record straight? One must cut into the falsehood. This takes courage to do and if you can’t muster it up, it certainly becomes the focus of therapy that I believe you need.
I don’t want to lose the one person I have in my life who cares about me. People have only ever wanted me for sex. It’s the only thing I’m good at. If I take that away I will have no one again and I don’t want to be on my own. I’m scared because every time I have said no in the past to someone they have done it anyway. I feel so worthless. I just have to learn to like it but I don’t know how.
Maybe you’ll gain her in a meaningful way. Why don’t you trust that she cares about you. You’ve said it yourself…. SHE CARES ABOUT YOU. L.. you are not caring about you…. you are stuck in a falsehood that your ownly worth is a as a sexual object. I understand why you feel like this given your accumulated experiences. You do not need to say NO to her; you just need to express the depth of your hurt and confusion….. It would be wise to get into some good therapeutic relationship….. Also let the human sexuality class work its magic….