Many people who suffer from PTSD find that the condition can affect their sex lives, sometimes for years. Fortunately, there is help for this problem.
After experiencing a traumatic event, some people develop post-traumatic stress disorder (PTSD). The types of events that can cause PTSD include accidents, sexual or physical assaults or abuse, natural disasters, combat, terror attacks, and other events. The condition can last for years and can be quite impactful for the person suffering from it and for their families.
RELATED PODCAST: What, Exactly, Is Trauma?
Sex and PTSD
PTSD’s effect on sex is influenced by whether the traumatic event was sexual in nature. For survivors of sexual assault, sex — even in the context of a committed relationship — can be triggering.
PTSD from Rape That Occurred As an Adult
Whether the sexual assault or abuse was committed by a male, female, romantic partner, acquaintance, or stranger, PTSD can make sex a profoundly negative emotional experience. In order to avoid unwanted feelings, someone with PTSD will often steer clear of certain sexual acts or situations or will avoid sex altogether. Of course, this can impact romantic relationships significantly.
Those with PTSD from a sexual assault or sexual abuse sometimes assume that “this is just what sex is like for me now,” and try to adapt. This is certainly understandable. However, it doesn’t take into account how effective treatment for PTSD can be — more on that below.
If You Have PTSD From Rape or Abuse During Childhood or Adolescence
For those who have PTSD following sexual abuse or assault that happened in childhood, the picture is a little different. All of the above-described difficulties people face after a sexual assault in adulthood still apply. In addition, the person with PTSD may have other emotional difficulties that affect close relationships. For people who experience multiple episodes of childhood sexual abuse, the type of PTSD they experience is sometimes called complex PTSD (learn more about complex vs. regular PTSD), or cPTSD. cPTSD often involves difficulty with intense emotions, negative beliefs about the self, or emotional numbing — in addition to the other symptoms of PTSD.
Dissociation during sex
Dissociation is a PTSD symptom that is essentially a change in consciousness. Things can start to seem unreal or dreamlike (this is called derealization). Or, perhaps more common during sex, you can feel detached from your body as if you were observing yourself from outside (depersonalization). Not everyone with PTSD has these symptoms, but for survivors of sexual assault, it’s not uncommon to experience dissociation during sex.
What It Looks Like If Your PTSD Is Not From a Sexual Trauma
You might think that someone suffering from PTSD following a non-sexual traumatic event would have no problems with sexual functioning. However, that’s often untrue. Often they have difficulties due to PTSD’s effect on the nervous system. The following PTSD symptoms are often a sign of overactivity in the sympathetic nervous system:
- exaggerated startle response
- panic attacks
- feeling constantly on-guard
The sympathetic nervous system is what’s responsible for our body’s fight-or-flight response. In PTSD, our body becomes quicker to activate the sympathetic nervous system in response to anything that seems like a threat. Furthermore, anything that reminds us of the traumatic event can trigger the fight-or-flight response. When this happens, our blood vessels constrict and our blood pressure goes up, among other changes.
Sexual arousal (especially for men; women’s arousal is more complex) requires the opposite of these physical changes. So for these physiological reasons, PTSD even from non-sexual traumas can affect your sex life.
Building trust after trauma
For those with PTSD whose traumatic event was perpetrated by another person (e.g., assault, sexual assault, domestic violence), the ability to trust others can be affected — sometimes severely. Sex and trust are closely related. Sexual intimacy requires some trust. The more difficult it is for you to trust your sexual partner, the more sexual difficulties you will have.
The effects of traumatic events on our ability to trust can be so significant that they are a specific focus of some therapies for PTSD such as cognitive processing therapy (CPT).
Can PTSD Treatment Help Your Sex Life?
Fortunately, there are several types of effective treatment for PTSD. The most effective ones over the long term are forms of therapy (as opposed to medication — in fact, some medications often prescribed for PTSD can actually cause sexual dysfunction as side effects). These PTSD therapies significantly improve every aspect of PTSD when they are effective. This extends to sexual arousal difficulties and avoidance of sex. It also includes derealization and depersonalization, symptoms described above that can occur during sex.
These effective PTSD therapies, such as prolonged exposure therapy or cognitive-behavioral therapy, involve learning how to make changes to the way you think about the traumatic event. They also address the way you deal with reminders of the event when they arise in your life now. People with PTSD are often surprised at how effective this approach can be. It does take some work and some time, but the rewards make it quite worthwhile.
If you’re looking for a PTSD therapist who uses these evidence-based therapies near you, consider using the clinical directories here or here. You can also contact us at the Manhattan Center for Cognitive-Behavioral Therapy, we would be happy to work with you or to help you find someone near you if you’re located outside of the New York / New Jersey area.