Sex after sexual abuse: the way back to your own body

“I want him to hold me. And then, when he does, I just want to disappear.”

That sentence is not rare. It is said by people who love their partner, who long for closeness, and who at the same time carry an experience of sexual abuse — from childhood, from adolescence or from adult life. Desire and fear live in the same body, sometimes in the same second. And because each seems to cancel the other out, people often wonder what is wrong with them.

This piece is about how an experience of sexual abuse can affect sexuality later on, and what the way back to your own body can look like. I will not write about the abuse itself in any detail — not because the subject is forbidden, but because this piece is not meant to make you relive it. If at any point while reading you feel it is too much, you can put it down. That, too, is part of what I am writing about: the right to stop.

If you are in distress right now, don’t wait until the end. In Slovenia you can call the mental health crisis line on 01 520 99 00 (every day from 7 pm to 7 am), the Samaritan helpline on 116 123 (24 hours a day) or the SOS helpline for women and children affected by violence on 080 11 55. If you are in danger, call 112 or the police on 113.

Your body remembered — and that is not your fault

Sadly, sexual abuse is common. A 2011 meta-analysis by Marije Stoltenborgh and colleagues, which brought together studies from around the world, found that roughly 18 per cent of women and 8 per cent of men reported sexual abuse in childhood. On top of that come all those who experienced sexual violence as adults. This is an experience carried by many people around you, even if nobody talks about it.

A review published in 2018 by Carey Pulverman, Chelsea Kilimnik and Cindy Meston summarised what therapists had long noticed in practice: women with a history of childhood sexual abuse more often report sexual difficulties — from problems with arousal and pleasure to pain, avoiding sex, or sex in which they are not really present. There is less research on men, but the patterns are similar. The opposite matters just as much, though: many people with a history of abuse go on to have a satisfying sex life. The experience is not a life sentence.

The key is to understand why this happens. When someone has been in a situation where they could not protect themselves, their nervous system learned that certain touches, positions, smells or words are linked with danger. That is not a choice and it is not a weakness. It is an old and very effective form of protection that works faster than thought. The psychiatrist Bessel van der Kolk summed it up in the title of his book: the body keeps the score — even when memory steps aside. I have written more about how trauma is stored in the body in How trauma stays written in the body.

And something else needs to be said clearly: the person who experienced abuse is not responsible for it. Many survivors carry a sense that they somehow caused it, allowed it or deserved it. I wrote about this separately in Self-image after abuse: when you believe it was your fault, so I won’t repeat it here. Here I am interested above all in what happens in intimacy.

How it can show up in sex

There is no single pattern. For some people the experience shows up as avoidance, for others as something close to the opposite. A few common forms:

• Avoidance. You avoid sex because it brings anxiety, disgust or panic — even when you love and trust your partner.
• Sex without presence. Your body is there, but you are not. Sex happens, but “from a distance”, as if you were watching it from outside.
• Feeling that you have to. Sex as a duty, or as a way to keep the peace, rather than something you have chosen.
• Shame or sadness afterwards. During sex it was fine, but afterwards comes a wave of shame, tears or emptiness.
• Physical difficulties. Pain, muscle tension or a lack of arousal, even though you long for closeness.

None of these means that something is wrong with you. They mean that your body once had to survive — and has not yet learned that things are different now. The shame that often comes with these experiences is a subject of its own; you can read more in Shame: the emotion that whispers “There is something wrong with me”.

If you feel pain or have other physical difficulties, the first step is an examination by a gynaecologist, urologist or your GP. Physical causes need to be ruled out or treated, whatever lies in the background. You can tell the doctor that the examination is hard for you — a good doctor will slow down, explain every step and wait. On pain where the body closes up regardless of what you want, there is more in Vaginismus: when your body says no, even though you say yes.

Triggers: when the present smells of the past

A trigger is something in the present that the body links with danger from the past. It might be a touch on a particular part of the body, a position, a smell, darkness in the room, a tone of voice, a certain word. Often you don’t even know what set it off — only that one moment it was fine and the next it wasn’t. You can find a short explanation in the knowledge base under trigger.

Triggers are not a sign that you are “oversensitive”. They are information. Once you get to know them, you can anticipate them, agree on how to handle them, or gradually soften them. A good place to start is the tool map of your triggers, in which you write down — on your own, calmly and away from intimate moments — what throws you off balance and what helps you come back.

It matters that you don’t do this in the middle of sex, when your body is already on alert. The map is drawn at a safe time, over a cup of tea, not at the moment when all you want is to get away.

Dissociation and the window of tolerance

What happens when a trigger hits? The psychiatrist Daniel Siegel described the window of tolerance — a range of arousal in which we can feel, think and stay in contact with another person at the same time. Inside the window we can be a little tense or upset and still be present. When something throws us out of the window, we can go in two directions.

The first direction is too much: your heart pounds, your muscles tense, panic rises along with the urge to pull away. The second is too little: numbness, absence, a feeling of fog. This second direction is also called dissociation — the mind withdraws because the body cannot. Once, it was the only protection available. Today, in a relationship with someone who means you no harm, it can cut you off from the person you want to be close to.

In sex, dissociation is especially insidious because a partner often doesn’t notice it. From the outside everything looks “normal”. That is why it matters that you notice it yourself first — and that you have words to say it. You can read more about the window of tolerance in the knowledge base under window of tolerance.

The right to say no — always, even halfway through

If you were to take just one thing from this piece, it would be this: you have the right to say no. At any time. Even halfway through. Even if you said yes before.

For people who have experienced abuse, this is not self-evident. The experience often left behind a message that your “no” doesn’t count, or that it is better to endure than to cause conflict. So sex can happen even when you don’t want it — not because your partner is forcing you, but because the “no” gets stuck in your throat.

The way back to your body starts right here: with the experience that your “no” is heard and respected. Only when you know you can stop at any moment can your “yes” become real. Without the possibility of refusal there is no true consent — and without consent there is no safe intimacy. This doesn’t only apply in the bedroom; you can read more about how boundaries are formed in relationships in general in the knowledge base under boundaries.

Exercise: get to know your window while you are on your own

This exercise is not sexual and it is not meant for your partner. It is meant for you, so that you can calmly learn how your body signals that it is at the edge of the window — and what helps you come back. Do it at a time when you are rested and have a few minutes to yourself.

1. Sit somewhere you feel safe. If closing your eyes is unpleasant, keep them open. Notice three things you can see, two you can hear and one you can feel beneath you.
2. Notice your body when you are inside the window. How are you breathing? Where do you feel warmth? What are your shoulders, jaw and belly like? Write down two or three words — this is your “home”.
3. Recall the early signs that you are drifting away. Not the situation itself, but the first signs in your body: tightness in the chest, numbness in the hands, a gaze that fixes on one point. Write them down.
4. Choose two ways of coming back. For example: press your feet into the floor and name the space around you; or breathe out more slowly than you breathe in and touch something with a texture. Try out which one works for you.
5. Choose your word or sign for “stop”. Something simple that you can say or show even when words are hard to get out. When you are ready, you can share it with your partner.

If the exercise brings up strong reactions, stop. That is not failure, but a sign that this part of the journey is better travelled with a professional who works with trauma.

Your partner as an ally

A partner cannot heal trauma. But they can become an ally — someone with whom intimacy is rebuilt, at your pace. For that they need two things: to know as much as you are willing to tell them, and to understand that your reactions are not a rejection of them.

For a partner this is often hard. When the other pulls away in the middle of a hug or “disappears”, it is easy to feel rejected, unwanted or even guilty. It helps to talk about it outside the bedroom, when things are calm. Here is how such a conversation might sound (composite, not a real person):

“Sometimes, in the middle of a hug, I freeze and I don’t know where I am any more.”
“And then you think I’m angry?”
“I think you will be. So I’d rather pretend everything’s fine.”
“I’m not angry. I just don’t know what to do.”
“You can ask me if I’m here. And wait. That’s enough.”

In a conversation like this, the partner gains not only information but also a role. They are no longer someone who has to be “put up with”, but someone who helps you come back. A few things you can agree on:

• a sign for “stop” that applies at once, with no explanation needed;
• a question your partner can ask when they notice you’re not there (“Are you here?”);
• that you actually stop, rather than “just a little longer”;
• that after stopping there is also something on offer that isn’t sex — a blanket, a cup of tea, holding hands.

A partner who feels helpless or worn out by all this may look for support for themselves too. In couples therapy, intimacy can be one of the subjects we talk about — how you both feel, what you haven’t dared to say, and how to keep closeness alive when sex is difficult.

The way back: slowly, at your own pace

In her book Trauma and Recovery, the psychiatrist Judith Herman described recovery from trauma in three stages: first safety, then remembrance and mourning, and finally reconnection with people and with life. The way back into intimacy follows a similar logic. First there has to be safety — in the relationship, in the body, in the space. Only then does it make sense to explore closeness.

In practice this often means that a couple agrees, for a while, that there will be no intercourse, and explores touch that leads nowhere. A hug that is just a hug. A hand massage that is just a hand massage. The person who experienced the abuse can lead: they say where, how and for how long. It is precisely this sense of being able to lead and to stop that slowly teaches the body that things are different now. Specialists in sexual medicine and sex therapists use similar gradual exercises; with more complex difficulties it is wise to seek out their help specifically.

A key part of the journey is often individual, trauma-focused therapy. For post-traumatic difficulties, the therapies with the strongest research support are those developed specifically for trauma, such as trauma-focused cognitive behavioural therapy and EMDR. For some people, work that involves the body also helps — there is more on this in The body says what we cannot put into words: an introduction to body psychotherapy. Wendy Maltz, who wrote one of the most widely read books on sexual healing after abuse, stresses that the aim of this work is a sexuality based on choice, safety and presence — not a return to some “normal” frequency.

Where do I fit in? I am a marriage and family therapist in training under supervision, not a sexologist or a sex therapist. In couples therapy, intimacy can be one of the subjects: how the two of you talk about it, how the one who is waiting feels, and how closeness stays alive when sex is difficult. For working through the trauma itself and for sexual difficulties, the right place is a therapist who specialises in trauma, or a doctor or specialist in sexual medicine. On when couples therapy is enough and when it is better to see another professional, there is more in When to see a doctor, when a sex therapist, and when couples therapy is enough.

When this is not the right path

I want to be careful here, because a piece like this can create a new kind of pressure — “I have to get back to sex, otherwise I’m not healed.” That is not true.

Sex is not a measure of recovery. Some people no longer want sex after abuse, or don’t want it for a long time. That is a legitimate choice, not a symptom to be removed. Recovery can also mean living calmly, without fear, in relationships that respect you — with sex or without it.

There is no deadline. There is no rule for how long it should take. For some, intimacy returns within a few months, for others over years. Comparing yourself with others, or with “how it should be”, usually only deepens the shame.

If the violence is still happening, safety comes first. If you are now in a relationship in which someone forces you, threatens you or humiliates you, then this piece is not about you and intimacy exercises are not the right step. In that case, in Slovenia, call the SOS helpline on 080 11 55, and if you are in danger, 112 or 113.

Not every sexual difficulty comes from the past. People with a history of abuse can also have pain caused by an infection, hormones or medication. That is why a medical examination matters even when the cause seems “obvious”.

Where to find help

If you have never told anyone about the abuse, a first step can be to tell one person you trust — or to call a helpline anonymously. You don’t have to say everything at once.

• SOS helpline for women and children affected by violence: 080 11 55 (in Slovenia) — free of charge.
• Mental health crisis line: 01 520 99 00 (in Slovenia) — every day from 7 pm to 7 am.
• Samaritan helpline: 116 123 (in Slovenia) — 24 hours a day.
• Emergency: 112, police: 113 (in Slovenia).
• Your GP or gynaecologist, who can refer you to a psychiatrist or another specialist.

What to remember

• Sexual difficulties after abuse are not your fault — they are your body protecting you, and it has not yet learned that things are different now.
• Triggers and dissociation are common; once you get to know them calmly, they are easier to name and anticipate.
• You have the right to say no — at any time, even halfway through. Only when no is possible is yes real.
• Your partner can be an ally: agree on a “stop” sign and on closeness that isn’t sex.
• Check physical causes with a doctor, work through trauma with a therapist who specialises in it — and sex is not the measure of whether you are “healed”.